Successful ex utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS) owing to a large oropharyngeal teratoma.
Large fetal neck masses can present a major challenge to securing an airway at birth, with associated risks of hypoxia, brain injury and death. The authors report a case of a giant oropharyngeal teratoma diagnosed in a fetus of 19 weeks gestation. The fetus was delivered by the ex utero intrapartum treatment procedure allowing sufficient time on placental support for bronchoscopy and tracheostomy to secure the airway. A multidisciplinary team approach combined with an accurate prenatal diagnosis obtained through fetal ultrasound was the key to a successful outcome. Unfortunately due to the large size of tumour and intracranial extension, the lesion was unresectable and the baby died 6 days after birth.
Glynn
F
F
Childrens University Hospital, Temple Street, Dublin. fglynn@rcsi.ie
Sheahan
P
P
Hughes
J
J
Russell
J
J
D000328:Adult; D000402:Airway Obstruction / Q000151:congenital* / Q000209:etiology; D036861:Delivery, Obstetric; D017809:Fatal Outcome; D005260:Female; D005333:Fetus / Q000002:abnormalities*; D006801:Humans; D007231:Infant, Newborn; D009959:Oropharyngeal Neoplasms / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D010348:Patient Care Team; D011247:Pregnancy; D013577:Syndrome; D013724:Teratoma / Q000150:complications / Q000151:congenital* / Q000175:diagnosis; D014139:Tracheostomy; D016216:Ultrasonography, Prenatal