Otolaryngologic manifestations of Down syndrome

Down syndrome involves otolaryngologic features that derive from congenital structural anomalies and acquired conditions. Upper airway problems include a decreased nasopharyngeal diameter, a narrowed retropalatal space, and hypotonia, all of which contribute to a high incidence of sleep apnea. Congenital or acquired subglottic stenosis and atlantoaxial instability may be present, potentially complicating general anesthesia. Conductive and sensorineural hearing loss is also significantly higher among children with Down syndrome. This article reviews the relevant literature and outlines a practical approach to the otolaryngologist's management of these children.