| CASE REPORT |
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| Year : 2007 | Volume
: 12
| Issue : 4 | Page : 226-227 |
Ex-Utero intrapartum procedure for congenital high airway obstruction syndrome in a neonate: First case in Alexandria
Mohammed Aly Youssef
Specialist of Pediatric Surgery, Alexandria Hospital for Sick Children, Health Insurance Authority, Alexandria, Egypt
Correspondence Address:
Mohammed Aly Youssef
Alexandria University, Alexandria
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-9261.40842
Introduction: Large fetal neck masses can present a major challenge for securing an airway at birth with associated risks of hypoxia, brain injury and death. Teratomas of the oropharynx are rare, presenting 3% of teratomas in childhood, and are treated by surgical excision. If respiratory distress accompanies the lesion, priority must be given to the securing of the airway. Case History: We present a case of an infant who was diagnosed antenatally as having a huge oropharyngeal teratoma. The anaesthetic, surgical and neonatology teams were ready to perform surgical excision depending on the placental circulation immediately after securing the airway. The tumour weighed 1591 g and was 20 x 22 x 12 cm. The patient was a male and weighed 715 g. Histopathology showed Grade II teratoma. Conclusion: Large fetal neck masses can present a major challenge for securing an airway at birth with associated risks of hypoxia, brain injury and death. A multidisciplinary team approach combined with an accurate prenatal diagnosis obtained through fetal ultrasound is the key to a successful outcome. Ex utero intrapartum treatment (EXIT) that is based on the placental blood during intubation, tracheostomy or surgical excision is the standard procedure.
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