Incidence and treatment of deviation of nasal septum in newborns.

Four thousand and ninety consecutive newborns were investigated for nasal septal deviations over a two-year period in the Bnai Zion Medical Center, Haifa. An incidence of 0.93% of anterior nasal septal cartilaginous dislocation was found. No statistically significant correlation was observed between the newborns' weight and the nasal deformities. Definite correlation between the type of delivery and the nasal deformity was noted, however. The importance of early treatment during the first three days after birth is stressed. The infants were followed for a three-year period and no evidence of recurring septal deformity was noted. Birth trauma was first reported by Metzenbaum in 1929 as being a causative factor in nasal septal dislocation. Since then, it has been reported by other authors. Deviated nasal septum in the newborn is said to occur due to various intrauterine and transnatal pressures operating on the fetus. In 1963, Klaff reported 12 cases of septal dislocation in newborns and went on to describe the causative factors and methods of treatment. Gray investigated septal deformities in 2,380 infants at birth and found anterior cartilage deformity in 4%. He put forward a maxillary moulding theory of transmitted pressure during pregnancy or birth in an attempt to explain septal deformities in the newborn. Hartikainen et al. screened 4,724 newborns for congenital nasal deformities and found a 1.9% incidence of anterior septal dislocation. In this study no evidence of birth trauma as the cause of congenital nasal deformities was found and it was proposed that the majority of dislocations originated during intrauterine life. Collo reported correction of 19 birth traumatic nasal septal deviations by manual manipulation.(ABSTRACT TRUNCATED AT 250 WORDS)