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[The EXIT procedure: principles and application in congenital cervical teratomas].
Rev Laryngol Otol Rhinol (Bord). 2009; 130(3):193-8.RL

Abstract

INTRODUCTION

The ex utero intrapartum treatment (EXIT) procedure uses uteroplacental gas exchange after caesarean section for foetus oxygenation. This placental support allows establishing an airway in the newborn in case of obstruction. Maintenance of placental perfusion requires uterine relaxation. A halogenated agent is classically use while nitroglycerine is used in the modified EXIT procedure.

CASE REPORT

We present the case of a newborn with a giant thyroid teratoma diagnosed on ultrasound at 20 weeks' gestation. At 32 weeks' gestation, a modified EXIT procedure was performed. The EXIT was successful and newborn was operated on the following day. Currently, the child is 32-month-old, has no sequelae and benefits from thyroid hormone substitution.

DISCUSSION

The EXIT procedure allows managing airway obstruction, even when complex, at birth. Nevertheless, prolonged uterine relaxation increases the risk of flooding. Because of its short half-life, nitroglycerine reduces this risk. In this case report we chose the modified EXIT procedure because the mother was young and primipara and foetal prognosis was poor.

CONCLUSION

Currently, the EXIT procedure is the technique of choice in the management of a foetal cervical mass. An exhaustive preoperative foetal workup is necessary to choose the classical or modified EXIT procedure.

Authors+Show Affiliations

CHU A. Michallon, Clinique ORL, Pôle tête cou et chirurgie réparatrice, 38043 Grenoble cedex 9, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

fre

PubMed ID

20345078

Citation

Hitter, A, et al. "[The EXIT Procedure: Principles and Application in Congenital Cervical Teratomas]." Revue De Laryngologie - Otologie - Rhinologie, vol. 130, no. 3, 2009, pp. 193-8.
Hitter A, Piolat C, Jacquier C, et al. [The EXIT procedure: principles and application in congenital cervical teratomas]. Rev Laryngol Otol Rhinol (Bord). 2009;130(3):193-8.
Hitter, A., Piolat, C., Jacquier, C., Thong Vanh, C., Wroblewski, I., & Righini, C. A. (2009). [The EXIT procedure: principles and application in congenital cervical teratomas]. Revue De Laryngologie - Otologie - Rhinologie, 130(3), 193-8.
Hitter A, et al. [The EXIT Procedure: Principles and Application in Congenital Cervical Teratomas]. Rev Laryngol Otol Rhinol (Bord). 2009;130(3):193-8. PubMed PMID: 20345078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The EXIT procedure: principles and application in congenital cervical teratomas]. AU - Hitter,A, AU - Piolat,C, AU - Jacquier,C, AU - Thong Vanh,C, AU - Wroblewski,I, AU - Righini,C A, PY - 2010/3/30/entrez PY - 2009/1/1/pubmed PY - 2010/6/4/medline SP - 193 EP - 8 JF - Revue de laryngologie - otologie - rhinologie JO - Rev Laryngol Otol Rhinol (Bord) VL - 130 IS - 3 N2 - INTRODUCTION: The ex utero intrapartum treatment (EXIT) procedure uses uteroplacental gas exchange after caesarean section for foetus oxygenation. This placental support allows establishing an airway in the newborn in case of obstruction. Maintenance of placental perfusion requires uterine relaxation. A halogenated agent is classically use while nitroglycerine is used in the modified EXIT procedure. CASE REPORT: We present the case of a newborn with a giant thyroid teratoma diagnosed on ultrasound at 20 weeks' gestation. At 32 weeks' gestation, a modified EXIT procedure was performed. The EXIT was successful and newborn was operated on the following day. Currently, the child is 32-month-old, has no sequelae and benefits from thyroid hormone substitution. DISCUSSION: The EXIT procedure allows managing airway obstruction, even when complex, at birth. Nevertheless, prolonged uterine relaxation increases the risk of flooding. Because of its short half-life, nitroglycerine reduces this risk. In this case report we chose the modified EXIT procedure because the mother was young and primipara and foetal prognosis was poor. CONCLUSION: Currently, the EXIT procedure is the technique of choice in the management of a foetal cervical mass. An exhaustive preoperative foetal workup is necessary to choose the classical or modified EXIT procedure. SN - 0035-1334 UR - https://www.unboundmedicine.com/medline/citation/20345078/[The_EXIT_procedure:_principles_and_application_in_congenital_cervical_teratomas]_ L2 - https://medlineplus.gov/headandneckcancer.html DB - PRIME DP - Unbound Medicine ER -