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Outcomes of tympanostomy tube placement in children with Down syndrome--a retrospective review.
Int J Pediatr Otorhinolaryngol 2014; 78(2):223-6IJ

Abstract

OBJECTIVES

Tympanostomy tubes are commonly used for treatment of chronic otitis media with effusion (COME) or recurrent acute otitis media (RAOM) in patients with Down syndrome, but hearing outcomes in this population have been mixed, and complications appear to be common. We aim to characterize outcomes and complications associated with tympanostomy tube placement in this population.

METHODS

Retrospective review. All patients with Down syndrome presenting to a tertiary academic pediatric otolaryngology practice over a ten year period from 2002 to 2012 who received tympanostomy tubes for COME, RAOM, or hearing loss were reviewed.

RESULTS

Long term follow up data was obtained in 102 patients, with average follow up 4.7 years. COME was the primary indication for tube placement in 100/102 (98%). Less than half of these patients (44%) initially failed their newborn hearing screen. Post operative hearing was found to be normal or near normal for the better hearing ear in 85/99 (85.9%), and normal to near normal in bilateral ears in 71/99 (71%). A majority (63.7%) of patients required two or more sets of tubes during the follow up period. Long term complications were common and were significantly increased if the patient required three or more sets of tubes, including chronic perforation (36.6% vs 8.2%, p<0.001), atelectasis (29.3% vs 1.6%, p<0.0001), and cholesteatoma (14.6% vs 0%, p=0.003).

CONCLUSIONS

COME is a frequent problem in Down syndrome, and the majority of patients will require two or more sets of tubes during their childhood and achieve normal postoperative hearing. Long term complications of otitis media appear to be more common in this population and appear to correlate with increasing number of tubes placed. More investigation is required to determine optimal treatment strategies for COME in patients with Down syndrome.

Authors+Show Affiliations

Department of Otolaryngology, Oregon Health Sciences University, Portland, OR, United States. Electronic address: lorienpaulson@gmail.com.Oregon Health Sciences University School of Medicine, Portland, OR, United States.Department of Otolaryngology, Oregon Health Sciences University, Portland, OR, United States.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24321289

Citation

Paulson, Lorien M., et al. "Outcomes of Tympanostomy Tube Placement in Children With Down Syndrome--a Retrospective Review." International Journal of Pediatric Otorhinolaryngology, vol. 78, no. 2, 2014, pp. 223-6.
Paulson LM, Weaver TS, Macarthur CJ. Outcomes of tympanostomy tube placement in children with Down syndrome--a retrospective review. Int J Pediatr Otorhinolaryngol. 2014;78(2):223-6.
Paulson, L. M., Weaver, T. S., & Macarthur, C. J. (2014). Outcomes of tympanostomy tube placement in children with Down syndrome--a retrospective review. International Journal of Pediatric Otorhinolaryngology, 78(2), pp. 223-6. doi:10.1016/j.ijporl.2013.10.062.
Paulson LM, Weaver TS, Macarthur CJ. Outcomes of Tympanostomy Tube Placement in Children With Down Syndrome--a Retrospective Review. Int J Pediatr Otorhinolaryngol. 2014;78(2):223-6. PubMed PMID: 24321289.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of tympanostomy tube placement in children with Down syndrome--a retrospective review. AU - Paulson,Lorien M, AU - Weaver,Tyler S, AU - Macarthur,Carol J, Y1 - 2013/11/21/ PY - 2013/09/15/received PY - 2013/10/16/revised PY - 2013/10/19/accepted PY - 2013/12/11/entrez PY - 2013/12/11/pubmed PY - 2014/12/17/medline KW - Complications KW - Down syndrome KW - Otitis KW - Tympanostomy tubes SP - 223 EP - 6 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 78 IS - 2 N2 - OBJECTIVES: Tympanostomy tubes are commonly used for treatment of chronic otitis media with effusion (COME) or recurrent acute otitis media (RAOM) in patients with Down syndrome, but hearing outcomes in this population have been mixed, and complications appear to be common. We aim to characterize outcomes and complications associated with tympanostomy tube placement in this population. METHODS: Retrospective review. All patients with Down syndrome presenting to a tertiary academic pediatric otolaryngology practice over a ten year period from 2002 to 2012 who received tympanostomy tubes for COME, RAOM, or hearing loss were reviewed. RESULTS: Long term follow up data was obtained in 102 patients, with average follow up 4.7 years. COME was the primary indication for tube placement in 100/102 (98%). Less than half of these patients (44%) initially failed their newborn hearing screen. Post operative hearing was found to be normal or near normal for the better hearing ear in 85/99 (85.9%), and normal to near normal in bilateral ears in 71/99 (71%). A majority (63.7%) of patients required two or more sets of tubes during the follow up period. Long term complications were common and were significantly increased if the patient required three or more sets of tubes, including chronic perforation (36.6% vs 8.2%, p<0.001), atelectasis (29.3% vs 1.6%, p<0.0001), and cholesteatoma (14.6% vs 0%, p=0.003). CONCLUSIONS: COME is a frequent problem in Down syndrome, and the majority of patients will require two or more sets of tubes during their childhood and achieve normal postoperative hearing. Long term complications of otitis media appear to be more common in this population and appear to correlate with increasing number of tubes placed. More investigation is required to determine optimal treatment strategies for COME in patients with Down syndrome. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/24321289/Outcomes_of_tympanostomy_tube_placement_in_children_with_Down_syndrome__a_retrospective_review_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(13)00549-1 DB - PRIME DP - Unbound Medicine ER -