Otorhinolaryngological manifestations in Down syndrome: MERF experience

Authors

  • Ronald Anto Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu
  • Kiran Natarajan Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu
  • Raghunandhan Sampathkumar Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu
  • Anand Kumar Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu
  • Mohan Kameswaran Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20192731

Keywords:

Down syndrome, Adenoid hypertrophy, Obstructive sleep apnea, Hearing loss

Abstract

Background: Syndromic children often pose a spectrum of challenges to the paediatric otolaryngologist. Syndromes like the Down syndrome present with a multitude of manifestations in the head and neck region and require careful management.

Methods: A retrospective study of thirty patients with Down syndrome presenting from January 2013 to January 2018 in a tertiary care setting was done. All patients were evaluated by ENT examination and further investigations based on the complaints. The aim was to study the various ENT disorders in Down syndrome patients and their management.  

Results: The most common disorder was hearing loss in eleven patients followed by rhinosinusitis in ten patients, adenoid hypertrophy and otitis media with effusion (OME) in six patients and obstructive sleep apnea in three patients. Most of the patients had medical management; very few needed surgery. Successful outcomes were possible for all patients.

Conclusions: Dealing with otorhinolaryngological disorders may pose a management challenge in Down syndrome and this requires a well experienced ENT, medical and rehabilitative team to provide optimal management and good quality of life to these children.

Author Biographies

Ronald Anto, Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

ENT Resident

Kiran Natarajan, Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

Senior ENT Consultant

Raghunandhan Sampathkumar, Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

Senior ENT Consultant

Anand Kumar, Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

Senior ENT Consultant

Mohan Kameswaran, Department of ENT, Madras ENT Research Foundation, Chennai, Tamil Nadu

Senior ENT Consultant

References

Chin CJ, Khami MM, Hussein M. A general review of the otolaryngologic manifestations of Down syndrome. Int J Pediatr Otorhinolaryngol. 2014;78:899–904.

Kwong KL, Wong V. Neurodevelopmental profile of Down syndrome in Chinese children. J Paediatr Child Health. 1996;32:153–7.

Venail F, Gardiner Q, Mondain M. ENT and speech disorders in children with Down syndrome: An overview of pathophysiology, clinical features, treatments, and current management. Clin Pediatr (Phila) 2004;43:783–91.

Rodman R, Pine HS. The otolaryngologist's approach to the patient with Down syndrome. Otolaryngol Clin North Am. 2012;45:599–629.

Park AH, Wilson MA, Stevens PT, Harward R, Hohler N. Identification of hearing loss in paediatric patients with Down syndrome. Otolaryngol Head Neck Surg. 2012;146(1):135–40.

Davies B. Auditory disorders in Down syndrome. Scand Audiol Suppl. 1998;30:65–8.

McPherson B, Lai SP, Leung KK, Ng IH. Hearing loss in Chinese school children with Down syndrome. Int J Ped Otorhinolaryngol. 2007;71:1905–15.

Shott SR, Joseph A, Heithaus D. Hearing loss in children with Down syndrome. Int J Ped Otorhinolaryngol. 2001;61:199–205.

Wai-Ling Lau, Chun-Hung Ko, and Wai-Wai Cheng. Prevalence and Parental Awareness of Hearing Loss in Children with Down Syndrome. Chin Med J (Engl). 2015;128(8):1091–5.

National Institute for Health and Clinical Excellence (NICE). Clinical guideline 60: Surgical Management of Otitis Media with Effusion in Children. London: RCOG Press; 2008.

Sheehan P.Z. & Hans P.S. UK and Ireland experience of bone anchored hearing aids (BAHA) in individuals with Down syndrome. Int. J. Paed. Otorhinolaryngol. 2006; 70, 981–986.

So SA, Urbano RC, Hodapp RM. Hospitalizations of infants and young children with Down syndrome: evidence from inpatient person-records from a statewide administrative database. J Intellect Disabil Res. 2007;51(12):1030–8.

Fitzgerald P, Leonard H, Pikora TJ. Hospital admissions in children with Down syndrome: experience of a population-based cohort followed from birth. PLoS One. 2013;8:e70401.

Mitchell R.B., Call E. & Kelly J. Ear, nose and throat disorders in children with Down syndrome. Laryngoscope. 2003;113:259–63.

Failla P, Barone C, Pettinato R. Romano C. IgG antibodies to beta-lactoglobulin and cow’s milk protein intolerance in Down syndrome. Down Syndr. Res. Pract. 1998;5:120–2.

Lal C, White DR, Joseph JE, van Bakergem K, LaRosa A. Sleep-disordered breathing in Down Syndrome. Chest. 2015;147:570–9.

Maris M, Verhulst S, Wojciechowski M, Van de Heyning P, Boudewyns A. Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome. Sleep. 2016;39(3):699–704.

Esbensen AJ, Beebe DW, Byars KC, Hoffman EK. Use of sleep evaluations and treatments in children with Down Syndrome. J Dev Behav Pediatr. 2016;37(8):629–36.

Chin CJ, Khami MM, Husein M. A general review of the otolaryngologic manifestations of Down Syndrome. Int J Ped Otorhinolaryngol. 2014;78(6):899-904.

Abdel-Aziz M, Ibrahim N, Ahmed A, El-Hamamsy M, Abdel-Khalik MI, El-Hoshy H. Lingual tonsils hypertrophy; a cause of obstructive sleep apnoea in children after adenotonsillectomy: operative problems and management. Int. J. Pediatr. Otorhinolaryngol. 2011;75:1127–31.

Miller R, Gray SD, Cotton RT, Myer CM, Netterville J. Subglottic stenosis and Down syndrome. Am J Otolaryngol. 1990;11(4):274-7.

Cebeci AN, Güven A, Yıldız M. Profile of Hypothyroidism in Down’s Syndrome. J Clin Res Pediatr Endocrinol. 2013 5(2):116–20.

Hassold T, Jacobs P. Trisomy in man. Ann Rev Genet. 1984;18:69–97.

Roizen NJ, Patterson D. Down’s syndrome. Lancet. 2003;361(9365):1281–9.

Malik V, Verma RU, Joshi V, Sheehan PZ. An evidence-based approach to the 12-min consultation for a child with Down’s syndrome. Clin. Otolaryngol. 2012;37:291–6.

Hankinson TC, Anderson RC. Craniovertebral junction abnormalities in Down syndrome. Neurosurgery. 2010;66(3 Suppl):32–8.

Borland LM, Colligan J, Brandon BW. Frequency of anaesthetic related complications in children with Down syndrome under general anaesthesia for non-cardiac procedures. Paediatr Anaesth. 2004;14:733–8.

Downloads

Published

2019-06-27

Issue

Section

Original Research Articles