Transient nasal deformations can occur secondary to fetal compression in utero or during delivery, and they typically resolve within the first several days of life without intervention (Fig. 62.1). In some cases, fetal compression during delivery can be sufficient to result in true dislocation of the nasal septum (Fig. 62.2). The incidence of true nasal septal dislocations is estimated to range from 0.6% to 4%, and correction within the first 3 to 4 days of life for severe septal dislocations with nasal obstruction is suggested to ensure the best possible long-term outcomes; however, observation with serial examinations can be considered in less severe cases without obstruction (1, 2, 3, 4, 5, 6, 7).

Physical examination of the newborn can distinguish between transient compression deformity and true dislocation. In order to make this distinction, gentle pressure should be applied to the nasal tip. If the septum moves from the midline at the base, dislocation should be suspected, as the compressed septum will not demonstrate this mobility. Additionally, application of gentle pressure will restore normal nasal anatomy in cases of compression deformity; however, this is not observed with true septal dislocations. Nasal endoscopy can also be performed to differentiate between the two.