Abstract：
OBJECTIVE: To characterize the management and outcomes of observation versus surgical intervention of tympanic membrane (TM) perforations in children with Down syndrome (DS). In addition, to estimate the prevalence of TM perforations in children with DS.
METHODS: Retrospective case review analysis of TM perforation rate in children with DS with history of tympanostomy tube (TT) insertion at a tertiary pediatric referral center. Patients were divided into observation or surgical intervention groups and then further evaluated for the type of intervention, the number of required procedures, and success rate of hearing improvement. Risk factors contributing to perforations were analyzed, including TT type, number of TT surgeries, and perforation size.
RESULTS: The TM perforation rate in children with DS with TT history was 7.0 %. Tympanoplasty was performed in 41.5 % of perforated ears with a success rate of 53.1 %. There was no statistical difference between the surgical intervention and observation groups regarding perforation characteristics or TT number and type, but the surgical intervention cohort was older. Hearing improvement based on postoperative pure tone average (PTA) threshold was noted in the successful surgical intervention group.
CONCLUSIONS: The rate of TM perforations in children with DS after TTs is comparable to the general population. Improved PTA thresholds were noted in the surgical success group influencing speech development. The overall lower success rate of tympanoplasty in patients with DS emphasizes the need to factor in the timing of surgical intervention based on the predicted age of Eustachian tube maturation.
METHODS: Retrospective case review analysis of TM perforation rate in children with DS with history of tympanostomy tube (TT) insertion at a tertiary pediatric referral center. Patients were divided into observation or surgical intervention groups and then further evaluated for the type of intervention, the number of required procedures, and success rate of hearing improvement. Risk factors contributing to perforations were analyzed, including TT type, number of TT surgeries, and perforation size.
RESULTS: The TM perforation rate in children with DS with TT history was 7.0 %. Tympanoplasty was performed in 41.5 % of perforated ears with a success rate of 53.1 %. There was no statistical difference between the surgical intervention and observation groups regarding perforation characteristics or TT number and type, but the surgical intervention cohort was older. Hearing improvement based on postoperative pure tone average (PTA) threshold was noted in the successful surgical intervention group.
CONCLUSIONS: The rate of TM perforations in children with DS after TTs is comparable to the general population. Improved PTA thresholds were noted in the surgical success group influencing speech development. The overall lower success rate of tympanoplasty in patients with DS emphasizes the need to factor in the timing of surgical intervention based on the predicted age of Eustachian tube maturation.
摘要：
目的：描述唐氏综合征（DS）儿童鼓膜（TM）穿孔的观察与手术干预的治疗和结果。此外,评估DS儿童TM穿孔的患病率。
方法：回顾性病例回顾分析在三级儿科转诊中心有鼓膜置管（TT）史的DS患儿TM穿孔率。将患者分为观察组或手术干预组，然后进一步评估干预类型，所需程序的数量，听力改善的成功率。分析了导致穿孔的风险因素，包括TT类型，TT手术的数量，和穿孔尺寸。
结果：有TT病史的DS患儿TM穿孔率为7.0%。鼓室成形术的穿孔耳占41.5%，成功率为53.1%。手术干预组与观察组之间在穿孔特征或TT数量和类型方面无统计学差异。但手术干预队列年龄较大.在成功的手术干预组中，观察到基于术后纯音平均（PTA）阈值的听力改善。
结论：TS后DS患儿的TM穿孔率与普通人群相当。在影响言语发育的手术成功组中注意到改善的PTA阈值。DS患者鼓室成形术的总体成功率较低，强调需要根据预测的咽鼓管成熟年龄来考虑手术干预的时机。
方法：回顾性病例回顾分析在三级儿科转诊中心有鼓膜置管（TT）史的DS患儿TM穿孔率。将患者分为观察组或手术干预组，然后进一步评估干预类型，所需程序的数量，听力改善的成功率。分析了导致穿孔的风险因素，包括TT类型，TT手术的数量，和穿孔尺寸。
结果：有TT病史的DS患儿TM穿孔率为7.0%。鼓室成形术的穿孔耳占41.5%，成功率为53.1%。手术干预组与观察组之间在穿孔特征或TT数量和类型方面无统计学差异。但手术干预队列年龄较大.在成功的手术干预组中，观察到基于术后纯音平均（PTA）阈值的听力改善。
结论：TS后DS患儿的TM穿孔率与普通人群相当。在影响言语发育的手术成功组中注意到改善的PTA阈值。DS患者鼓室成形术的总体成功率较低，强调需要根据预测的咽鼓管成熟年龄来考虑手术干预的时机。
