Oral Teratoma in a Neonate - Anesthetic Challenge

Congenital teratoma of oral cavity in a neonate is a rare condition associated with compromised airway and challenges anesthesiologist in airway mamagement. We report a case of neonate with multiple oral teratoma, cleft palate and bifid tongue who presented with respiratory distress. A one day old 2.8 kg female baby with multiple oral mass protruding from mouth, cleft palate and bifid tongue was scheduled for excision of mass. Injection Atropine 0.01mg/kg was given through already secure i. v. line to limit secretions. Oxymetazoline nasal drop were put in both nostrils and then patency of right nare was checked by nasogastric feeding tube. A bigger size mask was selected to ensure proper bag and mask ventilation. Anesthesia was induced by sevoflurane and oxygen in gradual incremental concentration. A check laryngoscopy was done to visualize glottis. As glottis was visible injection succinylcholine 1.5 mg/kg was given and nasal intubation was done with the help of magills forcep from right nostril. Injection Fentanyl 2 microgram/kg was given and anesthesia was maintained with oxygen, nitrous oxide and sevoflurane. Recovery was uneventful after the surgical procedure and extubation was done.