Nasoendoscopy showed bilateral inferior turbinate hypertrophy; in addition, a Grade 3 swollen adenoid that blocked the Eustachian tube opening and partially occluded the bilateral choanae
was also noted (Figure 3(a)).
All patients complained of classic symptoms of chronic nasal obstruction and had an estimated > 90% adenoid obstruction of the choanae
as determined with primary nasal endoscopy.
The nasal compartments of cavity extended from anterior nares to posterior nares (choanae
) and continued caudally as nasopharynx.
An exogenous nidus is usually a foreign body that has been inserted into the nasal cavity accidentally (occurring more frequently in children than in adults), or one that may have reached the posterior choanae
through forceful vomiting or coughing.
Whole genome "jumping libraries" of a prenatal sample identified a translocation breakpoint that disrupted chromodomain helicase DNA binding protein 7 (CHD7), a causal locus in the CHARGE syndrome (coloboma of the eye, heart defects, atresia of the choanae
, retardation of growth and/or development, genital and/or urinary abnormalities, and ear abnormalities and deafness), otherwise unidentifiable with current screening technology, the knowledge of which assists with prenatal counseling (68).
Vomerine teeth in two small oblique groups, are closer to each other than to choanae
. Tongue cordiform, broadly ovate, slightly emarginate posteriorly.Slight web between base of fingers; fingers slender, slightly flat; tips round, III greater than I greater than II greater than IV; inner palmer tubercles distinct, longer than wide at the base of I finger, outer longer than wide at the base of IV finger.
These are: C: Coloboma of the eye, central nervous system anomalies; H: Heart defects; A: Atresia of the choanae
R: Retardation of growth and/or development G: Genital and/or urinary defects (Hypogonadism) E: Ear anomalies and/or deafness.
Examination of the oral and nasal cavities while the animal was anesthetized revealed mucous entering the oral cavity through the nasal choanae
and hyperemic nasal mucosa.
* "CHARGE: Coloboma of the eye, Heart defects, Atresia of the choanae
, severe Retardation of growth and development, Genital abnormalities, and Ear abnormalities
rounded, not concealed by palatal shelf of maxillary arch; dentigerous processes of vomers prominent, oblique and moderately separated from each other, median and posterior to choanae
, each bearing row of 4-7 teeth; tongue oval, notched posteriorly; 2/3 of its extension adherent to floor of mouth; males with vocal slits and subgular vocal sac; long vocal slits, lateral to tongue.
Considering the upper airway, CT virtual endoscopy of the nasopharynx from a posterior view privides visualisation of the eustachian tube openings in reference to the choanae
and nasopharyngeal walls; an area difficult to appreciate with conventional CT.18 In addition to delineating normal anatomy, CT and VE are valuable in defining the type and extent of the disease.
They are C - Coloboma of the eye, H - Heart defects, A - Atresia of the choanae
, R - Retardation of growth, G - Genital and/or urinary defects and E - Ear anomalies.