Wong Birgitta Yee-Hang, Ng Raymond Wai-Man, Yuen Anthony Po-Wing, Chan Ping-Hon, Ho Wai-Kuen, Wei William Ignace
Division of Otorhinolaryngology, Head & Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Int J Pediatr Otorhinolaryngol. 2010 Mar;74(3):287-91. doi: 10.1016/j.ijporl.2009.12.005. Epub 2010 Jan 15.
Congenital airway obstruction can be caused by tumors or lesions arising from the neck, tongue and oral cavity. Neonates may require prolonged intubation or tracheostomy before curative resection and reconstruction. The aim of the study was to carry out surgical resection and reconstruction with locoregional flap and free bone graft in the neonatal and early infantile period for definitive management of head and neck masses and treatment of potential airway obstruction.
Newborns with obstructive head and neck masses in Queen Mary Hospital, University of Hong Kong Medical Centre between 2006 and 2009 were operated on in the neonatal period.
There were one obstructive neck teratoma, two intraoral teratomas and one neuroglial heterotopia. All tumors were resected within the first 3 months of life without major complication. A local cervical cutaneous flap was first used to reconstruct the lateral pharyngeal wall defect in a neonate with a huge neck teratoma, followed by another infant with a neuroglial heterotopia. A piece of cranial bone was used for reconstruction of the skull base defect. None of them required tracheostomy or prolonged intubation. Oral feeding was resumed in the early postoperative period.
Surgical resection and reconstruction with locoregional flap and bone graft can be performed safely in neonatal and early infantile period as management of head and neck masses and treatment of upper airway obstruction.
先天性气道梗阻可由颈部、舌部及口腔的肿瘤或病变引起。新生儿在进行根治性切除和重建之前可能需要长时间插管或气管切开术。本研究的目的是在新生儿期和婴儿早期进行手术切除和采用局部皮瓣及游离骨移植进行重建，以明确治疗头颈部肿块并处理潜在的气道梗阻。
2006年至2009年期间，香港大学玛丽医院医学中心收治的患有梗阻性头颈部肿块的新生儿在新生儿期接受了手术。
有1例梗阻性颈部畸胎瘤、2例口腔内畸胎瘤和1例神经胶质异位。所有肿瘤均在出生后3个月内切除，无重大并发症。首先使用局部颈部皮瓣为1例患有巨大颈部畸胎瘤的新生儿重建咽侧壁缺损，随后为另1例患有神经胶质异位的婴儿进行了同样的手术。使用一块颅骨重建颅底缺损。他们均无需气管切开术或长时间插管。术后早期即恢复经口喂养。
在新生儿期和婴儿早期，采用局部皮瓣和骨移植进行手术切除和重建可安全地用于治疗头颈部肿块及上气道梗阻。
