Neck

2016 ◽  
Vol 10 (3) ◽  
pp. 256-270
Author(s):  
Costin Berceanu
Keyword(s):  
Treatment Options ◽  
Late Pregnancy ◽  
First Trimester ◽  
Cystic Hygroma ◽  
Neck Mass ◽  
Tracheobronchial Tree ◽  
High Association ◽  
Tertiary Center ◽  
Fetal Goiter ◽  
Fetal Thyroid

ABSTRACT Cystic hygroma (CH) is the most frequently seen fetal neck mass on the first-trimester ultrasound (US). Overall prognosis is poor with a high association with chromosomal and structural anomalies. When diagnosed prenatally, fetal karyotyping and detailed US evaluation should be offered. Prenatal and postnatal surgical or nonsurgical treatment options are available. Fetal goiter (FG) and fetal thyroid masses are rare fetal conditions and may occur as part of a hypothyroid, hyperthyroid, or euthyroid state. Screening for FGs should be carried out in pregnancies of mothers with thyroid disease. If a FG is detected, a detailed US examination should be performed. Congenital high airway obstruction syndrome (CHAOS) is characterized by bilaterally enlarged lungs, flat or inverted diaphragms, dilated tracheobronchial tree, and massive ascites. It is usually a lethal abnormality. Fetuses with suspected CHAOS should be referred to a fetal medicine center able to perform ex utero intrapartum treatment (EXIT) delivery. Neck teratomas are associated with high mortality rates. Prenatal US diagnosis of cervical teratoma can be made at 15 and 16 weeks of gestation. Planning of delivery in a tertiary center allows the performance of EXIT. Lymphangioma of the neck usually diagnosed in late pregnancy could be traditionally referred to as CH, but there is a different prenatal history and outcome. How to cite this article Vladareanu R, Vladareanu S, Berceanu C. Neck. Donald School J Ultrasound Obstet Gynecol 2016;10(3): 256-270.

Iatrogenic fetal goiter. Conservative management and spontaneous resolution

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Margarita Alvarez de la Rosa ◽  
Olga Rosales Aedo ◽  
Ricardo Darias Garzón ◽  
Ana Isabel Padilla Pérez ◽  
Juan Mario Troyano Luque
Keyword(s):  
Conservative Treatment ◽  
Perinatal Asphyxia ◽  
Mass Effect ◽  
Neck Mass ◽  
Spontaneous Resolution ◽  
Anterior Neck ◽  
Case Presentation ◽  
Fetal Goiter ◽  
Fetal Thyroid ◽  
Intrauterine Treatment

AbstractObjectivesWe aim to report a case of a fetal goiter with postpartum spontaneous resolution. Fetal goiter can be secondary to maternal treatment and range from clinically asymptomatic or cause alterations in the fetus, from impaired swallowing to difficulty in vaginal delivery and even perinatal asphyxia due to the mass effect. The need for intrauterine treatment remains controversial.Case presentationWe present a case of fetal goiter with postpartum resolution. A 34-year-old multigravida presented to the emergency department with hiperemesis gravidarum at 10 weeks’ gestation. During evaluation for severe vomiting, Graves disease was diagnosed and treated with propylthiouracil. A routine ultrasound scan at 28 weeks gestation revealed a fetal anterior neck mass suggesting a fetal goiter. Cordocentesis showed fetal iatrogenic hypothyroidism. Conservative treatment was decided. Pregnancy concluded uneventful and the mass resolved spontaneously in the newborn.ConclusionsThe fetal thyroid gland is a structure that usually goes unnoticed during the process of prenatal diagnosis. In cases of maternal Graves diseases, fetal thyroid needs monitoring during pregnancy and conservative treatment is an option. Fetal goiter should be searched for secondary to thyroid alterations of the gravida, and in selected cases it can be managed without intrauterine treatment.

First trimester cystic hygroma colli: Retrospective analysis in a tertiary center

2018 ◽  
Vol 231 ◽  
pp. 60-64 ◽  
Author(s):  
Lore Schreurs ◽  
Lore Lannoo ◽  
Luc De Catte ◽  
Dominique Van Schoubroeck ◽  
Koenraad Devriendt ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
First Trimester ◽  
Cystic Hygroma ◽  
Tertiary Center

Abnormalities of the Fetal Head and Neck

2019 ◽  
Author(s):  
Ann McHugh ◽  
Fergal D. Malone
Keyword(s):  
Head And Neck ◽  
Treatment Options ◽  
Fetal Brain ◽  
3D Ultrasound ◽  
Cystic Hygroma ◽  
Neck Mass ◽  
Respiratory Compromise ◽  
Fetal Head ◽  
Neck Masses ◽  
Precise Diagnosis

Fetal head and neck abnormalities can be reliably assessed using a combination of 2D and 3D ultrasound. The accuracy of imaging depends to a large extent on gestational age. Magnetic resonance imaging (MRI) has evolved as a useful adjunct to ultrasound particularly for prenatal diagnosis of fetal head and neck anomalies. Intrauterine MRI improves diagnostic accuracy for fetal brain abnormalities and often leads to changes in management. MRI can be used to refine diagnoses in complex cases where ultrasound imaging is unclear or cannot determine the precise diagnosis. Some fetal neck masses can result in neonatal respiratory compromise. An ex utero intrapartum treatment (EXIT) procedure may be required if a neck mass is causing tracheal occlusion. Polyhydramnios can occur if there is oesophageal compression. When a fetal head and neck abnormality is detected, appropriate counselling regarding diagnosis, prognosis, and treatment options is crucial in allowing the patient to make an informed and timely decision in relation to pregnancy management. This review contains 14 figures, 3 tables, and 68 references. Key words: Intracranial abnormality, anencephaly, encephalocele, cystic hygroma, fetal neck mass, ventriculomegaly, fetal goiter, Craniosynostosis, Agenesis of the corpus callosum, Holoprosencephaly, EXIT

Abnormalities of the Fetal Head and Neck

2019 ◽  
Author(s):  
Ann McHugh ◽  
Fergal D. Malone
Keyword(s):  
Head And Neck ◽  
Treatment Options ◽  
Fetal Brain ◽  
3D Ultrasound ◽  
Cystic Hygroma ◽  
Neck Mass ◽  
Respiratory Compromise ◽  
Fetal Head ◽  
Neck Masses ◽  
Precise Diagnosis

Fetal head and neck abnormalities can be reliably assessed using a combination of 2D and 3D ultrasound. The accuracy of imaging depends to a large extent on gestational age. Magnetic resonance imaging (MRI) has evolved as a useful adjunct to ultrasound particularly for prenatal diagnosis of fetal head and neck anomalies. Intrauterine MRI improves diagnostic accuracy for fetal brain abnormalities and often leads to changes in management. MRI can be used to refine diagnoses in complex cases where ultrasound imaging is unclear or cannot determine the precise diagnosis. Some fetal neck masses can result in neonatal respiratory compromise. An ex utero intrapartum treatment (EXIT) procedure may be required if a neck mass is causing tracheal occlusion. Polyhydramnios can occur if there is oesophageal compression. When a fetal head and neck abnormality is detected, appropriate counselling regarding diagnosis, prognosis, and treatment options is crucial in allowing the patient to make an informed and timely decision in relation to pregnancy management. This review contains 14 figures, 3 tables, and 68 references. Key words: Intracranial abnormality, anencephaly, encephalocele, cystic hygroma, fetal neck mass, ventriculomegaly, fetal goiter, Craniosynostosis, Agenesis of the corpus callosum, Holoprosencephaly, EXIT

scholarly journals Pathology of the Fetal Neck

2012 ◽  
Vol 6 (1) ◽  
pp. 55-65
Author(s):  
Mona Zvanca ◽  
Cristian Andrei ◽  
Radu Vladareanu
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Neural Tube ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Point Of View ◽  
Antithyroid Drugs ◽  
Fetal Goiter ◽  
Fetal Thyroid ◽  
Structural Anomalies

ABSTRACT Fetal neck is the site of important pathological changes, related to genetic, cardiovascular, lymphatic, endocrine systems. Among the main neck pathology are fetal hygroma, goiter, teratoma/sarcoma, hemangioma/lymphangioma. Posterior anomalies of the fetal neural tube, such as occipital myelomeningocele or iniencephaly may also be included in this area. Fetal hygroma is the main pathology, probably related to abnormal development of the lymphatic drainage system. There is a large spectrum of the disease, from enlarged nuchal translucency to generalized edema. Enlarged nuchal translucency is often associated with aneuploidy, particularly trisomy 21 and Turner syndrome (monosomy X). However, the pathophysiology is different for the two aneuploidies. On the diagnostic side, cystic hygromas consist of large single or multilocular fluid-filled cavities, which are usually easily identified during first trimester ultrasound examination. About one-third of euploid fetuses with first trimester septated cystic hygromas have major structural anomalies. In contrast, structural anomalies are detected in only 4 to 10% of euploid fetuses with enlarged nuchal translucency. Enlargement of fetal thyroid gland is accompanied by increased or decreased level of thyroid hormones (hyper or hypothyroidism), but the thyroid function may also be normal. The physiopathology of fetal and neonatal goiter is complex. Causes of fetal goiter include inborn errors of thyroid hormone production, transplacental passage of maternal antibodies, maternal ingestion of antithyroid drugs and other goitrogens, thyroid tumors. Detection of the fetal goiter is facilitated by the associated maternal history, present in most of the cases. By definition, goiter means enlargement of the thyroid gland above the 95th centile of the normal range. Reliable and objective data about fetal thyroid function involves an invasive testing. Teratomas are large mixed tumors arising from the neck region. Teratomas are cystic, semicystic or solid tumors. They develop from all three germ cell layers. Cervical teratomas are detected antenatally in most cases, as they are large size tumors. Hemangiomas and lymphangiomas are tumors derived from the endothelial tissue of blood vessels or lymphatic vessels. They may develop anywhere in the body, but in the antenatal life and the first years they show a predisposition for the head, neck and axillar area. Regarding the occipital encephalocele and iniencephaly, even though they represent major anomalies that affect he cervical and cephalic area, from a developmental point of view they are part of the neural tube defects spectrum and should be considered as such especially from a prognosis point of view. How to cite this article Vladareanu R, Zvanca M, Andrei C. Pathology of the Fetal Neck. Donald School J Ultrasound Obstet Gynecol 2012;6(1):55-65.

A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

2021 ◽  
pp. 000348942199503
Author(s):  
Jerome Zhiyi Ong ◽  
Alex Chengyao Tham ◽  
Jian Li Tan
Keyword(s):  
Systematic Review ◽  
Botulinum Toxin ◽  
Traumatic Event ◽  
Botulinum Toxin Injection ◽  
Treatment Options ◽  
Neck Mass ◽  
Good Prognosis ◽  
Common Symptom ◽  
Management Options ◽  
Omohyoid Muscle

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition. Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020. Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed. Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively. Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

Episodic versus Chronic Dizziness: An Analysis of Predictive Factors

2021 ◽  
pp. 000348942110254
Author(s):  
Eric J. Formeister ◽  
Ricky Chae ◽  
Emily Wong ◽  
Whitney Chiao ◽  
Lauren Pasquesi ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Treatment Options ◽  
Depression And Anxiety ◽  
Imaging Studies ◽  
Comorbid Depression ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Chronic Dizziness ◽  
Associated Symptoms ◽  
History Of

Objectives: To elucidate differences in demographic and clinical characteristics between patients with episodic and chronic dizziness. Methods: A cross-sectional, observational study of 217 adults referred for dizziness at 1 tertiary center was undertaken. Subjects were split into a chronic dizziness group (>15 dizzy days per month) and an episodic dizziness group (<15 dizzy days per month). Results: 217 adults (average age, 53.7 years; 56.7% female) participated. One-third (n = 74) met criteria for chronic dizziness. Dizziness handicap inventory (DHI) scores were significantly higher in those with chronic dizziness compared to those with episodic dizziness (53.9 vs 40.7; P < .001). Comorbid depression and anxiety were more prevalent in those with chronic dizziness (44.6% and 47.3% vs 37.8% and 35.7%, respectively; P > .05). Abnormal vestibular testing and abnormal imaging studies did not differ significantly between the 2 groups. Ménière’s disease and BPPV were significantly more common among those with episodic dizziness, while the prevalence of vestibular migraine did not differ according to chronicity of symptoms. A multivariate regression that included age, sex, DHI, history of anxiety and/or depression, associated symptoms, and dizziness triggers was able to account for 15% of the variance in the chronicity of dizziness (pseudo- R2 = 0.15; P < .001). Conclusions: Those who suffer from chronic dizziness have significantly higher DHI and high comorbid rates of depression and anxiety than those with episodic dizziness. Our findings show that factors other than diagnosis alone are important in the chronification of dizziness, an observation that could help improve on multimodal treatment options for this group of patients.

Prenatal sonographic diagnosis of Cantrell's pentalogy with cystic hygroma in the first trimester

1998 ◽  
Vol 26 (8) ◽  
pp. 409-412 ◽  
Author(s):  
Yao-Yuan Hsieh ◽  
Chien-Chung Lee ◽  
Chi-Chen Chang ◽  
Horng-Der Tsai ◽  
Tai-Yen Hsu ◽  
...  
Keyword(s):  
First Trimester ◽  
Cystic Hygroma ◽  
Sonographic Diagnosis ◽  
Cantrell's Pentalogy

Karyotype and outcome of fetuses diagnosed with cystic hygroma in the first trimester in relation to nuchal translucency thickness

2006 ◽  
Vol 26 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Richard Kharrat ◽  
Masami Yamamoto ◽  
Joelle Roume ◽  
Sophie Couderc ◽  
Francois Vialard ◽  
...  
Keyword(s):  
First Trimester ◽  
Nuchal Translucency ◽  
Cystic Hygroma

scholarly journals Pregnancy- and lactation-associated osteoporosis with vertebral fractures: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ying Qian ◽  
Lei Wang ◽  
Lili Yu ◽  
Weimin Huang
Keyword(s):  
Back Pain ◽  
Vertebral Fractures ◽  
Data Extraction ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
Late Pregnancy ◽  
Mean Value ◽  
Thoracolumbar Region ◽  
Pregnancy And Lactation ◽  
Z Scores

Abstract Background To review, analyze and characterize the pregnancy and lactation-related osteoporosis (PLO) with vertebral fractures based on the extraction data in the previous studies. Methods A comprehensive literature search of electronic databases including the PubMed, Embase and Web of Science was conducted from January 1st,1990 to December 1st, 2020. The enrolled data were pooled to analyze the baseline characteristics, clinical features, risk factors and treatment options. Results A total of 65 articles with 338 cases were enrolled for data extraction. The enrolled cases aged from 19 to 47 years, with a mean value of 35.7 years old. The average body mass index (BMI) was 22.2 kg/m2 ranged from 16.0 to 39.0 kg/m2. Of the 173 cases, 149 cases with vertebral fractures occurred in the first pregnancy, 19 cases in the second pregnancy, four cases in the third pregnancy and one case in the fourth pregnancy. Up to 91.5% of the back pain occurred within the last 3 months of pregnancy and the first 3 months after delivery. The most involved vertebral levels were L2, L1 and T12 accounting for 32.6% of all the fractures. The average fracture numbers were 4.4 levels per patient. The lumbar Z-scores were mostly recorded with a mean value of − 3.2 ranged from − 7.8 to 0. Conclusions PLO with vertebral fractures is a rare clinical entity, which is more likely to occur in older and thinner pregnant women. Back pain is the clinical complaint and mostly occurs in the late pregnancy and early lactation periods. Most vertebral fractures appear in the first pregnancy but it can occur in any time of pregnancy. Thoracolumbar region is the mostly involved region. As compared with postmenopausal osteoporotic fractures, PLO usually has multiple levels fractures. Bisphosphonates are the most widely used treatment so far, however, many factors need to be taken into account to decide which drug to choose in PLO and further studies are necessary for clear recommendation in the future.

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