Background:The aim of this study was to determine the role of the nasal septum in embryonic facial development. Methods: Nasal septal growth and facial profile development were examined in sagittally-sectioned 6-9 week human foetuses and compared to previously published data for later prenatal periods. To complement this data a cephalometric study of a child with untreated warfarin embryopathy was undertaken since a previous study in rats had shown warfarin exposure interferes with septal growth. Results:The results showed that prenatal septal growth was maximal during the 6-9 week period and resulted in the establishment of a facial profile that was maintained until birth. This critical period of growth corresponds to the period of warfarin exposure of the human foetus that results in the warfarin embryopathy. The cephalometric examination of a child with untreated warfarin embryopathy showed a combination of short anterior cranial base and a short maxilla had contributed to a significant retrusion of the maxilla suggestive of failure of the midface to develop over the 6-9 week period. Conclusion: These findings would support the hypothesis that the nasal septum plays an active role in embryonic midfacial development.Key words: Facial development, nasal septum, warfarin embryopathy, cephalometric analysis.(Accepted for publication 5 March 2004.) Warfarin exposure during the first trimester of pregnancy can be associated with a distinct facies in the newborn characterized by a depressed nasal bridge, underdevelopment of the nasal cartilages causing a gross flattening of the nose and midfacial hypoplasia.

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