Abstract UENPS.123A multidisciplinary team approach for management of congenitalcervical teratoma

Francisco Jimenez Parrilla⁎, Juan Manuel Nuñez Solis,Antonio Perez Sanchez, Antonio Losada Martinez2JT30PR, 2JT30PR

Background and aim

Congenital cervical teratomas are rare, representing 3% of teratomas inchildhood. Although mostly benign, they are associated with a high mortalityrate due to respiratory distress and require immediate surgical excision.

Materials and methods

The diagnosis is usually suggested on the physical examination. Theimaging investigation is essential for the proper diagnosis and preoperativeplanning. Congenital cervical teratomas are associated with a high rate ofperinatal mortality due to airway obstruction. We describe a multi-disciplinary management of a neonate with prenatal diagnosis of giantcervical teratoma. We report the course and outcome of a pregnancyinvolving a giant fetal neck teratoma which was diagnosed at 23 weeks ofgestation.

Results

We describe a multidisciplinary management of a neonate with prenataldiagnosis of giant cervical teratoma. We report the course and outcome of apregnancy involving a giant fetal neck teratoma which was diagnosed at23 weeks of gestation. Sonographic surveillance of the fetal neck revealedcontinuing growth of the tumor with development of polyhydramnios An‘operation on placenta support’ (OOPS) technique was carried out duringdelivery, and intubation was successfully performed with no perinatal anoxicdamage. Postnatal computed tomography and angiography showed a hugeteratoma covering both sides of the neck with agenesis of the big bloodvessels on the left side. A rapidly developing third space phenomenon anddeterioration in the general status of the neonate, required early surgicalintervention. Pathologic examination confirmed the diagnosis indicatingimmature teratoma with no signs of malignancy.

Conclusions

This report confirms the efficacy of a multidisciplinary team-approachand the usefulness of the OOPS technique in prenatally diagnosed cervicalmasses. It emphasizes the extraordinary characteristics of this case, mainlythe development of a third space phenomenon and the unusual surgicalfindings.

doi:10.1016/j.earlhumdev.2008.09.139

Abstract UENPS.124Bulgarian–Italian experience with audiological neonatal screening

Dilyana Vichevaa, Penka Petleshkova⁎,b, Marco BarbiericaMedical University, Plovdiv, BulgariabPediatric Hospital, Pazardzhik, BulgariacUniversity of Genoa, Genoa, Italy

Background and aim

The aim of the study has been the development of a universal screeningfor congenital hearing loss in the neonatal period in Europe.

Materials and methods

1021 infants (both healthy and sick new-borns) were screened forcongenital hearing loss between September 2000 and January 2008. Allnewborns were screened primarily with otoacoustic emission and otoacous-tic products of distortion as first stage screening; with automated auditorybrainstem response audiometry and auditory steady state responses as asecond stage screening for those who failed the otoacoustic emission test.

Results

Hearing loss was confirmed in 11 patients (5 unilateral and 6 bilateral).The incidence of congenital hearing loss was 0.84% in presumed healthyinfants and 2.10% in infants admitted to the intensive care nursery.

Conclusions

Several protocols are available for universal newborn hearing screeningprograms: although otoacoustic emission is quicker and easier to performthan automated auditory brainstem response audiometry, otoacousticemission is affected by external ear wax or fluid. To avoid misinterpretation,we consider important combined measurements of otoacoustic emissionsand otoacoustic products of distortion with automated auditory brainstemresponse audiometry and auditory steady state responses. Screening forcongenital hearing loss can be carried out with a very low rate of referralsand a low rate of false positive tests, particularly if there is access tootoacoustic emission as well as automated auditory brainstem responsetesting and auditory steady state responses.

doi:10.1016/j.earlhumdev.2008.09.140

Abstract UENPS.125Characterization of an animal model of neonatal hypoxic–ischemic braininjury by targeted quantitative metabolomics

Vera Neubauer⁎,b, Denise Sonntaga, Matthias KellercaBIOCRATES Life Science AG, Innsbruck, AustriabBIOCRATES Life Science AG, Innsbruck, Medical University, Innsbruck, AustriacBIOCRATES Life Science AG, Innbruck, Austria, Medical University Erlangen,Germany

Background and aim

Current research to develop neuroprotective strategies in perinatalbrain injury is performed by the use of animal models. Key contributors tobrain injury are HI and inflammation leading to neuronal necrosis andapoptosis. These processes are initiated by metabolites of e.g. theeicosanoid pathway and excitotoxic neurotransmitters, but also by specificlipid signaling molecules. Current analytical methods assessing the effectof neuroprotective strategies are limited by certain weaknesses inquantification of effects, duration of method and by the selection of littlenumber of outcome parameters assessed. Targeted quantitative metabo-lomics in brain and plasma are able 1) to characterize these animalsmodels on a functional level 2) thus to gain new knowledge of thepathophysiology as a fundament for drug development 3) to monitortherapeutic effects and side-effects and 4) to develop biomarkers of brain

Abstracts S55