An Approach to Nasopharyngeal Mass in Newborns: Case Series and Systematic Literature Review.

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Rambam Maimonides Medical Journal Pub Date : 2022-01-27 DOI:10.5041/RMMJ.10463
Roee Noy, Liron Borenstein-Levin, Arie Gordin
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Abstract

Objective: Congenital nasopharyngeal masses (CNMs) are rare. Presenting symptoms vary, and the differential diagnoses cover a wide spectrum of possibilities. As it is uncommon, most examples discussed in literature are described as case reports or series. Guidelines on CNM patient management do not exist. In this study, we present two (2) cases of neonates with CNMs that were encountered at our tertiary center. Additionally, to best elaborate a comprehensive, case-based approach to CNM management, we offer an up-to-date, diagnosis-to-treatment review of current literature.

Methods: Case series and systematic literature review.

Results: Twenty-eight (28) studies are included since January 2000 to October 2021, with a total of 41 cases. Most common diagnosis was teratoma (78%). Female-to-male ratio was 2.5:1. Twenty percent of cases presented prenatally with polyhydramnios or elevated alpha-fetoprotein. Postnatally, the presenting symptoms most frequently encountered were respiratory distress (78%), oral mass (52%), and feeding difficulties (29%). Seventy-five percent of affected newborns showed symptoms within the first 24 hours of life. Forty percent of cases had comorbidities, especially in the head and neck region.

Conclusions: Congenital nasopharyngeal masses can be detected antenatally, or symptomatically immediately after birth. Airway protection is a cornerstone in the management. Selecting the right imaging modality and convening a multidisciplinary team meeting are important toward the planning of next steps/therapeutic approach. Typically, a transnasal or transoral surgical approach will be deemed sufficient to address the problem, with a good overall prognosis.

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新生儿鼻咽部肿块的诊断:病例系列和系统文献综述。
目的:先天性鼻咽部肿块(CNMs)是罕见的。表现出的症状各不相同,鉴别诊断涵盖了广泛的可能性。由于不常见,文献中讨论的大多数例子都以病例报告或系列描述。CNM患者管理指南尚不存在。在这项研究中,我们提出了在我们的三级中心遇到的两(2)例新生儿CNMs。此外,为了最好地阐述一个全面的、基于病例的CNM管理方法,我们提供了一个最新的、从诊断到治疗的文献综述。方法:采用病例法和系统文献法。结果:2000年1月至2021年10月共纳入28项研究,共41例。最常见的诊断是畸胎瘤(78%)。男女比例为2.5:1。20%的病例在产前表现为羊水过多或甲胎蛋白升高。出生后,最常见的症状是呼吸窘迫(78%)、口腔团块(52%)和喂养困难(29%)。75%的受感染新生儿在出生后24小时内出现症状。40%的病例有合并症,尤其是头颈部。结论:先天性鼻咽肿块可在产前发现,或在出生后立即出现症状。气道保护是管理的基石。选择正确的成像方式和召开多学科小组会议对于规划下一步/治疗方法非常重要。通常,经鼻或经口手术方法被认为足以解决问题,总体预后良好。
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来源期刊
Rambam Maimonides Medical Journal
Rambam Maimonides Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
6.70%
发文量
55
审稿时长
8 weeks
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