RESUMEN
The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report three cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered.
Asunto(s)
Obstrucción de las Vías Aéreas , Enfermedades Fetales/cirugía , Neoplasias Orofaríngeas , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Pediatría/instrumentación , Obstrucción de las Vías Aéreas/embriología , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Vértebras Cervicales/embriología , Vértebras Cervicales/cirugía , Femenino , Humanos , Linfangioma Quístico/complicaciones , Linfangioma Quístico/embriología , Linfangioma Quístico/cirugía , Masculino , Neoplasias Orofaríngeas/complicaciones , Neoplasias Orofaríngeas/embriología , Neoplasias Orofaríngeas/cirugía , Embarazo , Complicaciones del Embarazo , Índice de Severidad de la Enfermedad , Neoplasias de la Columna Vertebral/complicaciones , Neoplasias de la Columna Vertebral/embriología , Neoplasias de la Columna Vertebral/cirugía , Teratoma/complicaciones , Teratoma/embriología , Teratoma/cirugíaRESUMEN
Oropharyngeal teratomas are rare congenital malformations that arise from all three basic germinal layers and form a high risk situation for the neonate. Their incidence is only sporadic and they are not associated with a high recurrence risk, although some cases of associated chromosomal aberrations have been described. In this case report we present the clinical course and the histopathological findings of a prenatal diagnosed stillborn infant with an oropharyngeal teratoma of the left maxilla by a 33-year-old primigravida woman at 40 weeks 5 days' gestation. Moreover we emphasize on the relevance of the prenatal diagnosis and visualisation of such fetal tumors not only because of their great importance on the obstetrical management but also for their critical contribution to the optimal treatment of the affected newborn.