Associate Professor Albany Medical College Albany, New York, United States
Disclosure(s):
Aaron Zlatopolsky, MD: No relevant relationships to disclose.
Lara Reichert, MD MPH: No relevant relationships to disclose.
Introduction: At the end of this presentation, participants will understand a complex and rare case of a benign Nasopharyngeal Dermoid requiring surgical excision in a three-day-old. To our knowledge, this is the youngest patient that has ever undergone a tonsillectomy.
Methods: This presentation is a case report and review of literature looking at a single case which occurred in November of 2022. We describe a nasopharyngeal dermoid causing airway obstruction in a two-day-old female born at full term. The patient underwent surgical intervention at Albany Medical Center. Intra-operative photographs were utilized to document our findings.
Results: A one-day-old female was transferred to Albany Medical Center in respiratory distress. She was born at full term with no gestational complications. She was found to have increased work of breathing with oxygenation below 88%. Her respiratory status improved when she was placed on her side while on continuous positive airway pressure (CPAP). When examined, she was noted to have an oropharyngeal mass which extruded from her oral cavity. She was subsequently taken to the operating room where an endoscopic evaluation was performed using a rigid Hopkins telescope. A 4cm Mass with tongue-like tissue appearance was observed to be emanating from the left pharyngeal wall, soft palate and left palatine tonsil. Bovie cautery was utilized to excise the lesion from its attachments. The mass was noted to be adherent to the palatine tonsil and the decision was made to excise the tonsil with the lesion. The patient tolerated the procedure well and did not require any further airway support. The mass was found to be a benign nasopharyngeal dermoid tumor.
Conclusions: This report demonstrates a case of rare pathology arising from the palatine tonsils and other oropharyngeal structures causing airway obstruction. This resulted in the need for a unilateral tonsillectomy. To our knowledge, this is the youngest patient to ever undergo a tonsillectomy.
