A full workup for CHARGE syndrome should include a complete blood cell count with differential; serum calcium level; CT scan or MRI of the brain, temporal bone/mastoid,
choanae, and inner ears; dilated eye examination; echocardiogram; renal ultrasound; otoacoustic emissions and auditory brainstem response hearing tests; and swallowing studies (de Geus et al., 2017; Mehr, Hsu, & Campbell, 2017; van Ravenswaaij-Arts et al., 2015).
The degree of choanal obstruction due to the adenoids was used in grading the cases If less than one-third of the posterior
choanae is obstructed, it is classified as grade 1.
Their abbreviations and definitions are as follows: LD--length of upper diastema, LOSD--length of upper molar row (alveoli), L[M.sup.1]--length of first upper molar, La[M.sup.1]--widthof first upper molar, L[M.sup.2+3]--length of second and third upper molar, LOID--length of lower molar row (alveoli), L[M.sub.1]--length of first lower molar, La[M.sub.1]--width of first lower molar, LB--basal length, LCb--condylobasal length, LN--length of os nasale, LFI--length of foramen incisivum, LMd--length of mandible, LaZ--zygomatic breadth, LaI--interorbital width, ACr--brain-case height with the
choanae, FL--facial length, i.e.
SCC malformations are mostly reported in congenital syndromes with multiple deformities such as coloboma, heart defects, atresia
choanae, growth retardation, genital abnormalities, and ear abnormalities syndrome.[2] Until the first case was reported by Michel et al.
An adenoid size of Grade 0 signifies 0% obstruction of the
choanae with likely presence of scarring, Grade 1 signifies <40% obstruction, Grade 2 signifies 41-70% obstruction, Grade 3 signifies 71-90% obstruction, and Grade 4 signifies complete obstruction (91-100%) of the
choanae with lymphoid tissue touching the soft palate at rest.
Because the posterior end of the right inferior turbinate was blocking the posterior
choanae, it was removed using zero-degree nasal endoscopy and a straight shaver.
As an abbreviation CHARGE stands for: coloboma, heart defects, atresia
choanae, and retardation of growth, genital, and ear abnormalities.
Majority of study population (53.8%) had Grade III adenoids (Enlarged adenoids filling from 2/3rd of vertical portion of
choanae to nearly complete obstruction).
The nasal cavity compartments extended from anterior nares to posterior nares (
choanae).
Two subsequent attempts made at 3-week intervals were both unsuccessful; the rhinolith was too large to remove through the nostril or posterior
choanae. The rhinolith was scheduled for removal in the operating room, where it was removed under general anesthesia, without complications (Figures 2 and 3).