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Outcomes of tympanoplasty in children with down syndrome.

Abstract The prevalence of chronic otitis media with effusion (COME), and Eustachian tube dysfunction (ETD) is high in Down syndrome (DS) patients. This often necessitates multiple tympanostomy tube (TT) placements resulting in a higher rate of persistent tympanic membrane (TM) perforation requiring tympanoplasty for repair.
PMID
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Authors

Mayor MeshTerms
Keywords

Down syndrome

Tympanic membrane perforation

Tympanoplasty

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 29224762
OWN - NLM
STAT- MEDLINE
DCOM- 20171226
LR  - 20171226
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 103
DP  - 2017 Dec
TI  - Outcomes of tympanoplasty in children with down syndrome.
PG  - 36-40
LID - S0165-5876(17)30467-6 [pii]
LID - 10.1016/j.ijporl.2017.10.004 [doi]
AB  - INTRODUCTION: The prevalence of chronic otitis media with effusion (COME), and
      Eustachian tube dysfunction (ETD) is high in Down syndrome (DS) patients. This
      often necessitates multiple tympanostomy tube (TT) placements resulting in a
      higher rate of persistent tympanic membrane (TM) perforation requiring
      tympanoplasty for repair. OBJECTIVES: To assess risk factors for persistent
      perforation and outcomes of tympanoplasty in DS patients. METHODS: Retrospective 
      case series of 91 ears in 69 DS patients with TM perforations, who were either
      observed or underwent tympanoplasty. Clinical features, surgical outcomes, and
      hearing outcomes were assessed. RESULTS: 91 ears were evaluated. Sixty
      perforations were observed, and 31 perforations were repaired. The closure rate
      was 54.8% for primary surgery, and 70.9% after secondary surgical interventions
      in the Tympanoplasty Group, compared to 33.0% spontaneous closure rate in the
      Observation Group (p < 0.001). The only risk factor for failed tympanoplasty
      repair was persistent COME/ETD (OR 27.2, p = 0.001). In the Observation Group
      perforations diagnosed at an older age, with >3 TT insertions, and with
      persistent COME/ETD were less likely to close spontaneously. Patients undergoing 
      tympanoplasty had worse preoperative pure tone averages than those being
      observed, but significant improvement in air-bone gaps were noted in the
      Tympanoplasty Group (p = 0.02) post-operatively. Patients were often
      rehabilitated with hearing aids regardless of intervention (53.3% Observation
      Group, 48.4% Tympanoplasty Group). CONCLUSIONS: Persistent TM perforation in
      children with Down syndrome was associated with a history of COME/ETD, and
      multiple prior TT insertions. Tympanoplasty was successful for repair in most
      patients who underwent surgical intervention, but residual hearing loss was
      common.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Ghadersohi, Saied
AU  - Ghadersohi S
AD  - Northwestern University, Feinberg School of Medicine, Department of
      Otolaryngology - Head and Neck Surgery, Chicago, IL, USA.
FAU - Ida, Jonathan B
AU  - Ida JB
AD  - Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Otolaryngology 
      - Head and Neck Surgery, Chicago, IL, USA; Northwestern University, Feinberg
      School of Medicine, Department of Otolaryngology - Head and Neck Surgery,
      Chicago, IL, USA.
FAU - Bhushan, Bharat
AU  - Bhushan B
AD  - Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Otolaryngology 
      - Head and Neck Surgery, Chicago, IL, USA; Northwestern University, Feinberg
      School of Medicine, Department of Otolaryngology - Head and Neck Surgery,
      Chicago, IL, USA.
FAU - Billings, Kathleen R
AU  - Billings KR
AD  - Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Otolaryngology 
      - Head and Neck Surgery, Chicago, IL, USA; Northwestern University, Feinberg
      School of Medicine, Department of Otolaryngology - Head and Neck Surgery,
      Chicago, IL, USA. Electronic address: [email protected]
LA  - eng
PT  - Journal Article
DEP - 20171005
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Chronic Disease
MH  - Down Syndrome/*complications/surgery
MH  - Female
MH  - Humans
MH  - Infant
MH  - Male
MH  - Otitis Media with Effusion/surgery
MH  - Postoperative Complications/surgery
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Tympanic Membrane Perforation/etiology/*surgery
MH  - Tympanoplasty/adverse effects/*methods
OTO - NOTNLM
OT  - Down syndrome
OT  - Tympanic membrane perforation
OT  - Tympanoplasty
EDAT- 2017/12/12 06:00
MHDA- 2017/12/27 06:00
CRDT- 2017/12/12 06:00
PHST- 2017/07/11 00:00 [received]
PHST- 2017/10/02 00:00 [revised]
PHST- 2017/10/03 00:00 [accepted]
PHST- 2017/12/12 06:00 [entrez]
PHST- 2017/12/12 06:00 [pubmed]
PHST- 2017/12/27 06:00 [medline]
AID - S0165-5876(17)30467-6 [pii]
AID - 10.1016/j.ijporl.2017.10.004 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 Dec;103:36-40. doi:
      10.1016/j.ijporl.2017.10.004. Epub 2017 Oct 5.