Zielinski Rafal, Respondek-Liberska Maria
Department of Pediatric Otorhinolaryngology, Medical University of Lodz, Poland.
Department of Diagnosis and Prevention of Congenital Malformations, Polish Mother Memorial Hospital, Chair of Morphology and Embryology, Medical University of Lodz, Poland.
Int J Pediatr Otorhinolaryngol. 2015 Mar;79(3):363-8. doi: 10.1016/j.ijporl.2014.12.027. Epub 2014 Dec 31.
The aim of this retrospective study was to review and analyze ultrasonography examinations and follow-up of fetuses with cervicofacial tumors to develop bases for counseling specialist involved in perinatal treatment.
The study consisted of case series with chart review of 44 fetuses with cervicofacial tumors diagnosed in utero by ultrasonography. The study was carried in Department of Diagnosis and Prevention of Congenital Malformations, Medical University of Lodz in years 1998-2013. The analysis of the fetuses with cervicofacial tumors included assessment of fetal sonographic features, neonatal survival and in utero as well as perinatal treatments. The obtained data were analyzed by the standard statistical tests and the Pearson's Chi square test, statistical significance at p=0.05.
Cervicofacial tumors were detected at mean 19±7 weeks of gestation. Eighty-two percent of the fetuses were males. Lymphatic malformations followed by teratomas were the most common fetal tumors in the cervicofacial region. In most cases, fetuses with cervicofacial tumors had other abnormalities. Mortality rate in our case series was 43%. In utero treatment was introduced in 6 fetuses. In 4 neonates prenatal sonographic assessment revealed upper airway patency and EXIT procedure (ex-utero intrapartum treatment) was introduced.
Prenatal sonographic detection of cervicofacial tumor, in case of lymphatic malformations possibly as early as in the first trimester, in case of craniofacial teratomas, cervical teratomas, hemangiomas and thyroid tumors possibly as early as in the second trimester, and in case of epignathi possibly in the third trimester, permits planning further course of pregnancy as well as EXIT procedure before delivery.
本回顾性研究旨在回顾和分析患有头面部肿瘤胎儿的超声检查及随访情况，为参与围产期治疗的专科医生提供咨询依据。
本研究为病例系列研究，对44例经超声检查在子宫内诊断为头面部肿瘤的胎儿进行病历回顾。该研究于1998年至2013年在罗兹医科大学先天性畸形诊断与预防系开展。对头面部肿瘤胎儿的分析包括评估胎儿超声特征、新生儿存活率以及宫内和围产期治疗情况。所获数据采用标准统计检验和Pearson卡方检验进行分析，以p = 0.05作为统计学显著性水平。
头面部肿瘤在妊娠平均19±7周时被检测到。82%的胎儿为男性。淋巴管瘤其次是畸胎瘤是头面部区域最常见的胎儿肿瘤。在大多数情况下，患有头面部肿瘤的胎儿有其他异常。本病例系列中的死亡率为43%。6例胎儿接受了宫内治疗。4例新生儿产前超声评估显示上呼吸道通畅，并实施了EXIT手术（产时宫外治疗）。
产前超声检测头面部肿瘤，淋巴管瘤可能早在孕早期就能检测到，颅面部畸胎瘤、颈部畸胎瘤、血管瘤和甲状腺肿瘤可能早在孕中期就能检测到，而鼻后孔闭锁可能在孕晚期检测到，这有助于在分娩前规划进一步的妊娠过程以及EXIT手术。
