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At birth, the neonate is an obligate nasal breather and any compromise of the nasal
Passages is potentially life threatening. It is important for the otorhinolaryngologist
to quickly recognize and manage even subtle constrictionsor obstructions of the nasal
Passages in this age group. Many times the nasal airway is disregarded as the source
of airway difficulty if small catheters can be passed. Conversely, the inability to pass
nasal catheters is often arbitrarily diagnosed as choanal atresia or stenosis. This
limited outlook can delay appropriate therapy.
The differential diagnosis of nasal obstruction in the neonate is presented with
emphasis on evaluation of nasal obstruction in anatomically normal appearing
noses.