Roizen N J, Martich V, Ben-Ami T, Shalowitz M U, Yousefzadeh D K
University of Chicago Pritzker School of Medicine, La Rabida Children's Hospital and Research Center, IL 60649.
Clin Pediatr (Phila). 1994 Jul;33(7):439-43. doi: 10.1177/000992289403300710.
We hypothesized that many children with Down's syndrome have undiagnosed otitis media. In a 1989 study of lateral neck radiographs of 22 children with Down's syndrome, we found that 64% had sclerosis of the mastoid air cells, indicating untreated or inadequately treated otitis media. We reviewed the lateral neck radiographs of 53 children with Down's syndrome and interviewed their parents regarding the diagnosis of otitis media. Mastoid air cells were found to be sclerotic in 22 (42%) of study subjects; 32% of these had no known history of otitis media. For the 68% of children diagnosed as having had otitis media, the most common symptoms were fever (61%) and cough or coryza (58%). Sclerosis of the mastoid processes was not associated with a high frequency of otitis media (> 20 episodes) or a higher frequency of hearing loss, but was associated with subsequent myringotomy and insertion of a ventilatory tube (P = .038). Our finding of sclerotic mastoids in 42% of children with Down's syndrome raises the possibility that children with Down's syndrome have unidentified or inadequately treated episodes of otitis media.
我们推测，许多唐氏综合征患儿患有未被诊断出的中耳炎。在1989年对22名唐氏综合征患儿的颈部侧位X线片研究中，我们发现64%的患儿乳突气房硬化，这表明存在未经治疗或治疗不充分的中耳炎。我们复查了53名唐氏综合征患儿的颈部侧位X线片，并就中耳炎的诊断情况与他们的家长进行了访谈。在22名（42%）研究对象中发现乳突气房硬化；其中32%没有中耳炎确诊病史。对于被诊断患有中耳炎的68%的患儿，最常见的症状是发热（61%）和咳嗽或鼻黏膜炎（58%）。乳突硬化与中耳炎高发（>20次发作）或听力损失较高频率无关，但与随后的鼓膜切开术及置入通气管有关（P = 0.038）。我们在42%的唐氏综合征患儿中发现乳突硬化，这增加了唐氏综合征患儿存在未被识别或治疗不充分的中耳炎发作的可能性。
