Surgical Repair of Unidirectional Palatopharyngeal Epignathus: Case Report and Review of Literature

Oral teratoma in a neonate: A case report of anesthetic challenge

Congenital teratoma of oral cavity in a neonate is a rare condition associated with compromised airway and challenges anesthesiologist in airway management. In this report, we describe a scenario of neonate with multiple oral teratoma, cleft palate, and bifid tongue who presented with respiratory distress for surgical excision of mass. The compromised airway can be successfully managed by appropriate prior planning and effective communication between anesthesiologist and surgical team.

Partial midfacial duplication

A case of craniofacial duplication is presented. Details on this rare form are described, and its treatment is discussed with brief review of the pertinent literature. We excised the duplicate maxilla and also discovered bilateral macrostomia. A year later, a mass appeared again. By CT scan, we found that there was a mass in the skull base extruding to the superior wall of cavitas pharyngis. The mass below the sphenoid bone and the ethmoid bone connected with the skull base. CT scan also showed malformation of the first cervical vertebra and odontoid process had bifurcated. Once again, we excised the mass and found a cranial meningocele on the skull base, repaired the palate cleft, and closed the cerebral meningocele. The patient had a palate fistula after operation. A year later, the palate fistula and macrostomia were repaired. We think the patient should be operated on immediately after she was born so that we could relieve the dyspnea; furthermore, by one well-planned operation, we could repair the palate cleft and other deformity just after we excised the mass.

Functional reconstruction of epignathus with cleft palate using part of a mature teratoma

Epignathus is an extremely rare, benign, congenital teratoma that arises from the oral cavity. When treating epignathus with cleft palate, it is particularly important to consider velopharyngeal function and maxillary growth after surgical repair. The case of an infant with a complete cleft palate and a large mass, histologically diagnosed as a mature teratoma, that protruded from the right soft palate is described. At 8 months of age, a double-opposing Z-plasty was performed using a part of the tumor over the right soft palate that had been left at the time of primary excision at 3 months of age for an epignathus protruding from the mouth. Though all that could be done was suture tumor tissue on the right side and the left hypoplastic levator veli palatine muscle using the double-opposing Z-plasty, velopharyngeal function and maxillary growth were good at 10 years of age.

Congenital nasopharyngeal teratoma with a cleft palate: case report and a 7 year follow up

Teratomas are benign tumors containing cells from ectodermal, mesodermal and endodermal layers. They occur in about 1 in every 4,000 births and most commonly in the sacrococcygeal region, followed by the ovaries. Congenital epignathus teratomas are rare embryological neoplasms localised in the region of head and neck. An epignathus is found in approximately 1:35,000-1:200,000 live births. This accounts for 2-9% of all teratomas. Size and location of the neoplasm in the oronasopharynx is variable. Teratomas are partly undiagnosed at the time of birth. They may exist with an intracranial extension or as small polyps. Large epignathi can lead to difficult management during and after birth. We present a case of a female infant with a combination of nasopharyngeal teratoma and a cleft palate with successful multidisciplinary management via a staged surgical approach. The epignathus presented as a huge mass extending out of the mouth of the infant girl. On the day of birth debulking of the extraoral portion of the tumor, followed by intraoral extirpation and cleft palate repair at a later stage, was performed. The results of the histopathological examination confirmed diagnosis of a congenital teratoma.

Hemipalate deformity caused by a teratoma

Congenital intraoral tumors derived from embryological germ layers are very rare. These lesions include teratomas, dermoids, epignathi, and teratoid tumors. These embryological neoplasms may interfere with normal development and elevation of the palatal shelves, resulting in a cleft palate. We report the case of a patient with an intraoral teratoma associated with a hemipalate deformity and describe the treatment that was carried out. The classification and sometimes the confusing terminology associated with these lesions are discussed, as are the principles of managing them.

Transpalatal endoscopic endonasal resection of a giant epignathus skull base teratoma in a newborn. Case report

Teratomas are neoplasms composed of tissues from all three germ layers with varying degrees of differentiation. They are most commonly found in the sacrococcygeal and gonadal regions and rarely occur in the head and neck region. A teratoma is termed "epignathus" when it arises from the skull base or hard palate and is located in the oral cavity. The authors describe a case of a giant epignathus teratoma originating in the skull base of a neonate, extending bilaterally via two pedicles throughout the hard palate and protruding through the oral cavity. The tumor was completely resected using a transpalatal endoscopic endonasal approach. The excised tumor proved to be an immature teratoma with well-differentiated yolk sac elements. At the 1-year follow-up the patient showed no evidence of tumor recurrence and the child remains neurologically intact. This report demonstrates the use of a transpalatal endonasal corridor in a preterm infant. This approach provided an ample corridor into the ventral skull base without the need for external excisions and/or disruption of osseous elements.

Giant intracranial teratoma with epignathus in a neonate. Case report and review of the literature

Epignathus, a congenital oropharyngeal teratoma, is a rare clinical entity with variable clinical outcomes described in the literature. Even fewer cases of epignathus with intracranial extension have been reported, all with poor outcomes. In this manuscript, the authors present a case of epignathus with intracranial extension, emphasizing clinical presentation, imaging findings, a staged surgical approach, multidisciplinary management, and outcome.