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.
Manning SC. A 3-Year-Old Child With a Severely Deviated Septum and Airway Obstruction. Arch Otolaryngol Head Neck Surg. 1999;125(6):699-701. doi:10.1001/archotol.125.6.699