Skelton V A, Goodwin A
Department of Anaesthesia, King's College Hospital, Denmark Hill, London, UK.
Br J Anaesth. 1999 Dec;83(6):951-5. doi: 10.1093/bja/83.6.951.
Intra-oral masses in neonates can seriously compromise the airway, potentially causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intra-oral mass was diagnosed on antenatal ultrasound scan. Preparation for delivery involved a multidisciplinary team approach, with a strategy for management at delivery. The child was delivered by elective Caesarean section and had a patent airway. A tracheostomy was performed immediately after delivery. The infant underwent a debulking procedure 3 weeks after birth. A histological diagnosis of embryonal rhabdomyosarcoma was made and a course of chemotherapy commenced. The child had a partial response to treatment with considerable shrinkage of the tongue mass. We discuss the management options in neonates with intra-oral masses to provide an adequate airway and maintain fetal oxygenation. The differential diagnosis of fetal oral masses is reviewed.
新生儿口腔肿物可严重影响气道,若未得到正确识别和处理,可能导致缺氧甚至死亡。我们报告一例产前超声检查诊断为口腔肿物的病例。分娩准备采用多学科团队协作方式,并制定了分娩时的处理策略。患儿通过择期剖宫产娩出,气道通畅。出生后立即行气管切开术。婴儿出生3周后接受了减瘤手术。组织学诊断为胚胎性横纹肌肉瘤,并开始化疗疗程。患儿对治疗有部分反应,舌部肿物明显缩小。我们讨论了新生儿口腔肿物的处理方法,以确保气道通畅并维持胎儿氧合。同时回顾了胎儿口腔肿物的鉴别诊断。