There are many birth defect which needs to be corrected immediately following delivery of baby. Such a condition is bilateral choanal atresia.

Choana means back opening of nose and choanal atresia means absence of opening into the throat at the back of the nose. It is one of the least known birth defects with an occurrence of one in every 5000-8000 births.

It is a life threatening birth defect in which the nasal passage does not properly develop in the baby in mother's womb. During the sixth week of pregnancy, a membrane fails to properly develop thus an obstruction occurs in the nasal passage of the baby. This is a life-threatening event because it may take 6-12 weeks for a newborn to develop the ability to breathe through its mouth.

There are two forms of choanal atresia. Unilateral choanal atresia is less threatening to a newborn because the nasal passage is only blocked on one side. This allows an infant to breathe somewhat normally at birth, but bilateral choanal atresia with blockage of both sides of the nasal passage, is life threatening because the baby cannot breathe at birth.

A few weeks ago, a pre-term baby who was delivered at 32 weeks by caesarian section, was brought to the United Hospital in Dhaka from a local hospital of Keraniganj. The baby had severe cyanosis (bluish discolouration due to lack of oxygen) and failure in breathing with progressive breathing difficulty. He was also having difficulty in sucking mother's breast as he could not suck more than 3-5 seconds at a stretch.

The baby was admitted in Neonatal Intensive Care Unit of the United Hospital. After necessary investigation, the ENT and Head Neck Surgeon Prof. Dr. Zillur Rahman diagnosed the baby with bilateral choanal atresia as he had absence of opening at the back of the nose and there was no communication between his nose and throat for breathing.

After a difficult anaesthesia, Endoscopic LASER assisted surgery was done on the five days old baby, first of its kind in the country.

The baby recovered from the anaesthesia well and was kept in neonatal ICU where he showed good breathing with good feeding performance.