Nasopharyngeal brain heterotopia – A cause of upper airway obstruction in infancy

Abstract

The finding of mature neuroglial tissue in a mass from the head and neck region of a child raises four differential diagnostic possibilities: teratoma, encephalocelc, glioma, and heterotopic brain tissue. We present a review of the literature and discuss the clinical, radiographical, and pathological features of a rare nasopharyngeal brain heterotopia in an infant causing upper airway obstruction.

Neuroglial heterotopia causing neonatal airway obstruction: presentation, management, and literature review

“…This includes all cases involving the nasopharynx, oropharynx, or parapharyngeal space. Of these, 12 cases were localized to the nasopharynx, and all manifested as neonatal airway obstruction [1,2,4,5,10,16,[18][19][20][21]25].…”

“…MRI assists in discerning any intracranial connection through skull base defects [5,22,23]. Neuroglial heterotopias have magnetic resonance characteristics similar to normal brain tissue in all pulse sequences [5,19]. Cystic fluid-filled components are isointense with the intracranial CSF spaces [4,5,19].…”

“…Cystic fluid-filled components are isointense with the intracranial CSF spaces [4,5,19]. CT or magnetic resonance cisternography can be used to gain additional information regarding communication with the subarachnoid space [4,5,19].…”

“…While most commonly found in the nasal cavity, heterotopic neuroglial tissue has been found in the scalp, orbit, middle ear, pharynx, palate, tongue, and neck [5,13]. Approximately 12 cases of neuroglial heterotopias in the nasopharynx have been reported in the English literature [1,2,4,5,10,16,[18][19][20][21]25]. A case is discussed of neuroglial heterotopia in the nasopharynx manifesting as airway obstruction in the newborn.…”

Ectopic Secreting Choroid Plexus in the Oropharynx

“…Clini cal features are a function of the size and location of the mass, but in the neonate they usually include respiratory distress or feeding difficulties [5,7,15,[17][18][19]22]. As sociated congenital anomalies are frequently present, and include micrognathia [15], plexus excavatum [15,22], cleft palate [13,15,18,22] and unilateral choanal atresia [22].…”