Cretinism, endemic pathology

Most of the studies conducted in Mali have made use of similar clinical approaches to classify pathological thyroids (endemic goiter, hypo- and hyperthyroidism, endemic cretinism, etc.). Goiter has been assessed by palpation. The old goiter classification system used in the surveys by Pales in 1948 (Pales, 1950) was later replaced by the WHO classification proposed by Demaeyer et al. (1979). 

What is needed now is a comparison of brain pathology in neurological cretinism and cerebral palsy and in myxedematous cretinism and sporadic congenital hypothyroidism there is also a need for study of the brain in endemic mental retardation. 

We know very little about the pathology of the ear. And yet, hearing loss is a major component of cretinism. Old data summarized by Koenig (21) indicated that neurological endemic cretins present middle ear abnormalities characterized by hypertrophic bone changes of the promontorium, deformation of the ossicles, distorsion of the oval and round windows and thickening of the mucous membrane of the tympanic cavity. No data are available for the inner ear. 

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