Rethinking Otorhinolaryngologic Care Pathways in Children with Down Syndrome: A Multidisciplinary Framework for Early...

Area of Science:

• Otorhinolaryngology
• Pediatric Medicine
• Genetics

Background:

• Children with Down syndrome (DS) face a high prevalence of otorhinolaryngologic (ENT) disorders.
• These conditions, including hearing impairment, obstructive sleep apnea (OSA), dysphagia, and language delay, interact with DS-specific features.
• Current care pathways often lack consistent and comprehensive ENT management for pediatric DS.

Purpose of the Study:

• To provide an integrative overview of ENT manifestations in pediatric patients with DS.
• To identify key research findings and gaps in the characterization and management of ENT disorders in DS.
• To propose a framework for integrated ENT evaluation and care.

Main Methods:

• A narrative review of the literature was performed.
• Searches were conducted in PubMed, Scopus, and Web of Science (1979-2025).
• 45 relevant studies focusing on ENT disorders in pediatric DS were selected and analyzed.

Main Results:

• Observational studies dominated, highlighting conductive hearing loss, otitis media with effusion, sleep-disordered breathing, and feeding/swallowing issues.
• Early audiology and polysomnography screening are emphasized.
• Consistent reports indicated gaps in standardized, accessible, multidisciplinary ENT care.

Conclusions:

• ENT manifestations are common, complex, and impactful in pediatric DS.
• A multidisciplinary and proactive care model is essential for timely diagnosis and intervention.
• Formalizing ENT care pathways within DS protocols is necessary.