Perinatal airway management of neonatal cervical teratomas
| Autor: | Ross D. Farhadieh, Robert G. Berkowitz, Kiarash Taghavi, A. Michelle Fink, Anthony J. Penington |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Young Adult Pregnancy Intubation Intratracheal medicine Humans Intubation Retrospective Studies Fetal Therapies EXIT procedure business.industry Infant Newborn Teratoma Retrospective cohort study General Medicine Airway obstruction medicine.disease Magnetic Resonance Imaging Surgery Airway Obstruction Otorhinolaryngology Head and Neck Neoplasms Pediatrics Perinatology and Child Health Female Airway management Airway business |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 76:1057-1060 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/j.ijporl.2012.03.010 |
| Popis: | Cervical teratomas are rare but life-threatening neonatal tumors and management of the fetus with a cervical teratoma that threatens the airway remains a clinical challenge. This has been revolutionized by advances in fetal imaging and management of the airway at delivery including the use of Ex-utero Intrapartum Treatments (EXIT procedures). We present a retrospective case series of three neonates managed over a 12-month period. Following pre-natal fetal MRI and a multi-disciplinary management approach, two newborns were managed by prompt post-natal endotracheal intubation while an EXIT procedure was required in one. All three underwent surgical resection in the first few days of life. A decision regarding the best means by which to manage the airway in fetal cervical teratoma requires fetal MRI and a multi-disciplinary team approach to determine whether EXIT, or a safer approach from a maternal perspective can be employed. We also recommend routine endotracheal intubation at birth, due to the risk of spontaneous intra-tumoral hemorrhage. The need for surgery should be planned early, as rapid growth of the tumor can threaten the viability of the overlying skin and surrounding structures. |
| Databáze: | OpenAIRE |
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