Long-term outcome of pre- and perinatal management of congenital head and neck tumors and malformations.
Int J Pediatr Otorhinolaryngol
; 121: 164-172, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-30917301
ABSTRACT
INTRODUCTION:
Congenital head and neck pathology may cause direct postnatal airway obstruction. Prenatal diagnosis facilitates safe delivery with pre- and perinatal airway assessment and management and Ex-Utero-Intrapartum-Treatment (EXIT) if necessary. Fetoscopic airway evaluation can optimize the selection of patients in need of an EXIT procedure.METHODS:
Description of 11 consecutive fetuses, born with a potential airway obstruction between 1999 and 2011 and treated at the University Hospitals Leuven, with a long-term follow-up until 2018. An algorithm including fetoscopic airway evaluation is presented.RESULTS:
In utero imaging revealed seven teratomas, one fourth branchial pouch cyst, one thymopharyngeal duct remnant, one lymphatic malformation and one laryngeal atresia. A multidisciplinary team could avoid EXIT in eight patients by ultrasonographic (nâ¯=â¯2) or fetoscopic (nâ¯=â¯6) documentation of accessible airways. Three patients needed an EXIT-to-airway-procedure. Neonatal surgery included tracheostomy during EXIT (nâ¯=â¯2) and resection of teratoma (nâ¯=â¯7) or branchiogenic pathology (nâ¯=â¯3). All patients do well at long-term (minimum 54 months) follow-up.CONCLUSIONS:
Combining prenatal imaging and perinatal fetoscopy, EXIT-procedure and neonatal surgery yields an optimal long-term outcome in these complex patients. Fetoscopy can dramatically reduce the number of EXIT-procedures.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Anormalidades Congênitas
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Teratoma
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Obstrução das Vias Respiratórias
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Fetoscopia
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Neoplasias de Cabeça e Pescoço
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article