Down syndrome surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment of individuals with Down Syndrome depends on the particular manifestations of the disease. For instance, individuals with congenital heart disease may need to undergo major corrective surgery soon after birth. Other individuals may have relatively minor health problems requiring no therapy.

Surgery

A child born with a gastrointestinal blockage may need major surgery immediately after birth. Certain heart defects may also require surgery.

Plastic surgery

Plastic surgery has sometimes been advocated and performed on children with Down syndrome, based on the assumption that surgery can reduce the facial features associated with Down syndrome, therefore decreasing social stigma, and leading to a better quality of life.[1] Plastic surgery on children with Down syndrome is uncommon,[2] and continues to be controversial. Researchers have found that for facial reconstruction, "...although most patients reported improvements in their child's speech and appearance, independent raters could not readily discern improvement...."[3] For partial glossectomy (tongue reduction), one researcher found that 1 out of 3 patients "achieved oral competence," with 2 out of 3 showing speech improvement.[4] Len Leshin, physician and author of the ds-health website, has stated, "Despite being in use for over twenty years, there is still not a lot of solid evidence in favor of the use of plastic surgery in children with Down syndrome."[5] The National Down Syndrome Society has issued a "Position Statement on Cosmetic Surgery for Children with Down Syndrome"[6] which states that "The goal of inclusion and acceptance is mutual respect based on who we are as individuals, not how we look."

References

  1. Olbrisch RR (1982). "Plastic surgical management of children with Down syndrome: indications and results". British Journal of Plastic Surgery. 35: 195–200. doi:10.1016/0007-1226(82)90163-1.
  2. Parens, E. (editor) (2006). Surgically Shaping Children : Technology, Ethics, and the Pursuit of Normality. Baltimore: Johns Hopkins University Press. ISBN 0-8018-8305-9.
  3. Klaiman, P and E Arndt (1989). "Facial reconstruction in Down syndrome: perceptions of the results by parents and normal adolescents". Cleft Palate Journal. 26: 186–190, discussion 190–192. PMID 2527096. Also, see Arndt, EM, A Lefebvre, F Travis, and IR Munro (1986). "Fact and fantasy: psychosocial consequences of facial surgery in 24 Down syndrome children". Br J Plast Surg. 4: 498–504. doi:10.1016/0007-1226(86)90120-7. PMID 2946342.
  4. SA Pensler (1990). "The efficacy of tongue resection in treatment of symptomatic macroglossia in the child". Ann Plast Surg. 25: 14–17. doi:10.1097/00000637-199007000-00003.See also KM Van Lierde, H Vermeersch, J Van Borsel, P Van Cauwenberge (2002/2003). "The impact of a partial glossectomy on articulation and speech intelligibility". Oto-Rhino-Laryngologia Nova. 12: 305–310. doi:10.1159/000083122. Check date values in: |year= (help)
  5. Leshin, L (2000). "Plastic Surgery in Children with Down Syndrome". Retrieved 2006-07-25.
  6. National Down Syndrome Society. "Position Statement on Cosmetic Surgery for Children with Down Syndrome". Retrieved 2006-06-02.

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