CONGENITAL DISORDERS
8.1 Lingual Thyroid
Lingual
thyroid occurs when all or a part of the thyroid does not descend during
development. In 70% of cases it represents the whole of the thyroid at the back
of the tongue. The patient complains of dyspagia or airway obstruction. A
I131 scan will identify the lingual
thyroid at the back of the tongue. Small doses of thyroxin will reduce the size
and symptoms.
8.2 Thyroglossal Cyst
Thyroglossal
cyst presents as a cystic swelling in the midline and is due to persistence of
thyroid tissue in the thyroglossal duct. Its mobility is from side to side and
is restricted on protrusion of the tongue.
8.2.1 TREATMENT
Treatment is by surgery of the cyst
with the duct and the portion of the hyoid bone are excised. A similar
procedure is required for a thyroglossal fistula.
8.3 Inborn Errors Of Iodine Metabolism
These
inherited disorders are due to the deficiency of enzymes required for trapping,
organification or coupling in the process of hormone production. Absence of
thyroid hormone production in utero results in cretinism and later in goitre in
childhood.
8.4 Lateral Aberrant Thyroid
It
is now believed that this is most often a metastasis in a lymphnode from a
primary in the thyroid which is not palpable
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