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Pediatric Otolaryngology

(517) Trisomy 21 and Outcomes of Tympanostomy with Tube Insertion

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Joseph M. Berry, B.S.

    Clinical Research Fellow; M4 Medical Student
    University of Tennessee Health and Science Center; University of Mississippi Medical Center
    Jackson, Mississippi, United States

    • Co-Author(s)

  • Camron M. Davies, MD

    Resident Physician
    Loma Linda University Health
    Riverside, California, United States

  • Dhruv S. Kothari, MD

    Otolaryngology Resident
    Cedars-Sinai Medical Center
    Los Angeles, California, United States

    • Senior Author(s)

  • RY

    Robert J. Yawn, MD, MBA

    University of Tennessee Health Science Center, USA

  • Sanjeet V. Rangarajan, MD, MEng

    Associate Professor of Otolaryngology - Head and Neck Surgery
    University of Tennessee Health Science Center
    Memphis, Tennessee, United States

  • Anthony M. Sheyn, MD, FACS

    Division Chief, Pediatric Otolaryngology
    LeBonheur Children's Hospital
    Memphis, Tennessee, United States

Disclosure(s):
Joseph M. Berry, B.S.: No relevant relationships to disclose.
Camron M. Davies, MD: No relevant relationships to disclose.
Dhruv S. Kothari, MD: No relevant relationships to disclose.
Sanjeet V. Rangarajan, MD, MEng: No relevant relationships to disclose.
Anthony M. Sheyn, MD, FACS: No relevant relationships to disclose.


Introduction: Tympanostomy with tube insertion is a common procedure within the Trisomy 21 (Down Syndrome) population used to treat chronic otitis media effusion (COME) or recurrent acute otitis media (RAOM). While often viewed as a benign procedure, we set out to determine the rate of complications in the Down Syndrome population compared to those without Down Syndrome.

Methods: A retrospective analysis using TriNetX datasets from 2014 to present compared the outcomes of two cohorts: Cohort 1 (120) named Tympanostomy with Trisomy 21 ≤ 18 years old and Cohort 2 (5,120) named Tympanostomy without Trisomy 21 ≤ 18 years old. The following outcomes were measured: Development of cholesteatoma, hearing loss, tympanic membrane (TM) perforation, and requiring multiple sets of tubes.

Results: Results presented as risk ratios with 95% confidence interval (RR [95%CI]). We found Cohort 1 to have an increased risk of hearing loss [RR]: 2.048, [1.702, 2.465], TM perforation [RR]: 10.667, [5.464, 20.822], and requiring multiple sets of tubes [RR]: 3.413, [2.247, 5.184]. We found no increased risk of cholesteatoma formation.

Conclusions: We found that while tympanostomy with tube insertion is often viewed as a benign procedure, within the Down Syndrome population, we found there to be an increased risk of hearing loss, TM perforation, and requiring multiple sets of tubes. Further research should be conducted as to ways of reducing the negative outcomes observed.