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Neonatal septoplasty: case report and review of the literature
Insights
Severe childhood nasal septal deviation can be safely treated early to prevent complications. Endoscopic septoplasty in an 8-day-old infant resolved severe obstructive apnea and cyanosis, demonstrating the benefits of early intervention.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Engineering
Background:
- Nasal septal deformities in children were historically treated cautiously due to concerns about midface growth.
- Severe traumatic septal deviation can lead to significant nasal and systemic complications if left untreated.
Observation:
- A severe traumatic nasal deformity presented in an 8-day-old infant with obstructive sleep and awake apnea and cyanosis.
- Traditional interventions are often limited to newborns diagnosed shortly after birth.
Findings:
- A limited septoplasty using endoscopic techniques was performed on the 14-day-old infant.
- Post-operative resolution of apneic and cyanotic episodes was immediate.
Implications:
- Early correction of severe nasal septal deformities in infants is feasible and effective.
- Endoscopic techniques offer a viable approach for treating complex infant nasal septal deviations.
- Timely intervention can prevent severe respiratory compromise and long-term health issues in infants.
Abstract:
Treatment of nasal septal deformity in childhood has received growing acceptance in recent years. Traditionally, concern about the role of the septum in the overall growth of the midface has led otolaryngologists to take a very cautious approach to correction of septal deformities in children. However, a great deal of evidence now suggests that severe traumatic septal deviation can and should be corrected early in childhood to prevent future nasal and systemic complications. Closed manipulation of the septum in the first 1-2 days of an infant's life has been performed by many otolaryngologists with good results. The use of this technique, however, is usually limited to those subluxations of anterior cartilage which are diagnosed immediately or very shortly after birth. We present a case of severe traumatic nasal deformity presenting with obstructive asleep and awake apnea and cyanosis at the age of 8 days. The child underwent limited septoplasty using endoscopic techniques at age 14 days with resolution of both the apneic and cyanotic episodes immediately post-operatively. This unusual presentation and the literature surrounding infant nasal/septal surgery are discussed.