The pressure equalization tubes will be pushed out of the tympanic membrane after a few months to a year of having them in place, but if they are placed correctly they are extremely effective, allowing the fluid to leave the middle ear space. If an adenoidectomy is to be performed as well, it will probably be during the same surgery. Adenoidectomy removes the adenoids if they are enlarged. Removal may be beneficial because it is behind the adenoids that glue ear may reoccur after pressure equalization tube placement.
Another option is microsuction, which involves inserting a needle through the tympanic membrane and using it to draw out the fluid.
The upside to this procedure is that the fluid does not end up in the external auditory canal and have to be cleaned, which is especially helpful in children with Down syndrome with narrow canals. The downside of microsuction is that it often requires several procedures. Like glue ear, cerumen impaction is a very common otologic pathology, and it has a high incidence in individuals with Down syndrome.
It is a common cause of conductive hearing loss. Ear wax is meant to protect the skin of the canal, especially when it is filled with water. Normally, the wax should move towards the opening of the ear it is easily washed away. As mentioned before, individuals with Down syndrome often have cerumen that is abnormally hard or thick and accumulates quickly in a narrow ear canal and may quickly block the canal with partial or full occlusion.
This may result in a reversible conductive hearing loss. The combination of the accumulation of thick cerumen and auditory canal stenosis can quickly lead to a conductive hearing loss.
The symptoms of impacted cerumen are earaches, the sensation of plugged ears, tinnitus, and some hearing loss. To remove the ear wax, oil can be used to soften the cerumen. This may also be done as a preventative measure. Many cases of cerumen impaction may be treated at home, but in cases of auditory canal stenosis, the family may have an otolaryingologist remove the wax. Irrigation of the ear canal may also be effective, but irrigation should never be performed if the tympanic membrane may be perforated as this could lead to acoustic trauma or otitis media.
The cholesteatoma may continue to enlarge to the point where it will destroy bone. If untreated, lesions may break through the temporal bone and apply pressure to the brain, which may result in infection that may, in turn, lead to intercranial abscesses.
If an individual complains of otorrhea discharge from the ear or hearing loss, an otolaryngologist should realize that cholesteatoma might be present Bacciu et al. Cholesteatomas may cause irreversible hearing loss but fortunately, most incidences may be cured through surgery. The surgery's outcome depends on the size of the cholesteaoma when it is diagnosed.
For children, it is important that lesions in the tympanic membrane are diagnosed by a pediatrician and that the child is then referred to an otolaryngologist.
The cholesteatoma will be first noticeable as a round cyst, white in color, that can be seen behind the tympanic membrane, which is still in tact. If the cholesteatoma goes unnoticed, it will grow and the middle ear space will have a large white mass that bulges outward.
A cholestatoma may be congenital or acquired. As they enlarge, the normal variegated appearance of the middle-ear space disappears, replaced by a bulging white mass. In the early stages of the cholesteatoma, it is unusual for the tympanic membrane to be perforated and for drainage to occur. These incidents most often come months or years after the onset of hearing loss which helps emphasize the importance of early detection Issacson A study by Bacciu, Pasanisi, Vincent, et al.
This study exemplified some of the methods used to treat cholesteatoma as well as the challenges inherent in the treatment of this otologic pathology for Down syndrome individuals. They followed nine pediatric patients that were being surgically treated, and two of the patients had cholesteatoma in both ears bilateral , which brought the total of ears being treated to Two of the ears underwent a canal-wall-up mastoidectomy, while eight ears underwent a canal-wall-down mastoidectomy.
Mastoidectomy refers to the removal of an infected section of the mastoid bone. One ear underwent a modified Bondy procedure, a modification of the mastoidectomy which entails exteriorizing the mastoid cavity leaving the pars tensa and ossicles intact. The outcome of this study was that one of the ears that underwent the canal-wall-up mastoidectomy was found to have reamaining cholesteatoma present. Another ear, after the same procedure, developed recurrent cholesteatoma which necessitates a change to a canal-wall-down mastoidectomy.
Another patient's neotympanic membrane became perforated and had to be repaired. This study demonstrated that cholesteatoma can be difficult to completely eradicate in a patient with Down syndrome, and an emphasis should always be put on early diagnosis and prevention especially in light of the challenges presented by the orofacial and craniofacial anatomy of children with Down syndrome. One of the reasons this happens is because the Cochlear hair cells may be absent.
If the hair cells are present, they may still be subject to early degeneration. Once they reach their teenage years and after, they have a good chance of cochlear degeneration occurring.
Hearing aids are often looked at as a viable option for even mild loses and amplification plays an important role in treating hearing loss in children with Down syndrome because it is probable that even a mild loss will have a strong impact on the development of their language.
This is a severe concern, so hearing aids are also often recommended for conductive hearing loses that may last for over a few months. Hearing aids are also used with Down syndrome adult individuals who are living with early onset dementia because the loss may significantly affect their cognition skills. There are special considerations to take into account when Down syndrome individuals are to receive hearing aids because their ears tend to be smaller.
It may also be that hearing aids are not appropriate for a child and a classroom FM system may be implemented instead. For cases of sensorineural hearing loss, recruitment is nearly always concomitant with the loss.
Recruitment refers to the perception that the level of sound drastically increases for specific frequencies and becomes too loud too quickly and causes pain. It follows, then, that recruitment may lead to sound intolerance. This concern will be reflected in the prescription for the amplification devices. When sex cells divide through the process of meiosis, one cell splits into two parts so that each of the resulting cells only has 23 chromosomes, rather than But many mistakes can occur during cell division.
During meiosis, the chromosomes are supposed to split and go to different areas of the cell. This step of meiosis is called disjunction.
But sometimes during cell division, a chromosome will not remove itself and it will stay with its pair of chromosome. This ends in one of the new cells having 24 chromosomes and the other having only 22 chromosomes. A mistake such as this is called non-disjunction. If a cell with this mistake mates with a normal cell, the fertilized egg will end up with an uneven number of chromosomes. In people with Down syndrome, there are three 21st chromosomes due to non-disjunction and the mating of an abnormal cell with a normal cell of 23 chromosomes.
This is where the name trisomy 21 originated from. But many errors can occur during cell division. This step in the process of meiosis is called disjunction. But sometimes during cell division, a chromosome will not detach and it will stay with its pair chromosome. This results in one of the new cells having 24 chromosomes and the other having only 22 chromosomes. An error such as this is called non-disjunction. If a cell with this error mates with a normal cell, the fertilized egg will end up with an uneven number of chromosomes.
This is where the name trisomy 21 originates. The second factor affects Down syndrome phonological system is the differences in anatomy and physiology. Children with Down syndrome have similar features such as small mouth, the deficient in the facial and tongue muscles, muscle weakness, and protruded tongue.
All these features affect the pronunciation of both consonant and vowels. In terms of intervention in this domain, Yarter suggested physiotherapy and exercises to improve speech-motor deficits related to hypotonicity.
Kumin, Councill and Goodman suggested strengthening the orofacial musculature through a program of lip massage. The third factor is the language input the child received from his parents and caregiver. Parents and caregivers should increase this type of input. The second part of the study provides four aspects of Down syndrome phonology. The first aspect is the prelinguistic vocal development. Investigations of prelinguistic development suggests that infants with Down syndrome are nearly typical in this domain.
Because hypotonicity and delays in motor development are characteristic of Down syndrome, the relative instability in canonical babbling may be a consequence of deficits in the motor domain. The second aspect is the transition to speech. In a longitudinal study of typically developing infants, Robb, Bauer, and Tyler reported that when their subjects had a productive vocabulary of about 10 different words, the proportion of words and babble in their spontaneous productions was roughly equal.
When the productive vocabulary reached 50 words, at around 18 months of age, the ratio of words to babble was about three to one. During the transition to speech, the phonetic characteristics of babble and speech are highly similar Locke, ; Stoel-Gammon, Specifically, the types of consonants that occur most frequently in late babbling, namely, stops, nasals and glides, also predominate in early word productions, while the consonants that are infrequent in babble, liquids, fricatives, and affricates, are precisely those that appear later in the acquisition of meaningful speech Stoel-Gammon, Moreover, the consonant-vowel syllable structure which is characteristic of the canonical babbling period is also the most frequent syllabic type in early word productions.
Thus, among the typically developing population, babbling and early speech share the same basic phonetic properties in terms of sound types and syllable shapes. In general, increased use of complex babble in the prelinguistic period is linked to better performance on the speech and language measures after the onset of speech and in the years that follow.
These findings suggest that babbling serves as a foundation for the acquisition of speech and language; Most children with Down syndrome exhibit a substantial delay in the appearance of first words, in spite of their normal babbling patterns.
In this paper we will look at a short description of what Down syndrome really is, the genetic causes of Translocated Down syndrome, symptoms, characteristics, medications, intervention programs and .
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Down Syndrome can be diagnosed in infancy based on the characteristic medical findings. When Down Syndrome is assumed in a person, a genetic test called a “chromosome analysis” is performed on a blood or skin sample to look for an extra chromosome 21 (trisomy 21). DOWN SYNDROME Down Syndrome is a congenital disorder arising from a chromosome It comes from a defect involving chromosome The condition leads to impairments in both cognitive ability and physical growth that range from mild to moderate developmental disabilities.
Essay about Down Syndrome Words | 6 Pages. Down syndrome Down syndrome takes its name from Dr. Langdon Down. He was the first person to describe the syndrome in The earliest recorded incident of someone having Down syndrome dates back to an altar piece painted in a church in Aachen, Germany in Down syndrome is the most frequent genetic cause of mild to moderate intellectual and developmental, it occurs in out 1 of births (“Down syndrome” par.1). The discovery of Down syndrome was in by Dr. John Langdon Haydon Down, who worked in an English hospital for mental disabilities. Dr.