Contemporary management of paediatric head and neck teratomas

PURPOSE OF REVIEW: To summarise current understanding of and highlight recent literature on the management of paediatric head and neck teratomas. RECENT FINDINGS: Advances in foetal ultrasonography and MRI have enhanced early detection and anatomical characterisation, allowing for birth planning. The tracheoesophageal displacement index (TEDI) offers a predictive tool for airway risk. The EXIT (ex utero intrapartum treatment) procedure remains critical for airway control in high-risk cases, with foetal endoscopic tracheal intubation (FETI) emerging as a minimally invasive alternative. While histologically immature teratomas were previously thought to carry higher malignant potential, recent studies challenge this assumption. Complete surgical resection remains the cornerstone of treatment, with increasing use of intraoperative nerve monitoring. The role of adjuvant chemotherapy remains unclear, with limited evidence of efficacy in immature tumours. SUMMARY: Contemporary management of paediatric head and neck teratomas prioritises early identification, airway safety, and complete resection. Innovations in foetal imaging and perinatal planning have reduced morbidity, while long-term outcomes remain favourable. Ongoing research into minimally invasive foetal interventions and tumour biology is essential to further optimise care.