Nose
Positional Nasal Deformity
An occasional finding on physical exam is an asymmetric appearance of the nose due to a positional deformity. Most likely, this results from an unfortunate position in utero. The nares in this case are asymmetric and slightly flattened towards the infant's right, even though the septum is still centrally located.
photo by Janelle Aby, MD
Positional Nasal Deformity
Viewed from below, one can more clearly appreciate the asymmetry of the nares and the angulation of the septum.
photo by Janelle Aby, MD
Positional Nasal Deformity
When the tip of the nose is compressed gently in the presence of a dislocated septum, the deformity appears to worsen. In this photo, the tip of the nose is actually beside the base of the septum. With positional deformity, the septum would stay straight, even if the nares appear uneven. Although some authors estimate the incidence of dislocated septum to be as high as 4%, in our experience this condition is quite rare. An experienced pediatric otolaryngologist can relocate the septum fairly easily, without surgery, if consulted early (within the first few days of life), so recognition of this condition and timely referral is important to prevent permanent deformity.
photo by Janelle Aby, MD
