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Inicio Acta Otorrinolaringológica Española EXIT Procedure in the Management of Severe Foetal Airway Obstruction. The Paedia...
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Vol. 58. Issue 10.
Pages 487-490 (January 2007)
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Vol. 58. Issue 10.
Pages 487-490 (January 2007)
EXIT Procedure in the Management of Severe Foetal Airway Obstruction. The Paediatric Otolaryngologist's Perspective
Procedimiento EXIT en el manejo de fetos con severo compromiso respiratorio. La perspectiva del otorrinolaringólogo pediátrico
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Marc Pellicera,
Corresponding author
mpellicer@vhebron.net

Correspondence: Sección de Otorrinolaringología Pediátrica. Hospital Universitari Vall d’Hebron. Pg. Vall d’Hebron, 119-129. 08035 Barcelona. España.
, Félix Pumarolaa, José Luis Peirób, Vicente Martínez Ibáñezb, Juan Antono García Vaquerob, Elena Carrerasc, Susana Manriqued, Joan Vinzoe, Enrique Perellóf
a Sección de Otorrinolaringología Pediátrica, Hospital Universitario Vall d’Hebron, Barcelona, Spain
b Servicio de Cirugía Pediátrica, Hospital Universitario Vall d’Hebron, Barcelona, Spain
c Servicio de Obstetricia, Hospital Universitario Vall d’Hebron, Barcelona, Spain
d Servicio de Anestesiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
e Servicio de Neonatología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
f Servicio de Otorrinolaringología, Hospital Universitario Vall d’Hebron, Barcelona, Spain
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The ex-utero intrapartum treatment (EXIT) procedure is a technique designed to allow partial foetal delivery via caesarean section with establishment of a safe foetal airway by either intubation, bronchoscopy, or tracheostomy while foetal oxygenation is maintained through utero-placental circulation. The most common indication for the EXIT procedure is the presence of foetal airway obstruction, which is usually caused by a prenatal diagnosed neck mass. We report 3 cases of head and neck tumours with airway obstruction treated by means of EXIT and with different solutions in the management of the airway. With the involvement of Paediatric Otolaryngologists in EXIT, new indications and select variations from the standard EXIT protocol should be considered.

Key words:
Ex-utero intrapartum treatment (EXIT)
Cervical teratoma
Epignathus
Cervical lymphangioma
Foetal surgery

El ex-utero intrapartum treatment (EXIT) es una técnica diseñada para permitir un parto fetal parcial a través de una cesárea y el establecimiento de una vía aérea fetal segura a través de intubación, broncoscopia o traqueotomía mientras la oxigenación fetal se mantiene a través de la circulación uteroplacentaria. La indicación más frecuente de EXIT es la obstrucción de la vía aérea fetal, habitualmente causada por una masa cervical diagnosticada prenatalmente. Presentamos 3 casos de tumoraciones de cabeza y cuello con compromiso de la vía aérea tratados mediante EXIT y con diferentes soluciones en el manejo de la vía aérea. Con la implicación de los otorrinolaringólogos pediátricos en el EXIT, aparecerán nuevas indicaciones y podrán valorarse variaciones del protocolo básico.

Palabras clave:
Tratamiento ex utero intrapartum (EXIT)
Teratoma cervical
Epignatus
Linfangioma cervical
Cirugía fetal

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