Chen M K, Gross E, Lobe T E
Section of Pediatric Surgery, University of Tennessee, Memphis, USA.
Am J Perinatol. 1997 Mar;14(3):161-3. doi: 10.1055/s-2007-994119.
Intra-oral enteric duplication cysts are rare. We recently treated two infants with prenatally diagnosed large sublingual enteric duplication cysts. Antenatal aspiration of the cyst was attempted in one infant without success. Because of the potential for airway obstruction and respiratory distress at delivery, preparation for an immediate tracheostomy was made in case oral intubation was impossible. Fortunately, aspiration of the cyst provided adequate access to the oropharynx for intubation in both infants. The placental cord was not divided until the airway was secured to minimize the potential for anoxic injury. Complete excision of the cyst was subsequently done in one patient. The other infant had an initial marsupialization and laser ablation of the cyst mucosa but the cyst recurred. Cyst excision at 9 months of age resolved the problem. Pathological examination revealed columnar-lined mucosa consistent with enteric duplication cysts. An enteric duplication cyst may present as a large sublingual mass with potential for airway obstruction in the newborn infant. Antenatal diagnosis allows for the proper preparation of personnel and equipment in the management of these neonates during delivery. If the airway is compromised, aspiration of the cyst can be done to improve the access to the oropharynx for intubation. Preparation for emergent tracheostomy should be done before delivery in case oral intubation is not possible. Subsequent complete cyst excision is the treatment of choice.
口腔内肠源性重复囊肿很罕见。我们最近治疗了两名产前诊断为大型舌下肠源性重复囊肿的婴儿。其中一名婴儿尝试进行囊肿的产前抽吸，但未成功。由于分娩时存在气道阻塞和呼吸窘迫的可能性，因此做好了如果无法进行口腔插管则立即进行气管切开术的准备。幸运的是，囊肿抽吸为两名婴儿的口咽插管提供了足够的通道。在确保气道安全之前不切断脐带，以尽量减少缺氧损伤的可能性。随后，一名患者进行了囊肿的完整切除。另一名婴儿最初进行了囊肿造袋术和囊肿黏膜激光消融，但囊肿复发。9个月大时进行囊肿切除解决了问题。病理检查显示为柱状内衬黏膜，符合肠源性重复囊肿。肠源性重复囊肿在新生儿中可能表现为大型舌下肿物，并有气道阻塞的可能性。产前诊断有助于在分娩期间管理这些新生儿时妥善准备人员和设备。如果气道受到影响，可以进行囊肿抽吸以改善口咽插管的通道。如果无法进行口腔插管，应在分娩前做好紧急气管切开术的准备。随后的完整囊肿切除是首选治疗方法。
