Benlyazid A, Lescanne E, Marque A, Robier A, Beutter P, Ployet M J
Unité d'ORL et de Chirurgie Cervico-Faciale, Département de Chirurgie Pédiatrique, Hôpital Gatien de Clocheville, 49 bd Béranger, 37044 Tours Cedex.
Ann Otolaryngol Chir Cervicofac. 2001 Feb;118(1):54-60.
Teratomas are tumors which develop in childhood or early adulthood, generally in the gonads. More rarely these tumors may be found in an axial localization, notably in cervicofacial forms. We report three cases of teratomas observed in rhinopharynx of three neonates operated at the Clocheville General Hospital. We present the main anatomoclinical features of these tumors, focusing on the cervicofacial forms in neonates. All three cases occurred in female neonates presenting acute dyspnea within the first hours of life, requiring intubation in two cases. The first two tumors invaded the infratemoral region and the third was a pediculated tumor of the velum exteriorized via the mouth. In one case antenatal ultrasound had suggested the diagnosis of a right temporomaxillary tumor. Rapid excision of the rhinopharngyeal component allow extubation for the two intubated infants and pathology diagnosis. In the first infant operated at 2 months, the lateral route was adapted to age, with mandibulotomy with section of the coronoid process but preserving the mandibular condyle. The second infant was operated at the age of 3 weeks using a wide frontotemporoperitonial approach then at the age of 3.5 months for recurrence extending to the floor of the temporal fossa and the middle ear. A type C infratemporal approach was used with lost-bone temporal craniectomy. Per-buccal excision was possible in the third infant with resection at the base of implantation. No recurrence has been observed in the first two cases at 3.5 and 2.5 months follow-up in the first two cases. The third infant was lost to follow-up.
畸胎瘤是在儿童期或成年早期发生的肿瘤,通常位于性腺。这些肿瘤更罕见地可在轴位定位中发现,尤其是在颈面部形式中。我们报告了在克洛谢维尔综合医院接受手术的三名新生儿鼻咽部观察到的三例畸胎瘤。我们介绍了这些肿瘤的主要解剖临床特征,重点关注新生儿的颈面部形式。所有三例均发生在女性新生儿中,她们在出生后的头几个小时内出现急性呼吸困难,其中两例需要插管。前两个肿瘤侵犯了颞下区域,第三个是通过口腔外露的悬雍垂带蒂肿瘤。在一例中,产前超声提示诊断为右侧颞下颌肿瘤。迅速切除鼻咽部成分使两名插管婴儿得以拔管并进行病理诊断。在2个月时接受手术的第一名婴儿中,外侧入路根据年龄进行了调整,采用下颌骨切开术并切断冠状突,但保留了下颌髁。第二名婴儿在3周龄时采用广泛的额颞部骨膜下入路进行手术,然后在3.5个月龄时因复发延伸至颞下窝底部和中耳而再次手术。采用C型颞下入路并进行去骨颞骨颅骨切除术。第三名婴儿通过在植入基部切除进行颊部切除术。在前两例中,在3.5个月和2.5个月的随访中未观察到复发。第三名婴儿失访。