Josset P, Boccon-Gibod L, Lacombe H
Laboratoire Central d'Anatomie et Cytologie pathologiques, Hôpital Trousseau, Paris.
Arch Fr Pediatr. 1992 Jun-Jul;49(6):535-8.
Brain heterotopia can be reflected in disturbances of the oropharynx during the neonatal period, such as acute upper airway obstruction. The main differential diagnosis is encephalocele, which must be recognized before undertaking any surgical procedure.
A boy, aged 5 days, with a cleft palate and bifid uvula, was admitted for respiratory distress. The distress initially occurred during bottle-feeding, but later became permanent. A solid mass, seemingly implanted in the superior wall of the pharynx, was successfully removed by forceps. A later CT scan showed the absence of any defect in the cribriform plate, thus excluding diagnosis of encephalocele. Histological, examination of the mass showed glial tissue without neurons.
The presence of a pharyngeal mass in a newborn signals three possibilities: teratoma, heterotopic brain tissue or encephalocele. Encephalocele must by ruled out by a preoperative CT scan with a water soluble contrast agent in order to avoid CSF leakage and meningitis. Respiratory distress should be treated by oral endotracheal intubation to allow time for CT scan investigation.
脑异位在新生儿期可表现为口咽功能紊乱，如急性上呼吸道梗阻。主要鉴别诊断为脑膨出，在进行任何外科手术前必须明确诊断。
一名5天大的男孩，患有腭裂和双悬雍垂，因呼吸窘迫入院。呼吸困难最初在奶瓶喂养时出现，但后来持续存在。一个看似植入咽上壁的实性肿块被用镊子成功取出。后来的CT扫描显示筛板无任何缺损，从而排除了脑膨出的诊断。对肿块的组织学检查显示为无神经元的胶质组织。
新生儿出现咽部肿块提示三种可能：畸胎瘤、异位脑组织或脑膨出。术前必须用水溶性造影剂进行CT扫描以排除脑膨出，以免发生脑脊液漏和脑膜炎。呼吸窘迫应通过经口气管插管治疗，以便有时间进行CT扫描检查。
