Functional lingual thyroid as unusual cause of progressive Dysphagia.

Lingual thyroid is an uncommon developmental anomaly and is the result of failure of the thyroid to descend from the foramen caecum to its prelaryngeal site. The lingual thyroid with a functioning thyroid gland in the neck is even more rare. In this report, we describe a 40-year-old female patient with a foreign body sensation and progressive dysphagia caused by ectopic lingual thyroid that is 5 x 4 x 3 cm in size. Here we present a patient with functional lingual thyroid gland who had had thyroidectomy 20 years ago. Lingual thyroid, which is like a malignant mass, was excised by external approach without complications.

Evaluation of hearing loss with auditory brainstem responses in the early and late period of bacterial meningitis in children.

The hearing function of 50 children with bacterial meningitis was evaluated at the second and 10th days, and eight weeks after admission with auditory brain system responses (ABR) to investigate whether meningitis causes hearing loss. Normal values were obtained in all tests from both ears of 24 patients (48 per cent). Twelve patients (24 per cent) had temporary, and seven (14 per cent) patients had persistent mild degree hearing loss. Severe hearing loss was detected bilaterally in five (10 per cent) patients and unilaterally in two (four per cent) patients. Patients, with other complications such as subdural effusion, convulsion, brain oedema and paralysis were found to have a higher incidence of hearing loss. We observed that patients treated with dexamethasone had 7.7 per cent persistent hearing loss, 11.6 per cent mild hearing loss, 34.6 per cent transient hearing loss, but in the group who did not receive dexamethasone there was 19.2 per cent persistent hearing loss, 15.3 per cent mild hearing loss and 11.6 per cent transient hearing loss. There were other significant differences between the two groups in restoration of normal body temperature, the CSF/plasma glucose concentration ratio was elevated, CSF (cerebro-spinal fluid) protein concentration was decreased and the cell count in the CSF was decreased in the dexamethasone group, significantly more than the group who were not receiving dexamethasone. The hearing loss tended to be more frequent among younger children.

Comparison of topical silver nitrate and flunisolide treatment in patients with idiopathic non-allergic rhinitis.

In this study, 90 patients with idiopathic non-allergic rhinitis were divided into three groups. Silver nitrate was given to Group I, flunisolide to Group II, and placebo to Group III. Healing results according to symptoms, physical findings, nasal smear findings and biopsy findings were compared. Improvement ws noticed in symptoms (rhinorrhea 93%, sneezing 89%, nasal congestion 80%), physical findings (color of mucosa 89%, concha hypertrophy 87%, rhinorrhea 82%), nasal smear findings (94%) and biopsy findings (epithelium 76%, basal membrane 80%, edema 84%, eosinophilia 95%, inflammation 87%) in Group I. Recurrence was observed in symptoms and physical findings of 30% of the patients in Group I during the 6 months-follow-up period. In Group II, improvement was noticed in symptoms (rhinorrhea 73%, sneezing 70%, nasal congestion 61%), physical findings (color of mucosa 72%, concha hypertrophy 69%, rhinorrhea 62%), nasal smear findings (87%) and biopsy findings (epithelium 67%, basal membrane 63%, edema 70%, eosinophilia 77%, inflammation 70%). But symptoms recurred in all patients in approximately 1-3 months after competition of treatment. There was a statistically significant difference between silver treatment and flunisolide or placebo treatment.