1 - Otorrinolaringologia e Cirurgia da Cabeça e do Pescoço, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central
2 - Otorrinolaringologia e Cirurgia da Cabeça e do Pescoço, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central
3 - Otorrinolaringologia e Cirurgia da Cabeça e do Pescoço, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central
- Poste - 124 ème Congrès de la Société Française d’ORL et de Chirurgie de la Face et du Cou, 6 a 8 de outubro de 2018, Palais de Congrés de Paris, Paris
Resumo:
Introduction: A wide variety of congenital nasal lesions can present to clinical attention due to airway obstruction, the presence of a mass or cosmetic deformity including glial heterotopia and teratomas.
Aim: Analyse the signs and symptoms of patients with congenital nasal and nasopharyngeal masses (CNNM), the medical and surgical treatment and final outcomes.
Material and Methods: A retrospective review of all patients with the diagnosis of CNNM between January and December 2017 was performed.
Results: We reported two patients with CNNM. Case 1 was a newborn girl with respiratory distress, shortness of breath, cyanosis and apnea who was intubated. The examination showed a nasopharyngeal mass. A Magnetic Resonance Imaging (MRI) showed a cystic lesion with epicenter in the nasopharynx with anterior communication with choanas and inferiorly until the plane of the valleculae. Transoral endoscopic excision of nasopharyngeal mass was performed and the histopathology was consistent with hairy polyp. Case 2 was a four months boy with left nasal obstruction, the examination showed a firm, pink and noncompressible mass in the anterior half of the left nasal cavity. A MRI showed an expansive lesion located in the nasal vestibule and anterior segment of the nasal fossa on the left, extending through an isthmus to the region of the cecum foramen without presenting macroscopic continuation with the intracranial structures. The tumor was completely removed by endoscopic endonasal surgery. Histologic sections revealed ectopic glial tissue. There were no complications in the early postoperative period in both cases and, with mean follow-up time of 9 months, the children has asymptomatic and no signs of recurrence of the disease.
Conclusions: The CNNM generally require early excisions to avoid complications of infection, airway obstruction and nutritional compromise. These lesions may cause complete neonatal airway obstruction and management may involve prenatal diagnosis. Intranasal masses with no intracranial communication can be removed by endoscopic endonasal surgery. Usually, transoral resection is possible to remove nasopharyngeal masses and may be aided by the use of angled telescopes.
Palavras Chave: congenital nasal and nasopharyngeal masses; endoscopic endonasal surgery