title: The delivered promise of prenatal imaging and a challenge to the utility of sildenafil for severe lymphatic malformations.
abstract: We report the case of an infant with severe lymphatic malformation necessitating ex-utero intrapartum treatment (EXIT) procedure and examine recent advances in high resolution ultrasonography and magnetic resonance imaging, which allow for improved prenatal diagnosis of lesions that cause critical airway obstruction in the neonate. Treatments for lymphatic malformations including surgical resection, sclerotherapy, coblation, and sildenafil are discussed. Our patient did not have any reduction in the size of the lymphatic malformation from sildenafil as suggested in another series.
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, MD 20889, United States. Electronic address: ryangeorgemd@gmail.com.
authors.forename: Ryan
authors.initials: R
authors.lastname: George
authors.affiliation: Division of Otolaryngology, Children's National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010, United States. Electronic address: rshah@cnmc.org.
authors.forename: Rahul
authors.initials: R
authors.lastname: Shah
authors.affiliation: Division of Diagnostic Imaging and Radiology, Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, United States. Electronic address: dbulas@childrensnational.org.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Bulas
authors.affiliation: Division of Anesthesia, 111 Michigan Ave., NW, Washington, DC 20010, United States. Electronic address: skline@cnmc.org.
authors.forename: Shannon
authors.initials: S
authors.lastname: Kline
authors.affiliation: Division of Anesthesia, 111 Michigan Ave., NW, Washington, DC 20010, United States. Electronic address: salexand@cnmc.org.
authors.forename: Sean
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Division of Otolaryngology, Children's National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010, United States. Electronic address: breilly@cnmc.org.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Reilly
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D044148:Lymphatic Abnormalities / Q000175:diagnosis* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011687:Purines / Q000627:therapeutic use; D015911:Sclerotherapy; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000627:therapeutic use*
chemical_list: D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D000068677:Sildenafil Citrate
keywords: Congenital neck mass; EXIT; Laryngeal mask airway; Lymphatic malformation; Prenatal imaging; Sildenafil