Introduction: The researches about more specific audiological procedures is increasing. Differentiating the refers in audiological exams from middle ear changes to sensorineural hearing loss is important not only in newborn hearing screening programs. It is possible to investigate the functioning of the middle ear with a relatively recent procedure, the reflectance. This procedure can detect changes of the middle ear that the tympanometry can not detect, which may interfere in the results of otoacoustic emissions. The reflectance is a rapid procedure that can be applied in populations with difficulties for testing. Objective: To identify small changes of the middle ear status that the tympanometry can not detect and may be linked with failures in otoacoustic emissions. Methodology: The sample of the study will consist of 60 participants until 15 years, male and female gender, distributed into two groups: group 1: 30 individuals with Down syndrome and group 2: 30 individuals of the same age of group 1, without the Down syndrome with normal hearing, presence of acoustic reflex on 500, 1000, 2000 and 4000 Hz frequencies and no changes in middle ear at the tympanometry Procedures: The subjects will be evaluated with the tympanometry with the 226 Hz probe tone, otoacoustic emissions, reflectance of the middle ear to obtain the reflectance curve with chirp stimuli and pure tone stimuli at 200 to 6000 Hz frequencies range. The Individuals in Group 1 may be evaluated with audiometry, depending on their collaboration, or behavioral assessment of hearing. Results: The studied variables will be submitted to statistical analysis for comparison between groups, procedures and ear. It is expected that the results confirm the hypothesis of the study, that the reflectance is more sensitive in identifying middle ear changes instead of tympanometry with probe 226 Hz probe tone.
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