Figure - available from: Pediatric Radiology
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Micrognathia. a T2-W MRI shows severe micrognathia in a 24-week fetus with multiple additional anomalies, including near complete aglossia which was confirmed postnatally. The inferior facial angle is defined by the intersection of two lines: one is drawn along the nasal root (perpendicular to the forehead) and the other connects the upper lip edge and mentum. b The jaw index in the same fetus is established by MR axial T2-W image by determining the anteroposterior measurement (solid line) from the symphysis mentis to the posterior border of the masseter muscles (indicated by dashed line) and correlating this measurement with the biparietal diameter. Note that because of the severity of micrognathia in this case, both the maxilla (arrows) and abnormally small mandible (arrowheads) can be seen in the axial plane
Source publication
Magnetic resonance imaging has proved to be an extraordinarily useful adjunct modality in assessment of the fetal face, oral cavity, head and neck because of its soft-tissue contrast, utility for acquiring more precise planar imaging and the inherent advantage of contrast provided by fluid-filled structures, including the oropharyngeal cavity, nasa...
Citations
... Antenatal counseling helps the parents to better understand the natural history, fetal intervention, and perinatal management of these tumors, which differ dramatically depending on their size and location [17]. While teratomas are among the most seen antenatally diagnosed tumors, masses located in the face and neck region represent a minority of cases, estimated at 10% -15% [18]. ...
Background: Congenital teratomas are relatively rare neoplasms, which occurs in about 1:20,000 to 1:80,000 births, and only 1.5% to 5% of which are neoplasm of the cervical. They can be diagnosed through ultrasound during pregnancy and, if not properly handled, have a high mortality rate. Airway compression is a secondary complication following mortality. Case report: A solid-cystic mass was identified in the anterior cervical region of a 30-week-old fetus during an ultrasound scan. EXIT (Ex-Utero Intrapartum Treatment)-to-airway procedure was performed by a multidisciplinary team composed of obstetricians, anesthesiologists, neonatologists and pediatric surgeons to remove the neoplasm. The procedure occurred upon delivery of the fetus, resulting in a positive outcome with neonatal survival. In this case, the fetus was in breech position, and, differently from the usual EXIT protocol, it had to be completely extracted before guaranteeing airway flow. Conclusion: Although congenital teratomas are a rare condition with complex treatment, it is possible to achieve a satisfactory outcome when adequate planning and protocol are established.
