Guidelines suggest that all children with Down's syndrome have hearing testing on a regular basis. Since 2004, the ear, nose and throat (ENT), audiology and education services have conducted a joint clinic for annual ENT health and hearing surveillance of all preschool children with Down's syndrome in Greater Glasgow. The aim of this study is to report the prevalence of ENT problems in this well-defined birth cohort, and the proportion of children for whom ENT surgery is required. A prospective database has been kept since 2004, detailing the ENT health status of every child attending the community-based surveillance clinic. Between September 2004 and September 2008, 87 preschool (aged 9 months to 6 years) children with Down's syndrome were sent appointments for the clinic. Of these, 48 (55%) were female and 39 were male. Data were available for 79 (91%). Over the course of the study, 37% were listed for surgery at some point, either adenotonsillectomy for obstructive symptoms or grommet insertion for otitis media with effusion (OME). The prevalence of OME was 93% at age 1, falling to 68% by age 5. None had significant sensorineural hearing impairment. Obstructive symptoms were also common, with 79% of children having either currently symptomatic upper airways obstruction or a history of adenotonsillectomy by age 5. One child had laryngomalacia and two had symptomatic congenital subglottic stenosis. The prevalence of ENT problems in these children is high. Surgical intervention is frequently required. We advocate a proactive approach of regular ENT and audiology surveillance leading to early intervention, with the aim of maximizing health and educational achievement in the long term.

Introduction.  Guidelines for children with Down syndrome suggest hearing testing at birth, then annually until school entry, followed by checks every 2 years. For some time, the departments of Audiology and Educational Audiology have run a hearing surveillance clinic for all children with Down Syndrome in Greater Glasgow. Since September 2004, an ENT consultant has attended these clinics. A prospective record of the ENT health of children in Greater Glasgow with Down syndrome has been kept for 3 years. We present prevalence data for ENT problems between 1 and 6 years of age. Method.  Data were extracted from the database for the presence of otitis media with effusion (OME) and sleep disordered breathing (SDB) for every clinic visit. Results.  There were 76 children with Down syndrome in Greater Glasgow, aged 9 months‐6 years. 42 were female, 34 male. Of these, 70 were seen at the clinic at least once (92%). 25 (36%) underwent ENT surgery during the study period. The prevalence of OME (based on otoscopy, tympanometry and age‐appropriate audiometry) ranged from 92% at age 1 to 73% at age 5‐6. SDB was most prevalent at age 2 (44%). Other ENT diagnoses were subglottic stenosis (2), laryngomalacia (1) and congenital muscular torticollis (1). None had sensorineural hearing impairment. Conclusion.  ENT disorders are very common in preschool children with Down syndrome. It is likely that they will have a significant impact on development for some children. Further research is required to determine whether our intensive approach to surveillance and intervention will improve outcomes.