Jerome Thompson
University of Tennessee Health Science Center, USA.
Title: The EXIT Procedure: Current Status and Technical Tips for Otolaryngologist
Biography
Biography: Jerome Thompson
Abstract
Prior to the 1980s, births of fetuses with congenital abnormalities causing airway obstruction had mortality rates approaching 40%. Anoxic brain injury results if the airway is not secured within 5 minutes following termination of maternal-fetal circulation. The advent of the EXIT (ex utero intrapartum therapy) procedure allowed surgeons to operate on a partially delivered fetus, still connected to maternal circulation. This significantly extending the time allowed to secure the airway. It is particularly useful in cases of Congenital High Airway Obstruction Syndrome or CHAOS. Pediatric otolaryngologists have used the EXIT since 1994. It remains an infrequently performed operation, with even the largest academic pediatric hospitals averaging approximately only 5 procedures per year. It is now part of the armamentarium of pediatric and cardiovascular surgeons. In this article, we share our 9 most interesting experiences with the EXIT procedure, and what we have learned from each case.