Otolaryngologic management of Down syndrome patients: what is new?

Bassett, Ethan; Musso, Mary Frances

doi:10.1097/moo.0000000000000415

Cited by 14 publications

(5 citation statements)

References 37 publications

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“…Both feeding and swallowing management were among the top five areas that speech language pathologists wished they had more time to address in 0-3 year old individuals with DS. Many have advocated for a low threshold of clinical signs to examine feeding and swallowing in children with DS [Bassett and Musso, 2017;Jackson et al, 2016]. Taken together, prior studies and current data from this retrospective study suggest the need for a prospective controlled longitudinal study of dysphagia in infants and children with DS to identify measures that can be taken in infants with DS that will improve feeding and swallowing abnormalities with increased age.…”

Section: Discussionmentioning

confidence: 71%

Clinical identification of feeding and swallowing disorders in 0–6 month old infants with Down syndrome

Stanley

Shepherd

Duvall

et al. 2018

American J of Med Genetics Pt A

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Feeding and swallowing disorders have been described in children with a variety of neurodevelopmental disabilities, including Down syndrome (DS). Abnormal feeding and swallowing can be associated with serious sequellae such as failure to thrive and respiratory complications, including aspiration pneumonia. Incidence of dysphagia in young infants with DS has not previously been reported. To assess the identification and incidence of feeding and swallowing problems in young infants with DS, a retrospective chart review of 174 infants, ages 0 to 6 months was conducted at a single specialty clinic. Fifty-seven percent (100/174) of infants had clinical concerns for feeding and swallowing disorders that warranted referral for Videofluroscopic Swallow Study (VFSS); 96/174 (55%) had some degree of oral and/or pharyngeal phase dysphagia and 69/174 (39%) had dysphagia severe enough to warrant recommendation for alteration of breast milk/formula consistency or non-oral feeds. Infants with certain comorbidities had significant risk for significant dysphagia, including those with functional airway/respiratory abnormalities (OR=7.2). Infants with desaturation with feeds were at dramatically increased risk (OR=15.8). All young infants with DS should be screened clinically for feeding and swallowing concerns. If concerns are identified, consideration should be given to further evaluation with VFSS for identification of dysphagia and additional feeding modifications.

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Section: Discussionmentioning

confidence: 71%

Clinical identification of feeding and swallowing disorders in 0–6 month old infants with Down syndrome

Stanley

Shepherd

Duvall

et al. 2018

American J of Med Genetics Pt A

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“…For example, children with cleft palate have near-universal Eustachian tube dysfunction requiring tympanostomy tubes usually more than once 12 and children with Down syndrome commonly have ear disease as well as obstructive sleep disorders that lead to frequent adenotonsillectomy and/or placement of tympanostomy tubes. 13 Achondroplasia is a skeletal dysplasia with craniofacial structural anomalies and neuromotor abnormalities that impair Eustachian tube function and cause sleeprelated upper airway obstruction. 14 The high frequency of otitis media, Eustachian tube dysfunction, and hearing loss in patients with achondroplasia has been recognized for decades.…”

Section: Discussionmentioning

confidence: 99%

“…Special patient populations exhibit high incidence of otolaryngologic disease with resultant high utilization of common surgery. For example, children with cleft palate have near‐universal Eustachian tube dysfunction requiring tympanostomy tubes usually more than once 12 and children with Down syndrome commonly have ear disease as well as obstructive sleep disorders that lead to frequent adenotonsillectomy and/or placement of tympanostomy tubes 13 . Achondroplasia is a skeletal dysplasia with craniofacial structural anomalies and neuromotor abnormalities that impair Eustachian tube function and cause sleep‐related upper airway obstruction 14 …”

Section: Discussionmentioning

confidence: 99%

Otolaryngology Utilization in Patients With Achondroplasia: Results From the CLARITY Study

et al. 2021

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Objectives/Hypothesis: To quantify otolaryngologic surgery utilization in patients with achondroplasia, and to identify any changes in utilization over the past four decades.Study Design: Retrospective cohort study.Methods: A retrospective cohort study of 1,374 patients with achondroplasia enrolled in the CLARITY retrospective cohort study at four centers of multi-specialty care for patients with achondroplasia. Otolaryngologic surgeries are presented by birth cohort decade. The main outcomes were number of primary and additional otolaryngologic procedures; age at surgery; likelihood of repeated surgery; temporal trends in surgical utilization.Results: In this cohort of 1,374 patients with achondroplasia, 620 (45.1%) had pharyngeal surgery at least once, 150 (10.9%) had pharyngeal surgery on more than one occasion, and patients who had adenoidectomy first were 2.68 times more likely to require a second pharyngeal surgery than those who had adenotonsillectomy. Seven hundred and seventy-nine (56.7%) had tympanostomy tubes placed at least once, and 447 (32.5%) had tympanostomy tubes placed more than one time. Age at first pharyngeal surgery decreased by 1.2 years per birth cohort decade, and age at tympanostomy tube placement decreased by 1.1 years per decade.Conclusions: Patients with achondroplasia often require otolaryngologic surgery, particularly adenoidectomy and/or tonsillectomy as well as tympanostomy tube placement. Such surgery is performed now more frequently and at younger ages than in earlier decades. While otolaryngologic disease associated with achondroplasia is now recognized earlier and treated more frequently, long-term outcome studies are needed.

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“…However, Hill et al (2018) successfully screened for moderate to severe OSA via home pulse oximetry, helping determine which children need formal PSG to confirm OSA. New technologies are emerging to aid in OSA diagnosis (Bassett and Musso, 2017), particularly in these complicated children. Brockmann et al (2016) studied the feasibility of home PSG in children with Trisomy 21, and obtained a technically successful and acceptable home PSG in 83% of children, concluding that portable home PSG devices may be considered for diagnosis.…”

Section: Special Populationsmentioning

confidence: 99%

Novel Technologies in the Diagnosis and Management of Sleep-disordered Breathing

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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Otolaryngologic management of Down syndrome patients: what is new?

Abstract: Questions remain pertinent to the otolaryngologist regarding the ideal management of children with Down syndrome. Additional studies are necessary, to optimize understanding and treatment of this complex population, in particular as opportunities develop with technological advances.

Cited by 14 publications

References 37 publications

Clinical identification of feeding and swallowing disorders in 0–6 month old infants with Down syndrome

Clinical identification of feeding and swallowing disorders in 0–6 month old infants with Down syndrome

Otolaryngology Utilization in Patients With Achondroplasia: Results From the CLARITY Study

Novel Technologies in the Diagnosis and Management of Sleep-disordered Breathing

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