The skull base and nasopharynx in Down's syndrome in relation to hearing impairment

Children with Down's syndrome have a higher incidence of middle ear effusion than normal children. Twenty-eight patients with Down's syndrome and 33 age and sex-matched normal controls were studied. They were subdivided into 2 further matched groups on the basis of having normal or impaired hearing. Each underwent pneumatic otoscopy, audiometry and lateral head and neck radiography. This study examines radiological parameters to determine whether skeletal or soft tissue factors within the skull base or nasopharynx could be implicated as a cause or diagnostic feature of Eustachian tube dysfunction. The nasopharynx tended to be smaller in those with Down's syndrome and this resulted in a reduction in the airway size due to encroachment by the soft tissues. The angle between the base of skull and hard palate was significantly less acute in those with Down's syndrome and in those with hearing loss.