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Acute neonatal respiratory distress caused by a lingual thyroid: the role of nasendoscopy and medical treatment

Published online by Cambridge University Press:  27 February 2015

L Lane*
Affiliation:
Department of Paediatrics, Great North Children's Hospital, Newcastle upon Tyne, UK
S Prudon
Affiliation:
Department of Paediatrics, Great North Children's Hospital, Newcastle upon Tyne, UK
T Cheetham
Affiliation:
Department of Paediatric Endocrinology, Great North Children's Hospital, Newcastle upon Tyne, UK
S Powell
Affiliation:
ENT Department, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence: Dr Laura Lane, Department of Paediatrics, Great North Children's Hospital, Newcastle upon Tyne NE1 4LP, UK E-mail: LauraL231@doctors.org.uk

Abstract

Background:

A lingual thyroid is a known cause of oropharyngeal obstruction in the neonate. It can be asymptomatic, or present as stridor, dysphonia, dysphagia or dyspnoea with faltering growth. The therapeutic options include surgical resection.

Case report:

A 6-day-old female neonate, born at 36 weeks gestation, presented with stridulous breathing and poor feeding. Although the cause was initially thought to be laryngomalacia, nasendoscopy revealed a lingual thyroid. The baby had deranged thyroid function, as detected on neonatal screening, but this result was not available until a later date. Despite being symptomatic, the patient was managed medically; thyroxine therapy was associated with resolution of the respiratory symptoms.

Conclusion:

Nasendoscopy provides valuable information about an ectopic thyroid gland. Thyroid replacement therapy may help to suppress the size of the ectopic gland and ultimately prevent an unnecessary surgical procedure.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2015 

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