Arch Plast Surg.  2021 Sep;48(5):518-523. 10.5999/aps.2021.00318.

Surgical management of palatal teratoma (epignathus) with the use of virtual reconstruction and 3D models: a case report and literature review

Affiliations
  • 1Plastic, Aesthetic and Reconstructive Surgery Service, University Hospital “Dr. José Eleuterio González”, Faculty of Medicine, Autonomous University of Nuevo Leon, Monterrey, Mexico
  • 2Faculty of Medicine, Autonomous University of Nuevo Leon, Monterrey, Mexico
  • 3Pediatric Surgery Service, University Hospital “Dr. José Eleuterio González”, Faculty of Medicine, Autonomous University of Nuevo Leon, Monterrey, Mexico
  • 4Laboratory of Tissue Engineering, Faculty of Medicine, University of Colima, Colima, Mexico

Abstract

Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

Keyword

Teratoma / Pediatric plastic surgery / 3D reconstruction computed tomography / Improved surgical approach
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