Kelly M F, Berenholz L, Rizzo K A, Greco R, Wolfson P, Zwillenberg D A
Department of Otolaryngology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107.
Ann Otol Rhinol Laryngol. 1990 Mar;99(3 Pt 1):179-82.
Large congenital cervical neck masses present major difficulties in management of the neonatal airway at delivery and in the perinatal period. With ultrasound, these lesions can be predicted prenatally. An airway treatment plan can then be formulated and modified in relation to the airway presentation at birth. We describe a case of a massive cervical-mediastinal teratoma and our management plan. Preparation involved a multidisciplinary approach including endoscopy to secure the airway while the neonate remained on fetal circulation and an extracorporeal membrane oxygenation system was available. Once the infant's condition was stable, a cervical approach with resection of the massive teratoma with mediastinal dissection without sternotomy was successful. A differential diagnosis of cervical neck masses and review of cervical teratomas is presented.
巨大先天性颈部肿块在分娩时及围产期新生儿气道管理中存在重大困难。借助超声，这些病变可在产前得到预测。随后可根据出生时的气道情况制定并修改气道治疗方案。我们描述了一例巨大颈纵隔畸胎瘤病例及其治疗方案。准备工作采用多学科方法，包括在内科医生在新生儿仍处于胎儿循环状态且体外膜肺氧合系统可用的情况下确保气道安全。婴儿病情稳定后，采用颈部入路成功切除巨大畸胎瘤并进行纵隔解剖，未行胸骨切开术。本文还介绍了颈部肿块的鉴别诊断及颈畸胎瘤的综述。
