Gantwerker Eric A, Hughes Amy Lawrason, Silvera V Michelle, Vargas Sara O, Rahbar Reza
Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
Department of Radiology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
JAMA Otolaryngol Head Neck Surg. 2014 Nov;140(11):1065-9. doi: 10.1001/jamaoto.2014.2331.
Foregut duplication cysts are benign developmental anomalies occurring along the foregut-derived portion of the alimentary tract. Several cases of foregut duplications in the head and neck region have been reported, most without airway symptoms. This case is an antenatally recognized anterior tongue lesion leading to respiratory difficulties at birth that was successfully managed by a coordinated fetal care team.
We describe a 4.16-kg female born at full term whose anterior tongue lesion was noted on routine prenatal ultrasound. An airway management plan was developed by a multidisciplinary fetal care team, and the airway was controlled at the time of cesarean delivery. The lesion was completely excised on the sixth day of life without complications.
Given the extensive differential diagnosis of cystic head and neck lesions in neonates, imaging is recommended to localize and characterize the lesion because management of these lesions may differ substantially. For cases that are diagnosed antenatally, coordination of a multidisciplinary fetal care team and early discussions can optimize the predelivery workup and provide clear delivery and airway management plans. We recommend complete surgical excision of oral foregut duplication cysts in the perinatal period to prevent complications such as feeding difficulties, infection, and ulceration.
前肠重复囊肿是沿消化道前肠衍生部分发生的良性发育异常。头颈部区域的前肠重复已有多例报道，多数无气道症状。本病例为产前发现的舌前部病变，出生时导致呼吸困难，经胎儿护理团队协作成功处理。
我们描述了一名足月出生的4.16千克女婴，其舌前部病变在常规产前超声检查时被发现。多学科胎儿护理团队制定了气道管理计划，并在剖宫产时控制了气道。病变在出生后第六天被完全切除，无并发症。
鉴于新生儿头颈部囊性病变的鉴别诊断范围广泛，建议进行影像学检查以定位和定性病变，因为这些病变的处理可能有很大差异。对于产前诊断的病例，多学科胎儿护理团队的协作和早期讨论可优化产前检查，并提供明确的分娩和气道管理计划。我们建议在围产期对口腔前肠重复囊肿进行完整的手术切除，以预防诸如喂养困难、感染和溃疡等并发症。
