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Otorinolaringologia 2019 June;69(2):75-9

DOI: 10.23736/S0392-6621.18.02191-4


language: English

Effects of adenotonsillectomy in children with Down Syndrome

Francesco DISPENZA 1 , Massimo MESOLELLA 2, Sebastiano PUGLISI 3, Francesco A. SALZANO 4

1 Euromediterranean Institute of Science and Technology, Palermo, Italy; 2 Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy; 3 Department of Biomedicine and Clinical Neurosciences (Bio.Ne.C.), University of Palermo, Palermo, Italy; 4 Department of Medicine, Surgery, and Dentistry, Scuola Medica Salernitana, Salerno, Italy

BACKGROUND: Down Syndrome (DS) is one of the most frequent genetic abnormalities and the related otolaryngologic disorders may affect a full potential development and the quality of life of these patients. The aim of the present study was to evaluate which treatment, medical or surgical, may improve otolaryngologic symptoms.
METHODS: We conducted a case-control study considering the number of acute pharyngo-tonsillitis febrile episodes (PTFE), presence of obstructive sleep apnea (OSA) and middle ear disease in patients with DS referred to our centers. We selected 34 subjects with more severe symptoms and clinical course subdivided in two groups, the first group constituted by patients that underwent conservative therapy and the second group by those who underwent surgical therapy.
RESULTS: After surgical treatment we found a significant (P<0.01) reduction of PTFE and OSA grade with a normalization of tympanometry (P<0.01). Conversely, we observed a reduction of symptoms only in few cases (P>0.05) that underwent medical therapy. No major complications related to DS were observed in surgical therapy.
CONCLUSIONS: Adenotonsillectomy appears to be more helpful than medical therapy in DS subjects determining OSA, balanced with surgical risks/benefits, respiratory and ear function improvement.

KEY WORDS: Down Syndrome - Middle ear - Obstructive sleep apnea - Tonsillectomy - Adenoidectomy

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