Ear canal size, age, and ear wax problems in Down Syndrome

What is it about?

Down Syndrome (DS) has been associated with smaller ear canals, predisposing to ear wax problems, that may in turn lead to decreased hearing. Although the current recommendation is for persons with DS to undergo ear check ups every 3 months until the age of 3 to allow sufficient widening of the ear canals and lessen ear wax problems, it is not known at what age and ear canal diameter ear wax problems decrease (if indeed they do). We studied 260 ears of persons with DS to find out what age and ear canal size are associated with a significantly higher likelihood of earwax problems in DS.

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Why is it important?

We found that an ear canal diameter of 4mm or less, and age of 1 year or less, are associated with a significantly higher likelihood of ear wax problems, and attention should be particularly focused on these children by parents, caregivers, and healthcare providers (instead of recommending blanket ear check ups on all children with DS every 3 months until the age of 3, especially in low- and middle-income country settings). Providers should also be more vigilant in caring for persons with DS of Filipino heritage, as they have significantly more ear wax problems compared to the general Philippine population, and significantly smaller ear canals than persons with DS elsewhere.