While glue ear is common, Down syndrome provides extra complications to this condition. For one, the glue-like substance is stickier which makes it more difficult to wash and prone to infection. Again, anatomy may affect the condition because if the Eustachian tubes are narrower and more horizontal, it will be difficult for the Eustachian tube to let the middle ear drain.
Treatment of glue ear is essential because, if left untreated, glue ear may result in irreversible damage to the middle ear, this may be due to the lack of motility of the ossicles. Fortunately, there are three main approaches to treating glue ear: The procedure to inset pressure equalization tubes is called a myringotomy operation and refers to the small cut made in the tympanic membrane which may also be done as a separate procedure. It is generally performed with the patient under a general anesthetic.
If the fluid is very viscous a cut will be made to let air into the middle ear space while the other cut drains the fluid. Pressure equalization tubes go through the tympanic membrane, relieving the often painful pressure of the fluid against the eardrum, and allow for the fluid in the middle ear to drain into the external auditory canal. The tube is held in place by the tension in the tympanic membrane. 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. It occurs as a random mistake during cell division early in fetal development. Translocation Down syndrome can be inherited.
An unaffected person can carry a rearrangement of genetic material between chromosome 21 and another chromosome. This rearrangement is called a balanced translocation because there is no extra material from chromosome Although they do not have signs of Down Syndrome, people who carry this type of balanced translocation are at an increased risk of having children with the condition.
But now they are known as people, individuals with a condition known as Down syndrome. But with industrial advances within the scientific community, more information has been gathered about the condition research shows that Down Syndrome is a genetic condition caused by certain chromosomal abnormalities.
Chromosomes within cells are composed of proteins and genetic information in the form of DNA. Human cells normally contain 23 pairs of chromosomes to make a total of 46 chromosomes in each cell. 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.
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. Taken together, the research by Buckley and B. Smith indicates that the onset of meaningful speech is significantly delayed in the infants with Down syndrome and that after the appearance of words, growth of productive vocabulary is exceedingly slow.
Other investigations of lexical acquisition in children with Down syndrome have shown that even when the Down syndrome group is matched to a typically developing control group on mental rather than chronological age, lexical acquisition in children with Down syndrome is delayed Chapman, Smith, ; Stoel-Gammon, , As might be expected, however, phonological acquisition in children with Down syndrome proceeds more slowly than in their cognitively typical peers.
Smith and Stoel-Gammon calculated the rate of suppression of four phonological processes in their longitudinal study. Errors documented for young children with Down syndrome tend to persist through adolescence and even adulthood.
Dodd ; suggested that these errors are related toa general deficit in their motor abilities. In terms of intervention for single-word productions, most programs focus on increasing the phonetic repertoire and reducing the number of errors, using therapy techniques similar to those for children with phonological delay or disorder.
Long-standing difficulties with intelligibility can presumably be attributed to phonological patterns associated with Down syndrome. The ultimate goal of such programs is to allow individuals with learning disabilities to live independently and work in the community. In the domain of speech and language, efforts are often directed toward increasing the functional communication skills necessary for social interactions and vocational training with little emphasis on phonology skills per se.
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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 testing for Down syndrome while an infant is still in the womb.
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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.
Down Syndrome Essay Words | 5 Pages. Down Syndrome They used to be called "Mongoloids," an ethnic insult coined by John Langdon Down, an English physician during the nineteenth century. But now they are known as people, individuals with a condition known as Down syndrome. (3). Most children with Down syndrome exhibit a substantial delay in the appearance of first words, in spite of their normal babbling patterns. Taken together, the research by Buckley and B.L. Smith indicates that .