[Neonatal and surgical management of a prenatally diagnosed enteric sublingual cyst causing airway obstruction].

Abstract

The prenatal detection and neonatal definitive management of congenital expansive lesions affecting the oral cavity – due to potential airway compromise and feeding difficulties – represent a complex, multidisciplinary task requiring high-level professional and technical expertise. In this case report, we present the urgent management and subsequent definitive surgical excision of a cystic mass causing severe oral obstruction in a neonate, identified prenatally by ultrasound examination. The fetus was delivered at 38 weeks of gestation via elective cesarean section with a birth weight of 3400 g. Due to a protruding cyst approximately 6 × 6 cm in size arising from the oral cavity, immediate airway management was performed using a Mayo tube, along with multiple punctions of the cystic mass. This intervention successfully secured the airway. The infant was fed via a nasogastric tube. Following MR imaging, the cyst originating from the sublingual area was completely excised in toto on day 8 of life. The postoperative period was uneventful. Oral feeding was gradually initiated two weeks after surgery. Histopathological examination confirmed an enteric duplication cyst, a rare occurrence in the sublingual region. During an 11-month follow-up period, no signs of recurrence were observed. The infant experienced no breathing or feeding difficulties, and growth in weight and length was appropriate for age. Prenatal care is essential for detecting fetal congenital anomalies. In these cases with potential to cause respiratory compromise, expertise in emergency airway management during planned cesarean delivery is critical. Definitive neonatal treatment of oral cavity masses causing respiratory or feeding difficulties can shorten hospitalization and minimize the physical and psychological burden associated with repeated surgeries. Orv Hetil. 2025; 166(36): 1431–1437.