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Otolaryngologic Manifestations of Trisomy 13 and Trisomy 18 in Pediatric Patients
Jalen Benson1, Candace Stewart1, Margaret A Kenna1,2
1Department of Otolaryngology & Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA.
Insights
Survival rates for trisomy 13 and trisomy 18 patients have improved, increasing the need for otolaryngologic care. This study details the common head and neck conditions and procedures these patients require.
Area of Science:
- Otolaryngology
- Genetics
- Pediatrics
Background:
- Survival rates for trisomy 13 and trisomy 18 have significantly increased.
- This has led to a greater need for comprehensive medical management, including otolaryngologic care.
Purpose of the Study:
- To describe the otolaryngologic clinical characteristics and procedures for patients with trisomy 13 and trisomy 18.
- To understand the multidisciplinary management needs of these patients.
Main Methods:
- Algorithmic identification of patients with trisomy 13 or 18 seen by otolaryngology from 1997-2021.
- Retrospective chart review of clinical characteristics and procedures.
Main Results:
- 47 patients studied (18 trisomy 13, 29 trisomy 18); 81% were living.
- Common diagnoses included GERD, dysphagia, otitis media, and obstructive sleep apnea.
- 74% required otolaryngologic procedures, most commonly tonsillectomy/adenoidectomy; trisomy 18 associated with ear canal stenosis and OSA; trisomy 13 with cleft lip/palate.
Conclusions:
- Patients with trisomy 13 or 18 have complex otolaryngologic needs.
- Multidisciplinary management is essential for comprehensive care spanning various subspecialties within otolaryngology.
Objective:
The survival rate of patients with trisomy 13 and trisomy 18 has increased dramatically over the past two decades. We sought to comprehensively describe the otolaryngologic clinical characteristics and procedures required for these patients at our institution.
Methods:
We performed algorithmic identification of patients with a diagnosis of trisomy 13 and trisomy 18 for whom the otolaryngology service provided inpatient or outpatient care at our institution between the dates of February 1997 and March 2021.
Results:
Of the 47 patients studied, 18 patients had a diagnosis of trisomy 13, and 29 had a diagnosis of trisomy 18. Complete trisomy was present in 44% (8/18) of trisomy 13 patients and 55% (16/29) of trisomy 18 patients. 81% of patients were living at the time of the study. About 94% (44/47) of patients required consultation with another specialty in addition to Otolaryngology. Overall, the most common diagnoses among this cohort were gastroesophageal reflux disease (47%), dysphagia (40%), otitis media (38%), and obstructive sleep apnea (34%). Nearly three-quarters (74%) of patients studied required an otolaryngologic procedure. The most common surgical procedure was tonsillectomy and/or adenoidectomy. Patients with trisomy 18 were significantly more likely to have external auditory canal stenosis and obstructive sleep apnea whereas patients with trisomy 13 were more likely to have cleft lip and palate.
Conclusions:
Patients with a diagnosis of trisomy 13 or 18 often require multidisciplinary management and the range of required care spans the breadth of otolaryngology.
Level Of Evidence:
4 Laryngoscope, 133:1501-1506, 2023.
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