Early resection and reconstruction of head and neck masses in infants with upper airway obstruction

A newborn with respiratory distress and hydrocephalus caused by a giant mature teratoma

“…Survival after surgery is more than 80%, but since these tumors tend to be large, extensive neck dissection and multiple additional procedures are often necessary to achieve complete resection of the tumor. Difficulties in surgery can lead to a high level of mortality [7,12,13]. Mortality was unavoidable in the present case due to the impossibility of surgery; complete excision of the mass was not possible due to massive enlargement and invasion of neighbouring tissues, especially CNS and bone tissues of the head.…”

“…The intrauterine or neonatal mortality rate due to airway obstruction is about 80% [4,5]. Ex utero intrapartum treatment (EXIT) is the procedure of choice for treating fetuses with huge masses and suspected airway obstruction [4,12]. Establishment of adequate airway patency is crucial for preoperative preparation of patients with head and neck teratomas.…”

“…These lesions contain all three germ layers and may be composed of mature or immature elements. In the neonate, the presence of immature elements does not correlate with malignant potential, and most of these teratomas are benign [1,3,6,12,13].…”

Nasopharyngeal mature teratoma in the newborn

“…The head and neck region is the second most common site. Head and neck teratomas constitute 6-10% of all teratomas (4,5). Nasopharyngeal teratomas occur more rarely.…”

“…Early surgery is preferred in these babies. It has been reported that surgery performed in the early period shortens the period of intubation and the duration of hospital stay and intensive care unit stay (4). Surgically, it is aimed to remove the tumor completely.…”