Our Summary

This study looks at how ear problems, specifically chronic middle ear infections and issues with the Eustachian tube, are common in people with Down syndrome. These problems can lead to holes in the eardrum, which often require surgery to fix. The study looked at 91 ears in 69 patients with Down syndrome who had these holes in their eardrums. Some had surgery to fix the problem, while others were just monitored.

The study found that surgery was successful in repairing the eardrums in about half of the cases. The success rate increased to about 70% after a second surgery. In comparison, only about a third of the eardrums healed on their own without surgery. The biggest risk factor for surgery not working was ongoing problems with middle ear infections and the Eustachian tube.

The study also found that patients who had the surgery had worse hearing before the operation compared to those who didn’t have surgery. However, their hearing did improve after the operation. Regardless of whether they had surgery, a lot of the patients needed hearing aids (about half in both groups).

In conclusion, the study found that persistent holes in the eardrums in children with Down syndrome were associated with a history of chronic middle ear infections and Eustachian tube issues, as well as having had multiple previous surgeries to insert tubes into the ears. Surgery to repair the eardrums was generally successful, but many patients still had some hearing loss.

FAQs

  1. What was the main objective of the study on tympanoplasty and Down syndrome?
  2. What was the success rate of the surgery to repair the eardrums in patients with Down syndrome?
  3. Did the hearing of patients with Down syndrome improve after the tympanoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow post-operative care instructions carefully to ensure proper healing and minimize the risk of complications. This may include keeping the ear dry, avoiding activities that could increase pressure in the ear (such as flying or scuba diving), and attending follow-up appointments to monitor healing progress. It’s also important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended tympanoplasty are those who have persistent holes in their eardrums due to chronic middle ear infections, Eustachian tube issues, or previous surgeries. This includes individuals with Down syndrome, as they are more prone to developing these ear problems. Tympanoplasty may be recommended to improve hearing, prevent further infections, and repair the eardrum.

Timeline

Before tympanoplasty:

  1. Patient experiences chronic middle ear infections and issues with the Eustachian tube, leading to holes in the eardrum.
  2. Patient may have tried other treatments such as hearing aids or ear tubes before considering surgery.
  3. Hearing loss and ongoing ear infections may be present.

After tympanoplasty:

  1. Surgery is performed to repair the eardrum and improve hearing.
  2. Success rate of surgery is about 50%, increasing to 70% after a second surgery.
  3. Patients may still experience some hearing loss post-surgery.
  4. Patients with Down syndrome may still require hearing aids following surgery.
  5. Ongoing monitoring and follow-up care may be needed to ensure the success of the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tympanoplasty include:

  1. What are the risks and potential complications associated with tympanoplasty surgery?
  2. What is the success rate of tympanoplasty in repairing eardrums, particularly in cases of chronic middle ear infections and Eustachian tube issues?
  3. How long is the recovery period after tympanoplasty surgery?
  4. Will I need to wear a hearing aid after the surgery, and if so, for how long?
  5. Are there any alternative treatments or options to consider before undergoing tympanoplasty?
  6. What can I expect in terms of improvements in my hearing after the surgery?
  7. How many surgeries are typically needed to fully repair a hole in the eardrum?
  8. Will I need to follow any specific post-operative care instructions or restrictions?
  9. How will ongoing issues with middle ear infections and the Eustachian tube affect the success of the surgery?
  10. What is the long-term outlook for my ear health after undergoing tympanoplasty?

Reference

Authors: Ghadersohi S, Ida JB, Bhushan B, Billings KR. Journal: Int J Pediatr Otorhinolaryngol. 2017 Dec;103:36-40. doi: 10.1016/j.ijporl.2017.10.004. Epub 2017 Oct 5. PMID: 29224762