Background: Down syndrome (DS) can affect the upper and lower respiratory tract in a number of ways and disorders of
other systems can impact upon respiratory function, giving rise to a wide variety of respiratory manifestations.
Objective: To investigate the frequency, associated conditions, and type of airway anomalies in DS children with respiratory problems.
Material and Method: Twenty-nine children with DS were evaluated for airway anomalies, with indications of atelectasis, stridor, and recurrent or persistent pneumonia, using flexible fiberoptic bronchoscopy (FB). The children were assessed retrospectively.
Results: Results showed high frequency of associated conditions, which was found in 19 children. The most common associated condition was congenital heart disease. Other associated conditions were hypothyroid and duodenal atresia. Endoscopic findings showed several airways anomalies, including laryngomalacia, tracheal bronchus, and subglottic stenosis. Three patients had multiple airway anomalies and three had normal endoscopic findings.
Conclusion: DS children with respiratory problems have high frequency of airway anomalies and FB, which is a useful diagnostic procedure. A thorough understanding of the airway anomalies will aid in the evaluation and management of DS children with respiratory problems.

Keywords: Down syndrome, Bronchoscopy, Airway anomalies