Hairy Polyp Causing Upper Airway Obstruction and Respiratory Distress In A newborn

Objectives: Congenital hairy polyps are rare and benign, pedunculated masses, usually found in the pharynx of newborns and infants. Timing and types of presenting symptoms highly depend on the size and the localization of the mass. Methods: A case of a healthy female newborn with intermittent, life threatening, and significant airway obstruction due to a large hairy polyp pedunculated on the posterior soft palate is presented. After fiberoptic evaluation, the airway was secured by intubation. Magnetic Resonance Imaging (MRI) confirmed the fatty and pedunculated nature of the mass and excluded any endocranial communication. Results: Surgical resection at the site of pedicle attachment under endoscopic guidance allowed safe extubation and definitive discharge without symptoms 7 days after birth. Follow up checkups showed no signs of recurrence. Conclusions: Congenital hairy polyps are rare benign malformations with varied localization and size that determine the clinical presentation. Often airway obstruction is the presenting symptom and these cases require proper critical airway management. Imaging is mandatory to narrow down the differential diagnosis. The treatment is surgical excision and definitive diagnosis is histological. Keywords: Neonatal airway obstruction; Developmental anomaly; Hairy polyp; Endoscopic resection; Dermoid