title: An evidence-based approach to the 12-min consultation for a child with Down's syndrome.
abstract: BACKGROUND
  Down's syndrome is the commonest genetic condition. ENT problems are common in these children and can affect their development and quality of life.
  
  
  METHODS
  English literature review and experience of the senior author in managing ENT problems in children and adults with Down's syndrome.
  
  
  METHODS
  We carried out a Medline search on 31/03/2012 of English language publications using the following keywords: Down/Down's syndrome, hearing loss, ear infections, sleep apnoea, thyroid.
  
  
  RESULTS
  The prevalence, presenting features and management of many common ENT conditions are significantly different in children who have Down's syndrome. This is particularly true of otitis media with effusion and sleep-disordered breathing.
  
  
  CONCLUSIONS
  The outpatient consultation for a child with Down's syndrome should assess a range of specific ENT problems affecting this patient group including hearing issues, sleep-disordered breathing, recurrent upper respiratory tract infections, as well as other health conditions like hypothyroidism, atlantoaxial instability and cardiac issues, which can potentially affect the management of the patient.
authors.affiliation: Department of Otolaryngology and Head & Neck Surgery             Department of Paediatrics, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: V
authors.initials: V
authors.lastname: Malik
authors.forename: R U
authors.initials: RU
authors.lastname: Verma
authors.forename: V
authors.initials: V
authors.lastname: Joshi
authors.forename: P Z
authors.initials: PZ
authors.lastname: Sheehan
mesh_terms: D002675:Child, Preschool; D003937:Diagnosis, Differential; D004314:Down Syndrome / Q000150:complications*; D019317:Evidence-Based Medicine; D006801:Humans; D008487:Medical History Taking; D010038:Otorhinolaryngologic Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D010808:Physical Examination; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D013959:Thyroid Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy