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

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.