ABSTRACT
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.
Subject(s)
Airway Obstruction , Fetal Diseases/surgery , Oropharyngeal Neoplasms , Otorhinolaryngologic Surgical Procedures/methods , Pediatrics/instrumentation , Airway Obstruction/embryology , Airway Obstruction/etiology , Airway Obstruction/surgery , Cervical Vertebrae/embryology , Cervical Vertebrae/surgery , Female , Humans , Lymphangioma, Cystic/complications , Lymphangioma, Cystic/embryology , Lymphangioma, Cystic/surgery , Male , Oropharyngeal Neoplasms/complications , Oropharyngeal Neoplasms/embryology , Oropharyngeal Neoplasms/surgery , Pregnancy , Pregnancy Complications , Severity of Illness Index , Spinal Neoplasms/complications , Spinal Neoplasms/embryology , Spinal Neoplasms/surgery , Teratoma/complications , Teratoma/embryology , Teratoma/surgeryABSTRACT
El ex-utero intrapartum treatment (EXIT) es una técnica diseñada para permitir un parto fetal parcial a través de una cesárea y el establecimiento de una vía aérea fetal segura a través de intubación, broncoscopia o traqueotomía mientras la oxigenación fetal se mantiene a través de la circulación uteroplacentaria. La indicación más frecuente de EXIT es la obstrucción de la vía aérea fetal, habitualmente causada por una masa cervical diagnosticada prenatalmente. Presentamos 3 casos de tumoraciones de cabeza y cuello con compromiso de la vía aérea tratados mediante EXIT y con diferentes soluciones en el manejo de la vía aérea. Con la implicación de los otorrinolaringólogos pediátricos en el EXIT, aparecerán nuevas indicaciones y podrán valorarse variaciones del protocolo básico
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
Subject(s)
Male , Female , Pregnancy , Humans , Airway Obstruction/embryology , Airway Obstruction/surgery , Fetal Diseases/surgery , Oropharyngeal Neoplasms/complications , Otorhinolaryngologic Surgical Procedures/methods , Pediatrics/instrumentation , Cervical Vertebrae/surgery , Lymphangioma, Cystic/complications , Pregnancy ComplicationsABSTRACT
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