GUWAHATI, May 1 – In a positive development, recanalisation of absent nasal cavity in a premature newborn was successfully performed at a city-based hospital recently.
A premature low birth weight male newborn was referred to the neonatal intensive care unit of Pratiksha Hospital, Guwahati with history of breathing difficulty immediately after birth along with intermittent episodes of bluish discoloration of face and limbs.
The patient was admitted to the newborn unit (NICU) and after initial stabilisation, the newborn was evaluated for possible causes of respiratory symptoms. As medical causes were ruled out, the possibility of surgical causes was left behind.
“While trying to establish surgical grounds, it was surprising that both the nostrils did not show any passage into the trachea. As a clinical procedure, a small-sized feeding tube for infant was tried to introduce into the nostril. The tube could not be passed beyond a few centimetres on both sides of the nostril. It’s a rare clinical syndrome – a congenital disorder where the back of the nasal passages (choana) is blocked. In medical terms, it is known as Bilateral Choanal Atresia,” said Dr Mridu P Borah.
A CT scan was done which helped to confirm the diagnosis. The infant was searched for other associated renal and cardiac anomalies which can give a syndromic diagnosis of such presentation.
The newborn was taken up for operative intervention. It was team of doctors from paediatrics, anaesthesiology and otorhinolaryngology who attended to the infant. After endoscopic surgical recanalisation, a stent was placed to prevent restenosis. Post operatively, the baby was withdrawn from ventilatory support within six hours.
The challenging surgical procedure was performed by the team of doctors from Pratiksha Hospital, which included Dr Partha P Borah and Dr Mridu P Borah, among others. According to Dr Mridu P Borah, the operation has been done for the first time in the north-eastern region as per report from the ENT specialists’ body.