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Clinical Challenges in Otolaryngology
June 1999

A 3-Year-Old Child With a Severely Deviated Septum and Airway Obstruction

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery, Children's Hospital and Regional Medical Center, University of Washington School of Medicine, Seattle.



Arch Otolaryngol Head Neck Surg. 1999;125(6):699-701. doi:10.1001/archotol.125.6.699

The optimal treatment of a 3-year-old child with a severely deviated septum and symptomatic nasal obstruction resulting from blunt trauma 4 months previously is septoplasty.

Otolaryngologists recognized more than 100 years ago that radical surgery or severe injury to the pediatric nasal septum could result in substantial abnormalities of nasal and maxillary growth. Starting in the mid-1800s, studies of young pigs, rabbits, goats, dogs, and cats have shown consistently that removal of full-thickness portions of the growing nasal septum can lead to growth retardation of the palate, nasal dorsum, maxilla, and premaxilla and to malocclusion. This observation contributed to the view that the vomeroseptal junction was an important nasal growth center and that, in general, septal surgery should be avoided in young children.

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