Tympanostomy Tube Sequelae in Down Syndrome Children with Chronic Otitis Media

The management of otorrhea and hearing loss due to tympanic membrane perforation can be challenging in patients with Down Syndrome (DS) due to their narrow ear canals and developmental delays. Management of chronic otitis media in children with DS has been debated in the literature, as insertion of tympanostomy tubes may be associated with higher risk of complications. We observed a higher rate of tympanic membrane perforation in Down syndrome patients than in typically developing patients after first ventilation tube placement surgery. Follow up clinic notes were reviewed to determine if the patients were found to have a tympanic membrane perforation. Only the first-time tube insertion for patients who had bilateral myringotomies with tympanostomy tubes was included. Of the DS patients, tympanic membrane perforations rate was 27.8%, compared to a rate of 5.6% in typically developing children. We hope that a more conservative approach to the management of chronic otitis media and using ventilation tubes with smaller diameters will prevent tympanic membrane perforations in Down syndrome patients.