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EXIT (Ex utero Intrapartum Treatment) in lymphatic malformations of the head and neck: Discussion of three cases and proposal of an EXIT-TTP (Team Time Procedure) list.

FRUSCA, Tiziana;NICOLAI, Piero;
2011-01-01
2011
2011
Nessuno
LS7_9 Health services, health care research
sì
2-s2.0-84855535474
WOS:000301008000005
Sì, ma tipo non specificato
Inglese
Internazionale
unico
20
27
8
22078744
Abstract OBJECTIVES: Ex utero Intrapartum Treatment (EXIT) is a technique to secure the fetal airway while oxygenation is maintained through utero-placental circulation. The aim of the study is to present three cases of fetal lymphatic malformation of the head and neck that required EXIT and to summarize EXIT details. METHODS: The cases were studied before the delivery and EXIT was planned with a multidisciplinary team. The key factors of EXIT are considered and the type, stage and clinical score of the three lymphatic malformations are defined. RESULTS: In the three cases of EXIT the time working on placental support to secure the airway was 9, 7, and 9min, respectively (from the hysterotomy to clamping the umbilical cord). Procedures performed on the airway were laryngo-tracheo-bronchoscopy in the first case, laryngoscopy and intubation in the second one, laryngoscopy, drainage of the lymphatic macro-cyst, and intubation in the third case. A sketching to detail the EXIT steps are presented: EXIT-Team Time Procedure list (EXIT-TTP list). Lymphatic malformations were classified as mixed (micro/macro-cystic) in two cases, and macro-cystic in one. de Serres Stage was IV, V and II. Therapy varied in the three neonates (surgery alone, surgery+Picibanil(®)+Nd-YAG, or Picibanil(®) alone). CONCLUSIONS: In case of prenatal suspicion of airway obstruction, EXIT should be planned with a multidisciplinary team. The EXIT-Team Time Procedure list (EXIT-TTP list), reviews the most critical phases of the procedure when different teams are working together. The type of lymphatic malformation, the anatomic location and the clinical score predict the outcome.
malformation head and neck
17
info:eu-repo/semantics/article
262
Stefini, S; Bazzana, T; Smussi, C; Piccioni, M; Frusca, Tiziana; Taddei, F; Tomasoni, G; Recupero, D; Cavazza, A; Villani, P; Nicolai, Piero; Eivazi, ...espandi
1 Contributo su Rivista::1.1 Articolo in rivista
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1.1 Articolo in rivista
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/102116
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