A case of a neonate with cleft palate who developed respiratory disturbance caused by a tongue hamartoma and accessory tongue

Tongue hamartoma and accessory tongue are congenital tissue malformations, both of which occur rarely and may cause respiratory disturbance.We report a case of respiratory disturbance caused by a tongue hamartoma and accessory tongue in a neonate with a cleft palate.The patient had a tongue mass, cleft palate and respiratory disturbance at birth and was brought to our hospital by ambulance.Subsequently, he was referred to our department for further investigation and treatment of the cleft palate and tongue mass.Upon oral examination, a cleft palate and tongue mass on the accessory tongue were observed, which were the suspected causes of the respiratory disturbance.A transnasal endoscopy showed that the tongue mass was obstructing the cleft and nasal cavity.Considering the patient was a neonate, the surgical invasion, postoperative airway issues, and feeding difficulty, we planned to remove the tongue mass only, and the accessory tongue would be treated according to the postoperative course and the growth of the child.The tongue mass was removed surgically under general anesthesia on postnatal day 13.Histopathological diagnosis of the mass was tongue hamartoma.The respiratory disturbance improved after surgery.At the age of 1 year and 7 months, the child underwent a palatoplasty and accessory tongue resection at the same time.In this case, the intervention by an oral-maxillofacial surgeon early after birth led to early diagnosis and treatment of the oral disease that caused the respiratory disturbance in the neonate.