ABSTRACT

Children with special needs are prone to the usual childhood otolaryngological problems but they are also predisposed to specific problems mainly related to airway difficulties and hearing loss. Children with multiple comorbidities will see many different specialties, resulting in frequent trips to the hospital. Good doctor patient/parent communication has been shown to result in improved patient knowledge, better adherence to treatment, decreased surgical morbidity and greater satisfaction with care. Many people with severe functional limitations consider they have a life of high quality and are happy to be living it while an observer may not rate it so highly. Cholesteatoma in a child with special needs is a difficult situation often requiring a general anaesthetic to confirm the diagnosis. Children with craniofacial anomalies, Down syndrome and neuromuscular disorders are all at increased risk of obstructive sleep apnoea. Gastro-oesophageal reflux is also more common, and often more severe, in children with cerebral palsy or other neuromuscular disorders.