Journal of Neonatal Surgery is a peer-reviewed and open-access electronic journal. Only a few journals are being published on Neonatal Surgery especially from a developing country, which justifies the need of a new journal on this subject.

Airway management in neonates is difficult because of the risk of rapid hypoxia. It presents a challenge even for an experienced anesthesiologist. Oral tumors in neonates can obstruct the airway or feeding problems in the newborn. Surgical excision is the treatment of choice but these tumors can seriously worsen the conditions of intubation. To surmount these difficulties, a particular multidisciplinary approach and special precautions are needed. We describe the airway management and precautions taken in the anesthesia for surgical removal of a case of large congenital palate teratoma associated with a wide cleft palate in a 25-day-old girl. Impossible intubation was predicted on magnetic resonance imaging. The difficult airway management cart as well as an otorhinolaryngologist skilled in performing emergency tracheostomies in neonates were available. The patient was intubated by conventional laryngoscopy under sevoflurane inhalation anesthesia. The tumor was successfully resected. This case poses a challenge for managing the airway because of the possibility of obstruction of the airway and the difficulty of the airway that radiological exams have allowed us. So, a multidisciplinary team effort is needed for successful neonatal airway management.

A 4-month-old girl was referred to the dermatology department for bilateral branchial cleft fistula. She was a preterm baby. There was no history of consanguinity. A physical examination found a bilateral cleft lip (Figure 1), and a bilateral second branchial cleft fistula with skin discharge. Further examination revealed bilateral aplasia of the overlying skin with a hemangioumatous aspect (Figure 2). Low set ears with posterior rotation were present. There was also bilateral supra-auricular fissures (Figure 2). Ophtalmological workup revealed strabismus and nasolacrimal duct stenosis with recurrent dacrocystitis. Objective audiometry showed mixed bilateral hearing loss. Because branchio-oculo-facial syndrome (BOFS) was diagnosed, abdominal ultrasonography was indicated but it did not show abnormalities. Since there were no similar cases in her family, genetic testing was not necessary. Second branchial cleft anomalies, which arise from the incomplete obliteration of the branchial clefts during embryogenesis, account for approximately 69%–95% of all branchial malformations while bilateral lesions represent only 2%–3% of cases.1 Among the last ones, fistulae are rare1 as they are described in only 7.5% of cases.2 BOFS is rare, variable and remains unknown to dermatologists in spite of distinctive cutaneous features. Herein, we point out another case. It is usually an autosomal dominant disorder but can be sporadic as in our case. The symptoms of which include branchial arch anomalies with abnormal overlying skin, ocular findings, and facial anomalies.3 If all these BOFS features are present, the diagnosis can be carried out. Otherwise, two of these criteria plus either an affected first-degree relative or dermal ectopic thymus made the diagnosis.4 A differential diagnosis includes branchio-otorenal (BOR) syndrome. Both the BOR and BOFS can present with hearing loss, renal anomalies, and nasolacrimal stenosis. Facial abnormalities and skin lesions are characteristics of BOFS.3, 4 Branchial arch anomalies may present with sinus tracts or aplastic skin in the cervical area, supra-auricular sinuses or branchial clefts with hemangiomatous scarred skin extending along the sternocleidomastoid muscle like in our patient.3 The opposite skin may be thin or present hair patches, or linear, and non-healing erosions.4 The face may manifest dolichocephaly, a malformed, asymmetrical nose with a broad bridge and flattened lip, low set ears with posterior rotation, cleft palate and/or cleft lip. The last three findings were present in our case.4 Microphthalmia or anophthalmia, strabismus, nasolacrimal duct stenosis or atresia with recurrent dacrocystitis and cataracts represent ocular abnormalities in BOFS.3 Our patient underwent surgical treatment under general anesthesia. We started with repairing the bilateral cleft lip. Excision for second branchial cleft fistulae is planned few months later. A speech therapy may be needed after the age of 18 months. To conclude, we report an original case of BOFS, which showed dermatological features, including branchial arch anomalies with abnormal overlying skin and facial anomalies which made this syndrome suspicious. Ocular findings complete the third diagnosis criterion where dematologists, ophlalmologists and pediatricians should be aware of the BOFS to make the diagnosis as early as possible and multi-disciplinary management is crucial. Rekik Mariem, Sellami Khadija, Hableni Hanene and Baklouti Massara performed conceptualization, validation, visualization, writing—original draft preparation, and writing—review and editing. Rekik Mariem and Sellami Khadija performed data curation, formal analysis, investigation, visualization, and writing—original draft preparation. Rekik Mariem and Sellami Khadija involved in conceptualization, validation, visualization, writing—original draft preparation, and writing—review and editing. All authors read and approved the final version of the article. None. Any photos in this manuscript are from the parents of the patient who provided their consent. Written informed consent was obtained from the parent of the patient to publish this report in accordance with the journal's patient consent policy. We accept the fact that this journal publish our case.

Background: Congenital epulis is a benign gingival tumor whose differential diagnosis includes other oral-facial masses such as teratoma, hemangioma, lymphatic malformation and dermoid cysts. This tumor can cause obstruction of the airway or feeding problems in the newborn. Surgical excision is the treatment of choice. Case Report: We present a case of congenital epulis, diagnosed prenatally with ultrasonography. Conclusion: Although difficult, a defined prenatal image of congenital epulis is possible by means of accurate high-resolution ultrasonography. It facilitates the narrowing down of differential diagnosis. The confirmatory final diagnosis relies on histopathological examination.

Abstract Compound blue nevus had clinical and histological similarities with other heavily pigmented melanocytic tumor, like the pigmented epithelioid melanocytoma. Distinctive genomic aberrations have allowed differentiating it. The defining characteristic of blue nevi family is the presence of activating mutations in the G protein α‐subunits, GNAQ and GNA11.

Background Congenital epulis is a rare benign oral cavity tumor that usually arises from the maxillary alveolar mucosa. It is also known as congenital gingival granular cell tumor. This tumor can interfere with respiration and feeding. Prenatal diagnosis is uncommon and mostly confined to the third trimester. Case report A 30-year-old woman, gravida 5, para 3, had an ultrasound examination at 30 weeks of gestation. A intraoral mass was noted to fill the fetus’s oral cavity. Therefore, the woman was referred to our departement of neonatology, but she refused the complement of th explorations and the transfer. At 37 weeks of gestation, an elective cesarean section was performed. The newborn female child weighed 3 kg who had a large mass occupying the oral cavity. The mass prevented normal closure of the mouth and interfered with breastfeeding, but did not pose an immediate airway concern. She was referred to our departement immediately after birth. On clinical examination, a pedunculated mass, exhibiting a grey ulcerated surface was located on the left side of the maxillary alveolar ridge. This mass measured 6 cm × 4.5 cm × 3 cm and prevented normal closure of the mouth and interfered with breast or bottle-feeding, but did not cause airway obstruction or respiratory distress. Examination of other systems was normal. A surgical excision of the mass was performed on the second day of neonatal life confirmed the presence of a tumor resembling epulis. The correctness of this diagnosis was subsequently confirmed by histogenesis. The intraoperative and postoperative courses were uneventful. The newborn recovered with no complications, and breastfeeding was initiated on the subsequent day of operation. Conclusion Early diagnosis of CE in a newborn is of paramount importance in the successful management of these rare cases.

Since the 4th edition of the World Health Organization's Classification of Head and Neck Tumours was published in January of 2017, the keratocystic odontogenic tumor is back into the cyst category as odontogenic keratocyst (OKC). Depending on the size of the cyst, its location and the patients' age, several treatment options are available: curettage, enucleation, radical treatment and marsupialization. The marsupialization is a conservative technique used in early tumor stages, as curative treatment for the odontogenic cyst. Despite its disadvantages and controversies, the marsupialization remains an interesting therapeutic choice in the case of large cysts, or in very young or old patients. We describe, in this article, four clinical cases of odontogenic cysts. We report the surgical management and the subsequent evolution of the patients. The discussion focuses on the indications, advantages and limitations of the odontogenic cyst's marsupialization. We review the specific conditions of the odontogenic cysts that could make the marsupialization the optimal therapeutic option. In our cases, the marsupialization proved to be a conservative technique which allowed the respect of neighboring anatomical structures, particularly in the case of large cysts, but requires prolonged clinical and radiological monitoring. Pathological entity for our cases was different. Thus, the treatment outcome may be different too. This series is very small and the reader should be cautious about drawing broad conclusions regarding the optimal therapeutic choice. Key words:Marsupialization, odontogenic cyst.

Ewing’s  sarcoma  of  the  mandible  is  a  rare  deasese.  The  treatement  is  based  on  surgery  and  chemotherapy.  We  report  a  case  of  a  twenteen-year-old  girl  diagnosed and treated for an Ewing’s sarcoma of mandilble. Keywords: Cricotracheal stenosis, cricotracheal resection, single stage surgery.

This article reviews a myriad of common and uncommon odontogenic cysts and tumors. The clinical presentation, gross and microscopic features, differential diagnosis, prognosis, and diagnostic pitfalls are addressed for inflammatory cysts (periapical cyst, mandibular infected buccal cyst/paradental cyst), developmental cysts (dentigerous, lateral periodontal, glandular odontogenic, orthokeratinized odontogenic cyst), benign tumors (keratocystic odontogenic tumor, ameloblastoma, adenomatoid odontogenic tumor, calcifying epithelial odontogenic tumor, ameloblastic fibroma and fibroodontoma, odontoma, squamous odontogenic tumor, calcifying cystic odontogenic tumor, primordial odontogenic tumor, central odontogenic fibroma, and odontogenic myxomas), and malignant tumors (clear cell odontogenic carcinoma, ameloblastic carcinoma, ameloblastic fibrosarcoma).

SUMMARY Inclusion of the third molar is one of the most frequent pathologies encountered in oral and maxillofacial surgery, but ectopic placement is quite rare. Presented here is a case of ectopic location of a third molar in the mid-ramus of the mandible. It’s about a 42-year-old man who was referred due to swelling of the left parotid region, with history of similar symptoms. Radiological exams showed an ectopic third molar in the left mandibular mid-ramus with an associated cyst. Local symptoms were improved by a 15 day antibiotic therapy. One month later, the tooth extraction was performed via an oral approach. The therapeutic approach of ectopic inferior third molar requires a careful consideration. The choice of the surgical removal method depends on the tooth’s location and the surgeon’s experience. In the symptom-free cases, non removal is conditioned by a regular follow-up. (Med Buccale Chir Buccale 2009 ; 15 : 45-48).

Introduction. - Congenital epulis (CE) of the newborn also known as congenital granular cell tumor or Neumann tumor is an uncommun benign tumour occuring in the anterior alveolar rioge of the jaws. It may interfer with breathing and feeding. In our study, we discuss the clinicopathologic and evolutive caracteristics and the diagnosis problems of this entity.Observation. - A newborn girt, two months old, presented at birth a nodular mass in the upper alveolar crete of the maxilla. The mass measured 1,5 cm and exhibited a smooth surface. Histologically, it was composed of diffuse sheets and clusters of granular cells with abundant coarsely granular cytoplasm. The evolution was good without recurrence after five months.Discussion. - CE is a rare tumor; its etiopathogenesis is still unclear. The diagnosis suspected clinically is confirmed by the histopathological study. The prognosis is exellent without recurrence. (C) 2009 Published by Elsevier Masson SAS.