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Ear, nose and throat disorders in children with Down syndrome
Ron B Mitchell1, Ellen Call, James Kelly
1Department of Surgery, University of New Mexico Health Sciences Center, 915 Camino de Salud, Albuquerque, NM 87131, USA. rmitchell@salud.unm.edu
Insights
Children with Down syndrome commonly require otolaryngology referrals for airway obstruction and otological disorders. Routine surgeries for these conditions can lead to complications, highlighting the need for integrated care.
Area of Science:
- Pediatric Otolaryngology
- Genetics
- Sleep Medicine
Background:
- Children with Down syndrome present unique otolaryngological challenges.
- Referrals to pediatric otolaryngology are frequent for this population.
- Understanding referral patterns and outcomes is crucial for optimizing care.
Purpose of the Study:
- To identify reasons for pediatric otolaryngology referrals in children with Down syndrome.
- To investigate the underlying causes of these referrals.
- To document complications associated with surgical interventions.
Main Methods:
- Retrospective review of patients at a pediatric otolaryngology clinic.
- Data collection on demographics, diagnoses, surgical treatments, and complications.
- Analysis of 55 parameters including systemic comorbidities.
Main Results:
- The majority of referrals (76%) were for upper airway obstruction, primarily obstructive sleep apnea and laryngomalacia.
- Otological disorders were diagnosed in 70% of children.
- Complications occurred in 27% of pressure equalization tube insertions; 93% had systemic comorbidities, most commonly gastroesophageal reflux disease.
Conclusions:
- Obstructive sleep apnea and laryngomalacia are leading reasons for referral in Down syndrome.
- Surgical procedures under general anesthesia carry higher complication risks in this population.
- Integrated management of systemic conditions is vital for otolaryngological treatment success.
Objective:
To document the reasons for which children with Down syndrome were referred to a pediatric otolaryngology practice, the underlying causes for these referrals, and the complications of routine surgical therapy.
Study Design:
The study is a retrospective review of children referred to the Pediatric Otolaryngology Clinic at the University of New Mexico Health Sciences Center (Albuquerque, NM) during a period of 2.5 years.
Methods:
Data were collected on 55 parameters related to ethnicity, demographics, diagnosis, surgical therapy, complications, and systemic comorbid conditions.
Results:
The ethnicity of the study population was predominantly Hispanic or Latino (62%). The majority of children (76%) were referred for upper airway obstruction. Obstructive sleep apnea and laryngomalacia were the most common disorders in these children. An otological disorder was diagnosed in 70% of the children. Complications occurred after 27% of procedures for insertion of pressure equalization (PE) tubes to treat recurrent otitis media. Systemic comorbid conditions were present in 93% of the children, and the most common was gastroesophageal reflux disease.
Conclusions:
Obstructive sleep apnea and laryngomalacia were the most common reasons for referral of children with Down syndrome. Routine surgical procedures that required general anesthesia caused complications that are not common in other children. Treatment for systemic comorbid conditions should be considered as a component of therapy for otolaryngological disorders in children with Down syndrome.