A multidisciplinary team of neonatologists, otolaryngologists, anaesthesiologists, paediatricians and radiologists from UMHAT "St. Marina"-Varna saved a five-day-old baby weighing 2200 g. After being diagnosed, the new-born baby was stabilised, intubated and transported from another city with a rare and severe life-threatening anomaly - bilateral bony choanal atresia. This is a congenital malformation of the nasal passages, manifested in abnormal development of the bone structures or soft tissues forming the rear part of the cavities. Since new-borns breathe mainly through their nose, such bilateral obstruction of the nasal passages makes feeding impossible.
Due to his serious condition, the child was immediately admitted to the Paediatric Intensive Care Unit (PICU) headed by Dr. Darina Krumova, where doctors conducted additional tests and made preparations for emergency surgery. The intervention was performed applying an endoscopic method by the surgical team of the Clinic of Ear, Nose, and Throat, with the head of the Clinic, Prof. Dr. Nikolay Sapundzhiev, as the lead surgeon, who explains, "We used state-of-the art equipment available at UMHAT "St. Marina" - Varna, thanks to which we were able to re-canalise the nasal passages and create a normal lumen in the affected parts of the nose despite the patient's miniature size. I would like to thank the surgical team for their professionalism - Dr. P. Genova, Dr. M. Nikova, nurse V. Peneva, orderly D. Mihaylova, and the anaesthesiology team - Assoc. Prof. P. Ivanova, Dr. S. Borisova, nurse R. Mihaylova."
Highly professional postoperative care was provided by the doctors, nurses and orderlies at the Paediatric Intensive Care Unit (PICU) and the First Paediatric Clinic at UMHAT "St. Marina"–Varna, and consequently the new-born child had been fed for the first time through the mouth – something that would have been impossible with the malformation with which he was born. The baby now breathes easily through his nose, demonstrates a growing appetite, and every gram of weight he gains through natural feeding is a source of joy and pride for the multidisciplinary team.
Birth statistics in Bulgaria show that no more than one such case of severe bilateral choanal atresia could be expected in the entire country within a year. Only four to five children are born with unilateral atresia in Bulgaria each year, but their condition is much milder, and they can breathe and eat, whereas surgical intervention may be performed at a later stage when the child is already growing. Other anomalies are likely to be observed in about half of the children with choanal atresia. Early diagnosis and timely high-tech treatment ensure normal growth and development of new-borns affected by the disease. The study of the disease and its treatment is multidisciplinary and requires monitoring by specialists in this field.
