A 6-yrs-old child complains of difficulty in swallowing and on examination there is a sublingual swelling, which is suspected to be Lingual thyroid. The 1st step in management of this child would be:
Lingual Thyroid It represents failure of median thyroid tissue to descend normally. Presentation * Asymptomatic * Choking, dysphagia * Airway obstruction, hemorrhage * Hypothyroidism (occasionally) Investigation. Thyroid scan- always performed before radioablative therapy or surgery as it may be the only thyroid tissue present. Treatment * Replacement thyroxine - decrease the size * Radioactive iodine - decrease the size * Surgery- excision rarely required.
Tracheostomy and airway maintenance
Thyroid scan
Intubation
Explain to child's parents that he may require immediate surgery