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Septal manipulation in the neonate: method and results
Insights
Newborn nasal septal deviations (types A, B, C) correlate with feeding and respiratory issues. Early manipulation significantly reduced these problems, particularly in type B cases, preventing long-term health complications.
Area of Science:
- Pediatrics
- Otolaryngology
- Developmental Biology
Background:
- Septal configuration at birth, categorized as type A (straight), type B (bent), or type C (deformed), influences infant health.
- Specific septal types correlate with immediate issues like nasal obstruction and feeding difficulties, and later with dental abnormalities and respiratory infections.
Purpose of the Study:
- To assess the correlation between septal configurations at birth and subsequent health problems in infants.
- To evaluate the efficacy of early manipulation in mitigating these health issues.
- To elucidate the physiological mechanisms, including Bernoulli's phenomenon, underlying the increased incidence of ear disease in type B septal deviations.
Main Methods:
- A cohort of 284 infants was assessed at birth for septal configuration.
- Infants were followed up to approximately 5 years of age.
- A comparison was made between 105 control infants with minimal issues (unmanipulated) and 179 infants with symptoms who underwent manipulation.
Main Results:
- Type B septal deviation showed the highest incidence of associated health problems, while type A had the least.
- Infants who underwent manipulation exhibited a statistically significant reduction in the incidence of nasal obstruction, feeding problems, dental abnormalities, and respiratory infections.
- External nasal deformities, present in 4% of births, were successfully corrected through manipulation.
Conclusions:
- Infant septal configuration is a significant factor in early-life health outcomes, impacting feeding and respiratory systems.
- Early, non-invasive manipulation of septal deviations is an effective intervention to prevent or reduce the severity of associated health problems.
- Understanding nasal physiology, such as Bernoulli's phenomenon, is crucial for explaining the link between septal deviation and conditions like otitis media.
Abstract:
The septal configuration at birth may be straight (type A) which occurs in 42% cases, bent to one side (type B), or deformed to both sides (type C). There is a close correlation of these types, immediately with nasal obstruction and feeding problems and later with the development of dental abnormalities and respiratory infections of the throat and ear. These symptoms occur most in type B cases and least in type A cases. A total of 284 babies was assessed at birth and then when aged about 5 years. A total of 105 babies, who had minimal trouble and were used as controls and not manipulated, were compared with 179 who had troublesome symptoms and were manipulated. Manipulation greatly reduced the incidence of these problems at a statistically significant level. The physiological reason why type B causes more ear disease than types A or C is described. This involves the normally occurring Bernouilli's phenomenon in the nose. The external nasal deformity which causes minimal physiological changes, and occurs in 4% of births, can be successfully straightened by manipulation.