Peripheral and central auditory findings in individuals with Williams syndrome

Introduction: Williams syndrome (WS) is a rare neurodevelopment genetic condition. The syndrome may present manifestations associated with the central nervous system, hearing, and language. It is possible, as well, to observe an alteration in the central auditory system, which can be diagnosed through long-latency auditory evoked potential (LLAEP). Objective: The aim of this study was to describe and analyze the results obtained by peripheral and central auditory evaluation on individuals with WS, verifying if there is a relationship between audiological findings and gender, age and ear side. Methods: This is a cross-sectional study in which 14 individuals with WS were evaluated. The exams performed consisted of pure tone audiometry, vocal audiometry, acoustic immittance measures, LLAEP, and cognitive potential. Results: The sample was composed of patients from 4 to 18 years old, with a mean age of 11.6 years old (±5.3), being 9 males (64.3%) and 5 females (35.7%). We mainly verified mild to moderate degree (40-44%) of sensorineural auditory loss (35.7-42.9%), type A tympanometric curve (57.1-64.3%), and absent acoustic reflexes (57.1%). As for central auditory evaluation, the subjects showed latency delay in all of the LLAEP components. Moreover, it was evidenced a statistically significant difference when comparing ears for amplitude on cognitive potential evaluation (p = 0.032), observing higher values at the left ear. It was also observed an inverse association between age and P1 wave latency both on the right (p = 0.006) and on the left ear (p = 0.022), and this result can be related to the nervous system maturational process of the WS individuals. Conclusion: There are few studies investigating the central auditory pathway on WS in literature. The present study contributes to the extension of the knowledge about the central involvement of the auditory phenotype in the syndrome. However, considering the sample size, more studies are suggested to confirm these findings

Hearing characterization in oculoauriculovertebral spectrum : a prospective study with 10 patients

Oculoauriculovertebral spectrum (OAVS), also known as Goldenhar syndrome, is considered a condition associated to failing of embryogenesis involving the first and second branchial arches, leading to structural abnormalities arising from it. The aim of this study is to verify the hearing features presented by patients with OAVS and provide additional information that may contribute to improvement of speech therapy. The sample consisted of 10 individuals diagnosed with OAVS and cared for by the Clinical Genetics Service. All patients underwent objective assessment of auditory function through tonal and vocal audiometry. This evaluation was completed using TOAE and BERA. The patient’s age ranged from 1 year and 9 months to 27 years and 4 months. At physical examination it was found that 10 had microtia, 7 preauricular tags, 6 low-set ears, 6 ear canal atresia, and 2 preauricular pits. Among the patients, five presented with abnormal hearing. Three patients had conductive hearing loss ranging from mild to moderate, and two patients had sensorineural hearing loss from mild to profound. Three patients had hearing loss in both ears. Speech-language disorders are common in children with OAVS. Thus, the referral to the audiologist and speech pathologist is indicated as soon as possible. Early recognition and detailed understanding of aspects related to the etiology, clinical features, and outcome of patients with OAVS are essential for their proper management

Espectro óculo-aurículo-vertebral e malformações cardíacas

OBJETIVO: Verificar a frequência e tipos de cardiopatias congênitas em uma amostra de pacientes portadores de espectro óculo-aurículo-vertebral (EOAV), tentando correlacionar a presença desta malformação com suas demais características clínicas e evolução. MÉTODOS: A amostra foi composta por 33 indivíduos, todos atendidos em um mesmo centro, no período de janeiro de 1975 a dezembro de 2007. Vinte e dois deles eram do sexo masculino e 11 do feminino e suas idades variaram de 1 dia a 17 anos. Todos apresentavam avaliação cariotípica normal por bandas GTG. Realizou-se uma coleta de dados referentes à sua história clínica, exame físico e resultado de avaliações complementares. RESULTADOS: Anormalidades cardíacas foram observadas em 13 pacientes (39,4%). Dessas, cinco (38,5%) eram do tipo conotruncal, sendo o principal defeito a tetralogia de Fallot (n=2). Malformações não usuais identificadas incluíram o cor triatriatum e a dupla via de entrada de ventrículo esquerdo. Diferenças significativas entre as características clínicas do grupo com e sem cardiopatia foram verificadas somente em relação à idade na primeira avaliação, que foi mais baixa naqueles com malformações cardíacas. Cinco indivíduos foram a óbito, quatro deles portadores desses defeitos. CONCLUSÃO: Malformações cardíacas, em especial dos tipos conotruncal e septal, são frequentes entre pacientes com EOAV. A frequência encontrada em nosso estudo foi estatisticamente similar à da maior parte dos trabalhos descritos na literatura, que oscila de 18% a 58%. As cardiopatias congênitas também representam a principal causa de óbito desses indivíduos. Portanto, uma avaliação cardiológica, especialmente precoce, deveria ser sempre realizada nesses pacientes.OBJECTIVE: To verify the frequency and types of congenital heart defects in a sample of patients with oculo-auriculo-vertebral spectrum (OAVS), in an effort to correlate presence of these defects with other clinical characteristics and evolution. METHODS: The sample comprised 33 subjects, all attended in the same center, between January 1975 and December 2007. Twenty two of them were male and eleven female and their ages ranged from 1 day to 17 years. All presented normal karyotype by GTG-Banding. A data collection related to their clinical history, physical examination and result of complementary evaluations was performed. RESULTS: Cardiac abnormalities were observed in 13 patients (39.4%). Of these defects, 5 (38.5%) were conotruncal, tetralogy of Fallot being the main malformation (n=2). Unusual anomalies identified included cor triatriatum and double inlet left ventricle. Significant differences among the clinical characteristics of the group with and without heart defect were only verified in relation to age at first evaluation that was lower in subjects with cardiac malformations. Five patients died, four of them, bearers of congenital heart defects. CONCLUSION: Cardiac malformations, mainly conotruncal and septal defects, are frequent among patients with OAVS. Frequency found in our study was statistically similar to the majority of works described in literature where it ranged from 18 to 58%. Congenital heart defects also represent the main cause of death of these subjects. Thus, a cardiac evaluation should always be performed in these patients, especially at an early age