Differential risk for neonatal surgical airway intervention in prenatally diagnosed neck masses.
OBJECTIVE
We aimed to identify risk factors for neonatal surgical airway intervention among fetuses with prenatally diagnosed cervical masses.


METHODS
An 8-year retrospective review identified 23 consecutive patients with a prenatal diagnosis of a neck mass, managed at a single tertiary center. Variables analyzed included anticipated diagnosis, extent of the mass, need for any surgical airway intervention in the neonatal period, final histopathology data, and survival. Statistical analysis was based on the Fisher and Fisher-Freeman-Halton exact tests (significance set at P < or = .05) and exact 95% confidence intervals for risk differences.


RESULTS
Eight patients underwent termination of pregnancy or were lost to follow-up. The imaging-based prenatal diagnosis was confirmed postnatally in 93% (14/15) of the remaining patients. Final diagnoses included lymphatic malformation (8), teratoma (6), and esophageal duplication (1). Teratomas were associated with a significantly higher risk for neonatal airway intervention than lymphatic malformations (67% vs 11%, P = .02). The majority of such procedures were performed under ex utero intrapartum treatment. Survival was 93% (14/15).


CONCLUSIONS
Cervical teratomas are significantly more likely to demand surgical airway intervention in the neonate, typically under ex utero intrapartum treatment, than cervical lymphatic malformations. These findings should be considered in the prenatal counseling for fetal cervical masses.
Steigman
Shaun A
SA
Department of Surgery, Children's Hospital Boston and Harvard Medical School, MA 02115, USA.
Nemes
Luanne
L
Barnewolt
Carol E
CE
Estroff
Judy A
JA
Valim
Clarissa
C
Jennings
Russell W
RW
Fauza
Dario O
DO
D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000151:congenital* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D008208:Lymphatic System / Q000002:abnormalities*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013724:Teratoma / Q000151:congenital* / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal