Seguimiento otológico en niños con Síndrome de Down

Abstract

Introduction and objective: Trisomy 21 is the most frequent chromosomal alteration. Therapeutic advances have led to an increase in life expectancy, which implies more specialized care. Ear, nose and throat (ENT) manifestations are a dominant focus of morbidity in children with Down’s syndrome (DS). Hearing problems are more common than in the rest of the population, impacting their educational and social evolution and affecting their life quality. This study’s objective is to analyze the results of otological follow-up in children with DS studied in our ENT Service during 29 years. Method: Prospective/retrospective study of the registration we carried out in HCU of Valladolid ENT Service, of 83 children with DS who attended consultation from 1993 to 2021 and the data gathered after a current review of their histories. Results: 63% of the children studied were boys, 77% were less than 5 years of age and 88% came from Valladolid city and province. 19% were born in our hospital and 29% were lost during follow-up.  We detected 66% of external ear malformations. Middle ear pathology was present in 92% of the children. We performed hearing tests on 93% and 60% had hearing loss, bilateral in 78% and mild/moderate in 87% (8% profound). 39% of hearing loss was sensorineural. Prosthetic adaptation with hearing aids was carried out in 48% of children with hearing loss; receiving 11% an osseointegrated prosthesis and 4% a cochlear implant. ENT surgery was performed at 62%, highlighting in frequency, adenoidectomy and the placement of transtympanic drains. Discussion and conclusion: The recommended ENT follow-up for children with DS is a difficult task to organize. There are also other obstacles inherent to DS, such as intellectual disability, difficulties in exploration, the fluctuating nature of hearing loss, worse results in medical/surgical treatment, which is accompanied by greater morbidity... and parents who get tired of numerous visits and the chronicity of the processes.  Given the frequency of ENT pathology in children with DS and the repercussions it can have on their evolution; we consider this follow-up necessary.