The prevalence of hearing impairment in infants and children with down syndrome a cross sectional study in a Tertiary Care Center

Down syndrome is the most common chromosomal disorder in humans. Hearing impairment is a common feature of Down syndrome. To assess the prevalence of hearing impairment in children with DS attending the Mansoura University Children's Hospital. The study is a descriptive cross-sectional study on 170 pediatric patients with genetically confirmed DS. Patients were recruited from the genetic outpatient clinic of the Mansoura University Children's Hospital from October 2021 to October 2022. All infants and children were subjected to full history taking, and a lateral X-ray on the nasopharynx with open mouth and extended neck. The ears were examined and cleared from accumulated cerumen if present. The presence of middle ear pathology was assessed through an otoscopic examination of the tympanic membrane. Eustachian tube dysfunction and otitis media with effusion (OME) were assessed using tympanometry. Appropriate hearing tests including pure tone audiometry (PTA) and auditory brain stem response (ABR) were used. Conductive hearing loss (CHL) was observed in 48.8% of studied children with DS and 4.1% had sensorineural hearing loss (SNHL). Among patients with hearing impairment, 86.5% had bilateral affection. The severity of hearing loss was mild in 59.1% of patients with CHL and 71.4% with SNHL. Of the patients with CHL, HL remained stationary in 45.8%, regressed from moderate to mild HL in 15.7%, and normalized in 38.6%. SNHL was permanent in all 7 affected patients with a stationary course in 4 and a progressive nature in 3. OME, upper respiratory tract infections (URTI), and adenoid enlargement were commonly associated with CHL in infants and children with DS. Most children with DS have bilateral and mild hearing loss. HL is mostly conductive. Otitis media with effusion, adenoid enlargement, and recurrent upper RTI are common in patients with conductive hearing loss. Hearing assessment should be considered in all infants and children with Down syndrome.