Deviated Nasal Septum in Newborn and its Associated Factors

Abstract

INTRODUCTION: Deviated nasal septum (DNS) is a very common condition, causes considerable amount of morbidity among ENT patients. During the process of parturition the most common etiological factors for development of deviated nasal septum is nasal injury in the intra-uterine life. Nasal obstruction in newborns can leads to cyanotic spells, high pulmonary resistance and can even respiratory failure. Subluxation of the nose causing acute respiratory distress and cyanosis in newborns have been reported. The incidence of newborn DNS is observed to be 2.9 to 31% in various studies. Many of these deformities do persist in adult life and can give rise to psychological and cosmetic complications.

MATERIAL AND METHODS: Two days newborns were chosen by simple random sampling, using a random number table. Two days old newborns were selected because tissue oedema in the first day of life may give a high false positive result. It was done using acrylic strips measuring 2 mm thick, 4 mm wide, and 10 cm long with a mark at 4 cm from one end.

RESULTS: Of the 100 cases included there were 45 (45%) female and 55 (55%) male. 21(21%) cases were observed to be having DNS of which 10 (47.6%) were male and 11 (52.4%) were female. Of the 100 cases 53% were multipara and in new born of multipara 7 (33.3%) were having DNS while in 47% primipara 14 (66.4%) were having DNS. This was statistically significant with a P value < 0.05. The incidence of DNS  was  shown to increase proportionally with the increase in the amount of birth trauma, highest incidence was shown in instrumental deliveries and this difference was statistically significant with a P value of <0.001. DNS in babies born by normal vaginal delivery was 16 (76.2%), in LSCS it was 4 (19%) while in Instrumental delivery it was 01(4.8%).

CONCLUSION: DNS was 21% of all newborns. Birth trauma, primiparas, instrumental deliveries or emergency LSCS predisposes more to neonatal septal deviation. Strut test being a simple, non-invasive, and fairly accurate is quite useful for diagnosis of Neonatal septal deviations and can be performed at the peripheral level to diagnose DNS.