A Aubin1, S Pondaven2, D Bakhos3, H Lardy4, A Robier3, E Lescanne3. 1. Service ORL, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex 9, France. Electronic address: aubinalexandra@yahoo.fr. 2. Service ORL, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex 9, France. 3. Service ORL, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex 9, France; Université François-Rabelais de Tours, boulevard Tonnelé, 37044 Tours cedex 9, France. 4. Université François-Rabelais de Tours, boulevard Tonnelé, 37044 Tours cedex 9, France; Unité de chirurgie pédiatrique, CHRU de Tours, 49, boulevard Béranger, 37000 Tours, France.
Abstract
OBJECTIVES: Congenital teratomas of the oropharyngeal cavity are extremely rare and are associated with a high neonatal mortality rate due to severe airway obstruction. Management has been improved with progress in antenatal diagnosis. The authors describe this progress in the light of a series of 4 cases and a review of the literature. METHODS: The medical charts of four neonates treated in the department since 1995 were reviewed. The following criteria were studied: age at diagnosis, clinical and radiological features of the tumour, management at birth and outcome. RESULTS: All four cases occurred in female neonates with an antenatal diagnosis in two cases, allowing preparation for endoscopy in the delivery room in one case and an EXIT procedure in the other case. Three neonates had to be intubated in the delivery room. Imaging showed invasion of the infratemporal fossa in 3 of the 4 cases. Surgical resection via various approaches to the infratemporal fossa was complete in every case. Adjuvant chemotherapy was administered in one case. CONCLUSION: Surgery for these mostly benign tumours is very challenging and requires a multidisciplinary team. Perinatal planning allows appropriate management at birth, decreasing the risk of airway obstruction. Surgery is the mainstay of treatment of teratomas.
OBJECTIVES:Congenital teratomas of the oropharyngeal cavity are extremely rare and are associated with a high neonatal mortality rate due to severe airway obstruction. Management has been improved with progress in antenatal diagnosis. The authors describe this progress in the light of a series of 4 cases and a review of the literature. METHODS: The medical charts of four neonates treated in the department since 1995 were reviewed. The following criteria were studied: age at diagnosis, clinical and radiological features of the tumour, management at birth and outcome. RESULTS: All four cases occurred in female neonates with an antenatal diagnosis in two cases, allowing preparation for endoscopy in the delivery room in one case and an EXIT procedure in the other case. Three neonates had to be intubated in the delivery room. Imaging showed invasion of the infratemporal fossa in 3 of the 4 cases. Surgical resection via various approaches to the infratemporal fossa was complete in every case. Adjuvant chemotherapy was administered in one case. CONCLUSION: Surgery for these mostly benign tumours is very challenging and requires a multidisciplinary team. Perinatal planning allows appropriate management at birth, decreasing the risk of airway obstruction. Surgery is the mainstay of treatment of teratomas.