The most important component of the examination of the nose of newborns is to test for patency of the nasal passages. You can do this by gently occluding each nostril alternately while holding the infant's mouth closed. This will not cause stress in a normal baby, because most newborns are nasal breathers. Indeed, some infants are obligate nasal breathers and have difficulty breathing through their mouths. Do not occlude both nares simultaneously—this will cause considerable distress!
The nasal passages in newborns may be obstructed in choanal atre-sia. In severe cases, nasal obstruction can be assessed by attempting to pass a No. 8 feeding tube through each nostril into the posterior pharynx.
Inspect the nose to ensure that the nasal septum is midline. You can gently insert a wide nasal speculum of the otoscope into the nose.
At birth, only the ethmoid sinuses are developed. Palpation of the sinuses of newborns is not helpful.
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