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Efficacy of tympanostomy tube insertion for otitis media with effusion in children with Down syndrome.
Int J Pediatr Otorhinolaryngol 1999; 49(2):143-9IJ

Abstract

OBJECTIVE

Although the insertion of tympanostomy tubes is regarded as an effective treatment for otitis media with effusion in the general population, it remains to be determined whether tympanostomy tube insertion is also effective for otitis media with effusion in children with Down syndrome. The present study was carried out to determine the efficacy of tympanostomy tube insertion in children with Down syndrome.

PATIENTS AND METHODS

We studied 28 children (18 males and ten females) with Down syndrome and 28 age-matched control children who underwent tympanostomy tube insertion and were followed up for more than 2 years, up to 7 years of age or older. The children were followed up every month for 6 months after the operation and every 2 months thereafter. The tympanostomy tubes were not removed unless granulation tissue appeared around the ventilation tubes.

RESULTS

The cure rate for otitis media with effusion was lower in the children with Down syndrome than in the age-matched control children. Sequelae of otitis media with effusion (atelectatic eardrum, permanent perforation of the eardrum and middle ear cholesteatoma) were significantly often encountered in the former group. The children with Down syndrome had more frequent episodes of otorrhea from the tympanostomy tubes than the control children and antibiotic-resistant-bacteria were frequently isolated. Moreover, improvement in hearing acuity after the placement of tympanostomy tubes was not always achieved in children with Down syndrome.

CONCLUSION

The efficacy of the tympanostomy tube insertion for children with Down syndrome was much lower than in control children. We propose that in children with Down syndrome conservative management should be the treatment of first choice and that the insertion of tympanostomy tubes should be indicated only when hearing loss due to middle ear effusion is in a severe degree and when pathological changes of the eardrum, such as adhesion and deep retraction pocket formation, are going to occur.

Authors+Show Affiliations

Department of Otolaryngology, Teikyo University School of Medicine, Tokyo, Japan. yiorl@med.teikyo-u.ac.jp

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10504021

Citation

Iino, Y, et al. "Efficacy of Tympanostomy Tube Insertion for Otitis Media With Effusion in Children With Down Syndrome." International Journal of Pediatric Otorhinolaryngology, vol. 49, no. 2, 1999, pp. 143-9.
Iino Y, Imamura Y, Harigai S, et al. Efficacy of tympanostomy tube insertion for otitis media with effusion in children with Down syndrome. Int J Pediatr Otorhinolaryngol. 1999;49(2):143-9.
Iino, Y., Imamura, Y., Harigai, S., & Tanaka, Y. (1999). Efficacy of tympanostomy tube insertion for otitis media with effusion in children with Down syndrome. International Journal of Pediatric Otorhinolaryngology, 49(2), pp. 143-9.
Iino Y, et al. Efficacy of Tympanostomy Tube Insertion for Otitis Media With Effusion in Children With Down Syndrome. Int J Pediatr Otorhinolaryngol. 1999 Aug 5;49(2):143-9. PubMed PMID: 10504021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of tympanostomy tube insertion for otitis media with effusion in children with Down syndrome. AU - Iino,Y, AU - Imamura,Y, AU - Harigai,S, AU - Tanaka,Y, PY - 1999/9/30/pubmed PY - 1999/9/30/medline PY - 1999/9/30/entrez SP - 143 EP - 9 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 49 IS - 2 N2 - OBJECTIVE: Although the insertion of tympanostomy tubes is regarded as an effective treatment for otitis media with effusion in the general population, it remains to be determined whether tympanostomy tube insertion is also effective for otitis media with effusion in children with Down syndrome. The present study was carried out to determine the efficacy of tympanostomy tube insertion in children with Down syndrome. PATIENTS AND METHODS: We studied 28 children (18 males and ten females) with Down syndrome and 28 age-matched control children who underwent tympanostomy tube insertion and were followed up for more than 2 years, up to 7 years of age or older. The children were followed up every month for 6 months after the operation and every 2 months thereafter. The tympanostomy tubes were not removed unless granulation tissue appeared around the ventilation tubes. RESULTS: The cure rate for otitis media with effusion was lower in the children with Down syndrome than in the age-matched control children. Sequelae of otitis media with effusion (atelectatic eardrum, permanent perforation of the eardrum and middle ear cholesteatoma) were significantly often encountered in the former group. The children with Down syndrome had more frequent episodes of otorrhea from the tympanostomy tubes than the control children and antibiotic-resistant-bacteria were frequently isolated. Moreover, improvement in hearing acuity after the placement of tympanostomy tubes was not always achieved in children with Down syndrome. CONCLUSION: The efficacy of the tympanostomy tube insertion for children with Down syndrome was much lower than in control children. We propose that in children with Down syndrome conservative management should be the treatment of first choice and that the insertion of tympanostomy tubes should be indicated only when hearing loss due to middle ear effusion is in a severe degree and when pathological changes of the eardrum, such as adhesion and deep retraction pocket formation, are going to occur. SN - 0165-5876 UR - https://www.unboundmedicine.com/medline/citation/10504021/Efficacy_of_tympanostomy_tube_insertion_for_otitis_media_with_effusion_in_children_with_Down_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165587699001172 DB - PRIME DP - Unbound Medicine ER -