title: Floor of mouth masses in children: proposal of a new algorithm.
abstract: OBJECTIVE
  Many surgical techniques have been described to manage floor of mouth masses, but few studies have described the approach to these masses in children. This case series summarizes a single institution's experience with pediatric floor of mouth masses.
  
  
  METHODS
  We performed a retrospective chart review of all children who presented at our tertiary care facility with FOM masses between 2007 and 2012. Charts were reviewed for clinical presentation, preoperative, intraoperative and postoperative management.
  
  
  RESULTS
  Thirteen cases were retrieved: 6 dermoid cysts, 4 ranulas, 1 lymphatic malformation, 1 imperforate submandibular duct, and 1 enlarged salivary gland. In 10 of 13 patients, clinical diagnosis was consistent with postoperative diagnosis. Imaging was consistent with postoperative diagnosis in 8 of 9 cases. Ten of 13 masses were managed transorally; 7 were excised, 2 were marsupialized and 1 was managed with submandibular duct dilation. Three masses with a larger submental component, 2 dermoids and 1 ranula, were removed transcervically. Most patients undergoing transoral excision underwent nasotracheal intubation; patients who underwent marsupialization underwent orotracheal intubation. There were no recurrences, complications or postoperative infections. An additional surgical procedure was necessary in one patient.
  
  
  CONCLUSIONS
  Our cohort displays a common distribution of lesion types when compared to the literature. Low recurrence and infection rates are observed when oral masses are removed transorally, and masses with a larger cervical component are removed transcervically. More complex masses may warrant additional surgical procedures.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Pediatric Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College, 428 East 72nd Street, Suite 100, New York, NY 10021, USA.
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Schwanke
authors.forename: Karin P Q
authors.initials: KP
authors.lastname: Oomen
authors.forename: Max M
authors.initials: MM
authors.lastname: April
authors.forename: Robert F
authors.initials: RF
authors.lastname: Ward
authors.forename: Vikash K
authors.initials: VK
authors.lastname: Modi
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003884:Dermoid Cyst / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008208:Lymphatic System / Q000002:abnormalities / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D009060:Mouth Floor / Q000473:pathology* / Q000601:surgery; D009062:Mouth Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D009519:New York City; D011379:Prognosis; D011900:Ranula / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012466:Salivary Gland Diseases / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D012469:Salivary Glands / Q000473:pathology* / Q000601:surgery; D013361:Sublingual Gland / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
keywords: Dermoid cyst; Floor of mouth; Lymphatic malformation; Ranula