title: Analysis of subtle auditory dysfunctions in young normal-hearing subjects affected by Williams syndrome.
abstract: OBJECTIVE
  To assess if young subjects affected by Williams syndrome (WS) with normal middle ear functionality and normal hearing thresholds might have subtle auditory dysfunctions that could be detected by using clinically available measurements.
  
  
  METHODS
  Otoscopy, acoustic reflexes, tympanometry, pure-tone audiometry, and distortion product otoacoustic emissions (DPOAEs) were measured in a group of 13 WS subjects and in 13 age-matched, typically developing control subjects. Participants were required to have normal otoscopy, A-type tympanogram, normal acoustic reflex thresholds, and pure-tone thresholds≤15 dB HL at 0.5, 1, and 2 kHz bilaterally. To limit the possible influence of middle ear status on DPOAE recordings, we analyzed only data from ears with pure-tone thresholds≤15 dB HL across all octave frequencies in the range 0.25-8 kHz, middle ear pressure (MEP)>-50 daPa, static compliance (SC) in the range 0.3-1.2 cm3, and ear canal volume (ECV) in the range 0.2-2 ml, and we performed analysis of covariance to remove the possible effects of middle ear variables on DPOAEs.
  
  
  RESULTS
  No differences in mean hearing thresholds, SC, ECV, and gradient were observed between the two groups, whereas significantly lower MEP values were found in WS subjects as well as significantly decreased DPOAEs up to 3.2 kHz after adjusting for differences in middle ear status.
  
  
  CONCLUSIONS
  Results revealed that WS subjects with normal hearing thresholds (≤15 dB HL) and normal middle ear functionality (MEP>-50 daPa, SC in the range 0.3-1.2 cm3, ECV in the range 0.2-2 ml) might have subtle auditory dysfunctions that can be detected by using clinically available methods. Overall, this study points out the importance of using otoacoustic emissions as a complement to routine audiological examinations in individuals with WS to detect, before the onset of hearing loss, possible subtle auditory dysfunctions so that patients can be early identified, better monitored, and promptly treated.
authors.affiliation: National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy. Electronic address: alessia.paglialonga@ieiit.cnr.it.
authors.forename: Alessia
authors.initials: A
authors.lastname: Paglialonga
authors.affiliation: Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Barozzi
authors.affiliation: Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Brambilla
authors.affiliation: Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Soi
authors.affiliation: Audiology Unit, Department of Specialistic Surgical Sciences, University of Milan; Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, via Pace 9, I-20122 Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cesarani
authors.affiliation: Audiology Unit, IRCCS Eugenio Medea, via Don Luigi Monza 20, I-23842 Bosisio Parini, Lecco, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Spreafico
authors.affiliation: National Research Council of Italy (CNR), Institute of Electronics, Computer and Telecommunication Engineering (IEIIT), Piazza Leonardo da Vinci 32, I-20133 Milano, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Tognola
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D004432:Ear, Middle / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D038781:Otoscopy; D011312:Pressure; D012022:Reflex, Acoustic / Q000502:physiology; D018980:Williams Syndrome / Q000503:physiopathology*; D055815:Young Adult
keywords: Distortion product otoacoustic emissions (DPOAE); Middle ear functionality; Otoacoustic emissions (OAE); Williams syndrome (WS)