Abstract
Following a dislocation of the lower edge of the nasal septal cartilage from the furrow in the pre-maxilla and vomer (Figs. 1, 2) the cartilaginous outer nose is often twisted and the support is poor (Figs. 4 a, b). In 7% of the cases no deviation is evident unless a compression-test is carried out (Fig. 4 b). This procedure is recommended in the routine examination of newborn infants. If twisting is found the infant should be examined by a specialist in ear, nose and throat diseases. 141 cases of dislocation of the nasal septal cartilage were found in a series of 9 707 living newborn infants (1.45%) (Fig. 5). However, in a series of 907 newborn infants all examined rhinologically 29 cases were found (3.19%) (Fig. 6). Two thirds of the cases are apparently caused by trauma during pregnancy and the early stages of labour. They are equally distributed between right and left. One third of the cases are caused by trauma solely during internal rotation, which in the L.O.A.-presentation causes a dislocation of the inferior edge to the right, in the R.O.A.-presentation to the left (Figs. 10, 11, 12). The condition occurred significantly more commonly in firstborn infants but the reason for this was not evident from the analyses of the data. It was also more common in multiparae if second-stage of labour was prolonged beyond 15 min (Table VIII). Therefore it is suggested that the second stage should not exceed 15 min in multiparae. The dislocation does not reduce spontaneously. The results obtained after reduction according to the method of Metzenbaum (Fig. 4 c) are good (Fig. 13), and the procedure can be carried out under local anaesthesia.