A Comparison of Preoperative Characteristics of Chronic Otitis Media in Down and Non-Down Syndrome

Abstract

Frequent draining ear and extremely immature mastoid pneumatization, regardless of the presence or absence of a past history of tympanostomy tube insertion, were clinically important characteristics of COM in patients with Down syndrome.

Down Syndrome as an indicator for pediatric otolaryngologic procedures

“…[8] Shinnabe et al found that persistent otorrhea was significantly more frequent in DS patients than non-DS prior to tympanoplasty. [6] Manickam et al followed a group of DS patients for 15 years and found that chronic otitis media and indications for pressure equalization tube placement are still prevalent as DS children age. [4] These studies support our findings that DS is over-represented in the upper airway and otologic procedures.…”

“…Most of the current literature describes surgical outcomes of DS patients undergoing more common otolaryngologic procedures such as adenoidectomy, tonsillectomy, and tympanostomy tube placement. [3-6] Surgical intervention in DS patients is complicated by multiple systemic comorbidities and certain anesthetic considerations like atlantoaxial instability. [7, 8] There are only a few studies looking at the treatment of DS patients from a broad otolaryngologic perspective.…”

Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid—Anatomy, Physiology, Pathophysiology, and Pathogenesis)

“…Poor mastoid pneumatization is characteristic in patients with Down syndrome, regardless of the presence or absence of a history of TT insertion. 170 Similarly, children with CP, especially bilateral CP, had smaller mastoid areas than did subjects with OME. Srzentić et al 171 measured the mastoid size in children with CP and found that the lowest pneumatization was found in bilateral CP.…”

A mixed‐methods study of the management of hearing loss associated with otitis media with effusion in children with Down syndrome

“…There is little evidence regarding the effectiveness of these management strategies in children with DS, with each having associated risks specific to children with DS. For example, grommet surgery may be difficult due to a narrow ear canal and children with DS are at increased risk of grommet associated ear discharge and eardrum perforation . Air conduction hearing aids often do not fit well or exacerbate ear infections.…”

“…For example, grommet surgery may be difficult due to a narrow ear canal and children with DS are at increased risk of grommet associated ear discharge and eardrum perforation. 3 Air conduction hearing aids often do not fit well or exacerbate ear infections. Consequently, there is a need for further research regarding the effectiveness, acceptability and utilisation of management strategies for hearing loss associated with persistent OME, in children and young people with DS.…”