There have been over 500 cases of congenital choanal atresia reported in the literature,1-3 but the cause of this developmental anomaly has continued to remain obscure. Several theories have been advanced concerning the mechanism of development,4 and among these are (1) continued dorsal growth of the nasal fossae in front of the nasopharynx, with a variable amount of mesenchymal tissue being caught between their epithelial surfaces5; (2) closure of the primitive nasal fossae by an epithelial plug, which then organizes forming a bony or membranous closure posteriorly6; (3) failure of development of the posterior end of the primitive posterior nares while there is a normal full development of the palate2; (4) failure of the buccopharyngeal membrane to be absorbed (this occurs in those cases of atresia which lie posterior to and against the posterior choanae),7 and (5) embryological overproduction of tissue in the region
MacLEAN RG, HAMMACK W. Congenital Choanal Atresia: Report of Three Cases Occurring in One Family. AMA Arch Otolaryngol. 1959;70(1):137–138. doi:10.1001/archotol.1959.00730040141022
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