2023 Volume 126 Issue 6 Pages 794-798
The EXIT (ex utero intrapartum treatment technique) is a technique used to remove tumors causing upper airway obstruction in the fetus and to secure the neonatal airway while maintaining oxygenation, without cutting the umbilical cord following delivery by caesarean section. Herein, we report performing tracheostomy using the EXIT technique for a suspected case of agnathia-otocephaly. Prenatal imaging revealed a defect of the mandible and deviation of the auricle, which was suspected as a manifestation of agnathia-otocephaly, and we selected the strategy of performing tracheostomy under EXIT. The EXIT procedure was discontinued 16 min after the start owing to fetal bradycardia; however, the tracheostomy to secure the airway was completed 4 min after umbilical cord amputation. As compared with normal tracheostomy, there were many restrictions for EXIT in this case, such as body position, surgical field, and inability to perform neck extension by mandibular elevation due to a defect of the mandible.
