Emami A J, Brodsky L, Pizzuto M
Department of Otolaryngology, State University of New York, Buffalo, USA.
Int J Pediatr Otorhinolaryngol. 1996 May;35(3):271-5. doi: 10.1016/0165-5876(95)01306-7.
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.
近年来，儿童鼻中隔畸形的治疗越来越被人们所接受。传统上，由于担心鼻中隔在中面部整体生长中的作用，耳鼻喉科医生对儿童鼻中隔畸形的矫正采取了非常谨慎的态度。然而，现在大量证据表明，严重的创伤性鼻中隔偏曲能够且应该在儿童早期得到矫正，以预防未来的鼻腔和全身并发症。许多耳鼻喉科医生在婴儿出生后的头1至2天对鼻中隔进行闭合性手法操作，效果良好。然而，这项技术的应用通常仅限于出生时或出生后不久就被诊断出的前软骨半脱位。我们报告一例8天大的婴儿，因严重创伤性鼻畸形出现阻塞性睡眠和清醒时呼吸暂停及发绀。该患儿在14天时接受了有限的内镜下鼻中隔成形术，术后呼吸暂停和发绀症状立即消失。本文讨论了这种不寻常的表现以及围绕婴儿鼻腔/鼻中隔手术的文献。
