Facial Injuries
1. Nasal Septal Dislocation:
- It occurs due to compression of the nose from the maternal symphysis pubis or sacral promontory during labor and delivery.
- The examination reveals deviation of the nose to one side with asymmetric nares and flattening of the dislocated side.
- The pressure of the tip of the nose causes the nares to collapse, resulting in a more apparent deviated septum, which does not resume a normal position when pressure is released.
- The diagnosis is made by rhinoscopy.
- Manual reduction by an otolaryngologist using a nasal elevator should be performed by three days of age.
- No treatment or a delay in treatment may result in nasal septal deformity.
2. Ocular Injuries:
- Minor ocular trauma, such as retinal and subconjunctival hemorrhages, and lid edema, are common and resolve spontaneously without affecting the infant.
- Resolution of a retinal hemorrhage occurs within one to five days and a subconjunctival hemorrhage within one to two weeks.
- Significant ocular injuries (hyphema, vitreous hemorrhage, orbital fracture, lacrimal duct or gland injury, and disruption of Descemet’s membrane of the cornea) occur with a higher incidence associated with forceps-assisted delivery.
- Prompt ophthalmologic consultation should be obtained for patients with, or suspected to have these injuries.