phenylephrine-hydrochloride and Birth-Injuries

During delivery the delicate structures of the face are predominantly exposed to external force effects and hence deformities on the nose can emerge as a birth-related trauma in newborns. As self-straightening of the nasal septum commonly occurs, a conservative therapy is recommended for most cases. We report on a case where a birth-related trauma of the nose leaded to acute breathing problems in a newborn with insufficient oxygenation. An overview about the available literature is given. A cautious reposition of the nose proved to be an appropriate management for short- and long-term development.

Topics: Birth Injuries; Humans; Infant, Newborn; Joint Dislocations; Nose

Nasal vestibular stenosis is caused by a disruption of the nasal vestibular lining with secondary proliferation of granulation and fibrous tissue. It is most commonly the result of significant nasal trauma of foreign body reaction. In the pediatric population, it is exceedingly rare, with only a few cases reported in the literature. We report the first case, to our knowledge, of complete stenosis caused by traumatic vaginal delivery. This case demonstrates the profound effect nasal vestibular stenosis can have on the developing nose. Correction can be difficult because of the tendency of wound contracture and recurrence. A new approach is presented, using a hard palate mucosal graft. This graft is tough, resilient, and easily harvested. Its ability to resist contracture obviates the need for postoperative stenting, which is especially useful in the pediatric population.

Topics: Birth Injuries; Constriction, Pathologic; Contracture; Fibrosis; Granulation Tissue; Humans; Infant; Male; Mouth Mucosa; Nasal Mucosa; Nasal Obstruction; Nose; Nose Diseases; Obstetrical Forceps; Palate; Recurrence; Wound Healing

Topics: Birth Injuries; Brachial Plexus; Cerebral Hemorrhage; Eye Injuries; Female; Humans; Infant, Newborn; Nose; Prognosis; Respiratory Paralysis; Skull Fractures; Spinal Cord Injuries

In the newborn the following traumatic alterations of the nose can be seen: lesions of the soft tissues, flat noses (30--60%), damage by tubes, fixed nasal deformities (0.5%), treatable anterior septal dislocations (2--23%), and combined septal deformities (up to 50%). The literature of the last 100 years is reviewed as to the high frequency of these alterations, their etiology, diagnosis, and treatment, which is necessary within the first days of life. Therefore routine examination of each newborn by an oto-rhino-laryngologist is recommended.

Topics: Birth Injuries; Humans; Infant, Newborn; Nasal Septum; Nose; Nose Deformities, Acquired; Time Factors

We saw a child after normal delivery with mild hematoma but a substantial deviation of the nose. The child had no respiratory distress nor in rest nor during effort. We decided not to perform a reposition of the nose but watched further development. After a few weeks the nose straightened significantly, and was nearly normal after 3 months. An exam after 1 year did not show any deviation. Recent studies only advise to perform surgical steps, if there is respiratory distress. This well documented case is an impressive example for the ability of the neonatal nose to help itself.

Topics: Birth Injuries; Female; Humans; Infant, Newborn; Nasal Septum; Nose; Nose Deformities, Acquired; Prognosis

Although they are traditionally reserved for "aesthetic refinement" in the latter stages of facial reanimation surgery, the author uses a variety of autogenous fascia lata grafts in a very aggressive approach as the primary therapeutic option in static facial rebalancing and/or in conjunction with dynamic muscle transfers to achieve architectural integrity and functional restoration of the totally or partially paralyzed face.. Forty-nine autogenous fascia lata grafts, harvested through serial incisions in the lateral thigh, were placed in 35 totally or partially paralyzed faces. The grafts were categorized by anatomical location: I and II, lateral lip in totally paralyzed and partially paralyzed faces, respectively; III, nostril suspension; IV, lower eyelid suspension; V, bimalar lower lip sling; and VI, platysma transfer/autogenous fascia lata extension for lower lip invagination.. In all group I and II cases, static balance of facial architecture was restored at 4 to 6 weeks (after swelling resolved). Average lip commissure displacement was corrected to within 0.5 cm of the horizontal axis. Subjective functional improvement in speech, fluid retention, and chewing was immediate in all cases. In group I (n = 10; median age, 10.5 years), a 60 to 100 percent symmetrical smile was achieved with voluntary gracilis contraction of 3 of 5 to 5 of 5. In group II (n = 20; median age, 33 years), with 16 sling only patients, one to two grades of voluntary risorius and lip elevator motion were achieved in most. When accompanied by a temporalis turnover flap, both risorius and lip elevator function improved two to three grades. In group III (n = 5), inspiratory collapse was ameliorated in all cases and nasal flow improved subjectively 80 to 100 percent. In group IV (n = 4), scleral show and keratitis were improved in all cases. In group V (n = 6), improved oral competence was achieved in all patients. In group VI (n = 4), static lip evagination was achieved in all cases; voluntary lip depressor function was two to four grades improved.. Early placement of autogenous fascia lata restores static balance of the deeper facial architecture in repose. Functional improvement of chewing, fluid retention, speech articulation, smile symmetry, and ectropion is immediate. The psychological effect is also immediate, with achievement of self-esteem and acceptance by family and peers.

Topics: Adolescent; Adult; Aged; Birth Injuries; Brain Stem Neoplasms; Child; Ectropion; Extraction, Obstetrical; Facial Expression; Facial Paralysis; Fascia Lata; Female; Humans; Lip; Male; Mastication; Middle Aged; Mobius Syndrome; Nose; Recovery of Function; Speech; Transplantation, Autologous

Childhood and perinatal nasal traumatisms involve an anterior septal deviation or an anterior septal lysis. These complications induce a soft nasal tip. Nasal obstruction et oral ventilation are responsible for the development of facial and occlusal sequelae. A better knowledge of anatomy and physiopathology of nasal traumatisms is needed for an earlier treatment.

Topics: Birth Injuries; Humans; Infant; Infant, Newborn; Maxillofacial Injuries; Mouth Breathing; Nasal Bone; Nasal Obstruction; Nasal Septum; Nose; Skull Fractures

In 1000 healthy born neonates the nose and nasal septum were examined with special attention to injuries. Three types traumatic deformities of the nose and nasal septum were detected. The most frequent type were so-called flattened noses which, however, did not require treatment. More serious were subluxations of the cartilaginous part of the nasal septum or combined deformities in view of possible late sequelae. The authors emphasize the necessity of early diagnosis and early treatment which can be ensured only by close collaboration of the neonatologist and otolaryngologist.

Topics: Birth Injuries; Female; Humans; Infant, Newborn; Labor Presentation; Male; Nose; Pregnancy

Topics: Airway Obstruction; Birth Injuries; Female; Humans; Infant, Newborn; Mouth Breathing; Nose; Time Factors

A total of 4724 newborns were screened for congenital nasal deformities with two simple tests which were performed by specialized nurses. Altogether 91 (1.9%) pathological cases were found. The parturients' external features and the course of the deliveries showed no differences from those of a control group, nor did the groups differ regarding features of the newborns. On the other hand, in the nasal deformity group, highly significantly (P less than 0.001) more cases of stuffy nose were found already during the first days after birth. In this study, no evidence of birth trauma as the cause of congenital nasal deformities was found. It is proposed that at least the majority of them originated during intrauterine life. The screening method was quite valid: every newborn who failed the screen tests showed some kind of nasal pathology and, on the other hand, those who passed had only minor deviations of the septum.

Topics: Birth Injuries; Female; Humans; Infant, Newborn; Male; Nasal Cavity; Nasal Mucosa; Nasal Septum; Nose

After having emphasized the frequency of the newborn's and young child's nasal fractures, the authors insist on the difficulty of: - a precise outcome of the lesions, - the complications due to nasal obstruction, - the impossibility to anticipate the evolution of these lesions, which is being precised by a brief embryological recall. The traumas are deliberately presented according to the age of the patients: 1) the newborn's fractures: - the prenatal fractures, which generally have a favorable evolution. - obstetrical traumas, with nasal obstruction and feeding difficulty, both being indications to surgery. 2) The young child's fractures: often misknown, and relatively frequent, the nasal wall's hematoma is a dreadful complication. 3) During school years: (sports, car accidents, Silverman's syndrome) Nasal fractures are here generally associated to other facial lesions. Indications to surgery: Always: If it is a recent fracture, provoquing nasal obstruction with respiratory and feeding problems. Sometimes: Septoplasty as minima in case of respiratory difficulties. Never perform true rhinoplasty and/or osteotomies.

Topics: Age Factors; Birth Injuries; Child, Preschool; Female; Fractures, Bone; Fractures, Closed; Humans; Infant; Infant, Newborn; Labor Presentation; Nasal Septum; Nose; Pregnancy; Rhinoplasty

Topics: Birth Injuries; Cleft Lip; Cleft Palate; Esophageal Atresia; Heart Defects, Congenital; Hematoma, Subdural; Hernias, Diaphragmatic, Congenital; Humans; Hydrocephalus; Infant, Newborn; Infant, Newborn, Diseases; Larynx; Lung Diseases; Neoplasms; Neural Tube Defects; Nose; Parenteral Nutrition; Postoperative Care; Preoperative Care

Three different types of nasal deformities are described in the newborn: 1. Fixed deviations caused by injury in the prenatal period, which are mainly selfcorrecting. 2. Deviations brought about during delivery, requiring repositioning, and 3. Deformities caused by pressure and moulding of the foetal head, which also require treatment. Methods for the detection of the last two groups are also described.

Topics: Birth Injuries; Female; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nose; Pregnancy; Pressure; Skull

The extremely flat nose is a handicap because of nasal airway obstruction, and its consequences, and cosmetic unsightliness. This problem which is rarely discussed in the literature is considered to be inherited. We feel that it is also traumatic in origin. Two patients are presented in whom trauma to the nose is known to have occurred at birth by obstetric forceps. The surgical correction of the flat nose should restore normal function and produce a cosmetically satisfactory result.

Topics: Adult; Birth Injuries; Congenital Abnormalities; Female; Humans; Nose; Nose Deformities, Acquired; Rhinoplasty

Nasal problems in children are very common. The factors that affect the embryologic development have been discussed. Injuries that occur in prenatal, natal, and postnatal periods affect normal development. Prompt treatment of minor injuries is necessary to prevent airway problems later. The "wait and see" attitude toward nasal deformity is ill advised. X-ray findings are not conclusive, as the nasal pyramid in a child is largely cartilaginous. Obstructive nasal breathing can result in facial asymmetry, malocclusion, and cardiopulmonary problems. Allergy and sinusitis are frequently causes of obstruction.

Topics: Acute Disease; Adolescent; Airway Obstruction; Birth Injuries; Cartilage; Child; Child, Preschool; Facial Injuries; Female; Humans; Infant; Infant, Newborn; Male; Malocclusion; Nasal Bone; Nasal Septum; Nose; Nose Deformities, Acquired; Pregnancy; Sinusitis; Skull Fractures; Wounds, Nonpenetrating; Wounds, Penetrating

Both the outer and inner nose as well as the position of the parietal bones of 972 patients at an age of 3 to 82, were examined giving evidence of the configuration of the infant's head at birth and thereby of the "severity" of the birth. In comparison with the sectio-patients the configuration of the infant's head in the birth canal reveals statistically recorded deformations of the outer and inner nose with an obstruction of the nasal breathing in 20% of the patients examined. The degree of the configuration has a definite influence on the degree of the nose deformation. The adjustment of the rotary direction of the infant's head in the 1st and 2nd vertex presentation determines the direction of the nose deformation. The demand of many authors for an immediate rhinological examination and corrections in the newborn child, for instance on the septum, to be performed still in the obstetrical department, must due to our own examinations be advocated.

Topics: Adolescent; Adult; Aged; Birth Injuries; Cesarean Section; Child; Child, Preschool; Delivery, Obstetric; Female; Humans; Male; Middle Aged; Nasal Septum; Nose; Parietal Bone

Topics: Birth Injuries; Delivery, Obstetric; Female; Humans; Infant, Newborn; Labor Presentation; Nose; Pregnancy

Topics: Birth Injuries; Burns; Diaphragm; Embolism, Amniotic Fluid; Female; Fractures, Bone; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nose; Obstetrical Forceps; Pelvic Bones; Pregnancy; Pregnancy Complications; Scalp; Snake Bites; Uterine Rupture; Uterus; Wounds and Injuries

Topics: Birth Injuries; Cartilage; Child; Child, Preschool; Fracture Fixation; Fractures, Bone; Fractures, Cartilage; Humans; Infant; Infant, Newborn; Nasal Bone; Nose

Topics: Birth Injuries; Female; Fetus; Humans; Male; Nasal Septum; Nose; Nose Deformities, Acquired; Prognosis; Radiography; Respiration

Topics: Adolescent; Birth Injuries; Child; Child, Preschool; Ectodermal Dysplasia; Female; Humans; Male; Maxilla; Maxillofacial Development; Nasal Septum; Nose; Nose Deformities, Acquired

Topics: Birth Injuries; Humans; Infant, Newborn; Infant, Newborn, Diseases; Nasal Septum; Nose; Nose Deformities, Acquired; Time Factors

Topics: Adaptation, Biological; Birth Injuries; Brain Injuries; Extraembryonic Membranes; Female; Fetal Death; Fetus; Hearing Disorders; Humans; Infant, Newborn; Infant, Premature, Diseases; Labor, Obstetric; Nose; Otitis Media; Pregnancy; Respiration; Respiratory Distress Syndrome, Newborn; Respiratory Tract Infections

Topics: Birth Injuries; Humans; Infant; Infant, Newborn; Nose; Nose Deformities, Acquired; Nose Diseases; Obstetrical Forceps

Topics: Adolescent; Birth Injuries; Child; Humans; Infant; Nasal Septum; Nasal Surgical Procedures; Nose; Nose Neoplasms; Rhinoplasty

Topics: Birth Injuries; Humans; Infant, Newborn; Nose

Topics: Birth Injuries; Humans; Medical Records; Meningocele; Meningomyelocele; Nose; Spinal Dysraphism