A 1-year-old girl with Down syndrome is brought to the clinic with poor feeding, irritability, and pulling at both ears. On examination, both tympanic membranes are dull and immobile, without obvious signs of acute inflammation. What is the likely diagnosis and treatment?
This child's symptoms and physical examination findings suggest bilateral otitis media with effusion (OME), a common condition in children with Down syndrome due to Eustachian tube dysfunction. Initial management typically involves observation, as many cases resolve spontaneously. However, due to the increased risk of speech and language delay in children with Down syndrome, early intervention with tympanostomy tube placement may be considered.