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Barriers to timely tympanostomy tube placement in trisomy 21

Kevin Bachrach1, Ashank Bains1, Jennifer N Shehan2

  • 1Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118, USA.

International Journal of Pediatric Otorhinolaryngology
|December 9, 2020
PubMed

Insights

Children with trisomy 21 (Down syndrome) face longer waits for tympanostomy tube insertion compared to the general population. This delay in ear tube surgery may stem from the higher prevalence of other health issues in children with Down syndrome.

Area of Science:

  • Pediatrics
  • Genetics
  • Otolaryngology

Background:

  • Trisomy 21, or Down syndrome, is a common genetic disorder associated with increased risks of chronic ear disease.
  • Children with Down syndrome often have complex medical needs that can impact healthcare access and timely treatment.
  • Understanding care disparities for medical interventions like tympanostomy tube insertion is crucial for this population.

Purpose of the Study:

  • To investigate potential delays in tympanostomy tube insertion for children with trisomy 21.
  • To identify factors contributing to any observed delays in surgical care for this group.

Main Methods:

  • Retrospective analysis of electronic medical records at Boston Medical Center (2005-2019).
  • Comparison of patients with trisomy 21 undergoing tympanostomy tube insertion against a matched cohort without trisomy 21.
  • Primary outcome measured: time from surgical decision to tympanostomy tube insertion.

Main Results:

  • A cohort of 20 patients with trisomy 21 was matched with 39 patients from the general population.
  • The average time to tympanostomy tube insertion was significantly longer for children with trisomy 21 (119.0 days) compared to the general population (43.1 days).
  • The difference in wait times was statistically significant (p < .01).

Conclusions:

  • Children with trisomy 21 experience significant delays in receiving tympanostomy tube insertion.
  • These delays may be attributed to the greater burden of comorbid conditions common in individuals with trisomy 21.
  • Addressing these delays is important for managing chronic ear disease in children with Down syndrome.
Abstract

Keywords:
DisparityDown syndromeHealthcare accessMyringotomy tubeTrisomy 21Tympanostomy tube

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