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Following a dislocation of the lower edge of the nasal septal cartilage from the furrow in the pre‐maxilla and vomer (Figs. 1, 2) the cartilaginous outer nose is often twisted and the support is poor (Figs. 4 a, b). In 7% of the cases no deviation is evident unless a compression‐test is carried out (Fig. 4 b). This procedure is recommended in the routine examination of newborn infants. If twisting is found the infant should be examined by a specialist in ear, nose and throat diseases. 141 cases of dislocation of the nasal septal cartilage were found in a series of 9 707 living newborn infants (1.45%) (Fig. 5). However, in a series of 907 newborn infants all examined rhinologically 29 cases were found (3.19%) (Fig. 6). Two thirds of the cases are apparently caused by trauma during pregnancy and the early stages of labour. They are equally distributed between right and left. One third of the cases are caused by trauma solely during internal rotation, which in the L.O.A.‐presentation causes a dislocation of the inferior edge to the right, in the R.O.A.‐presentation to the left (Figs. 10, 11, 12). The condition occurred significantly more commonly in firstborn infants but the reason for this was not evident from the analyses of the data. It was also more common in multiparae if second‐stage of labour was prolonged beyond 15 min (Table VIII). Therefore it is suggested that the second stage should not exceed 15 min in multiparae. The dislocation does not reduce spontaneously. The results obtained after reduction according to the method of Metzenbaum (Fig. 4 c) are good (Fig. 13), and the procedure can be carried out under local anaesthesia.

A comparison between the results obtained from X-ray examination and endoscopy (sinoscopy) of the maxillary sinus has not previously been published. In the present series 585 maxillary sinuses were examined by both methods. In 3 % of the cases we were unable to accomplish sinoscopy, and in 9% we may have overlooked the changes seen on the X-ray pictures. Sinoscopy was superior to the X-ray examination in the remaining cases, giving more exact information for differential diagnosis of the type and degree of the changes found in the sinus. An exact diagnosis by X-ray was not obtained in 29% of the sinoscopical diagnoses, although this could reasonably have been expected. The presence of discharge was incorrectly diagnosed at X-ray examination in 38% of the cases. Sinoscopy can give valuable information in cases of malignancy of extension to the maxillary sinus prior to irradiation or surgery. Consequently, in many cases one must consider whether the standard X-ray examination of the sinus can be replaced by sinoscopy. Acta Otolaryng 74Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 12/26/14 For personal use only. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 12/26/14 For personal use only. Acta Otolaryrig 74 Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 12/26/14 For personal use only. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 12/26/14 For personal use only.

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