Nasal septum deformity in the newborn infant during labour.

The incidence of nasal septum dislocation (NSD) was studied in 447 newborns and was found to be 17%. The aim of this study was to establish its aetiology as well as to find ways of prevention and early diagnosis of this obstetrical injury. The following conclusions were drawn: (a) The high frequency of NSD is due to the inadequate support technique (Playfair manoeuvre) currently in use. This is true even when birth weight is normal or less than normal. (b) The severity of injury is lessened by the degree of experience of the obstetrician. This is why NSD is characterised as an obstetrical injury. (c) NSD to the right is more frequent in the front left position of occipital presentation. (d) NSD is more frequent in the anterior part of the nose because the injury is sustained by the anterior part of the septum. (e) The frequency of NSD was not higher in classical forceps delivery, in caesarean section, and in spontaneous delivery. (f) No statistically significant correlation was found between the duration of expulsion and nasal septum dislocation (chi 2 = 4.43, p greater than 0.1). Due to present conditions, a general rhinological examination of all neonates is necessary. The use of Metzenbaum's sign (asymmetry of nostrils) and Jeppesen and Windfeld's test (pressure on the tip of the nose), along with rhinoscopy are recommended. Early diagnosis and treatment of NSD is of great importance, since all complications arising from this obstetrical injury can be prevented and normal function of the nose restored.