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Partycka-Pietrzyk K, Niedzielski A, Kasprzyk A, Jabłońska J, Mielnik-Niedzielska G, Chmielik LP. Audiometric Outcomes of Ventilation Drainage Treatment for Otitis Media with Effusion in Children: Implications for Speech Development and Hearing Loss. Med Sci Monit 2023; 29:e941350. [PMID: 37752698 PMCID: PMC10543299 DOI: 10.12659/msm.941350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/18/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Otitis media with effusion is the most commonly recognized condition in childhood. Chronic otitis media with accompanying hearing loss is particularly unfavorable in the first years of the child's life because it can not only permanently damage the structure of the middle ear, but also adversely affect speech development and intellectual abilities in the child. MATERIAL AND METHODS This study, from a single center in Poland, included 201 children (372 ears) requiring surgical treatment due to otitis media with effusion. The condition was diagnosed by an ear, nose, and throat specialist, and each patient had a hearing test performed. The control group consisted of 21 patients (42 ears) with negative outcomes following an audiological interview. RESULTS Among all of the patients enrolled in the study, a normal tympanometry result was found in 60.6% of ears, and otoemission occurred in 63.3% of ears. The average hearing threshold in the study group was 22.01 Hz in the 500 Hz frequency range, while they were 16.76 Hz, 12.72 kHz, and 14.78 kHz for the corresponding 1 kHz, 2 kHz, and 4 kHz ranges, respectively. CONCLUSIONS Ventilation drainage is an effective treatment for otitis media with effusion. The presence of genetic disease has the greatest impact on the course of otitis media. These patients most often require reinsertion of a ventilation tube.
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Affiliation(s)
- Kornela Partycka-Pietrzyk
- Department of Pediatric Otolaryngology, Audiology, and Phoniatrics, Medical University of Lublin, Lublin, Poland
| | - Artur Niedzielski
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Dziekanów Leśny, Poland
| | - Anna Kasprzyk
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Dziekanów Leśny, Poland
| | - Joanna Jabłońska
- Department of Pediatric Otolaryngology, Audiology, and Phoniatrics, Medical University of Lublin, Lublin, Poland
| | - Grażyna Mielnik-Niedzielska
- Department of Pediatric Otolaryngology, Audiology, and Phoniatrics, Medical University of Lublin, Lublin, Poland
| | - Lechosław P. Chmielik
- Department of Pediatric Otolaryngology, Centre of Postgraduate Medical Education, Dziekanów Leśny, Poland
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Intractable middle ear effusion in EGPA patients might cause permanent hearing loss: a case-control study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:68. [PMID: 35933390 PMCID: PMC9357339 DOI: 10.1186/s13223-022-00706-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
Abstract
Background Ear, nose, and throat involvement are common in eosinophilic granulomatosis with polyangiitis (EGPA). Among otologic manifestation, middle ear effusion (MEE) is less recognized but a problematic condition as it may progress to hearing impairment when left untreated. This study aimed to evaluate the characteristics, risk factors and clinical outcomes of MEE in EGPA patients. Methods This is a case–control study of patients who were diagnosed and treated for EGPA from January 1995 to November 2018. Patients with ear symptoms (ear fullness, ear discharge, tinnitus or hearing loss) were assessed by otologists and were included in the case group (n = 23) if clinically relevant. The other patients without MEE were included in the control group (n = 52). Risk of MEE was calculated using the Cox proportional-hazard model. Results During median follow-up of 9.9 years, 23 (30.7%) out of 75 patients had MEE. In MEE group, 12 (52.2%) patients had hearing loss; conductive type in 10 (10/12, 83.3%) and mixed type in two (2/12, 16.7%). In multivariable regression analysis, major organ involvement at diagnosis (adjusted hazard ratio [aHR] 65.4; 95% confidence interval [CI], 1.50—2838.39; P = 0.030] , early onset of ear symptom after systemic therapy (< 6 months) (aHR 40.0; 95% CI, 1.35—1183.43; P = 0.033) and continuing the maintenance steroid without cessation (aHR 8.59; 95% CI, 1.13—65.42; P = 0.038) were independently associated with a risk of MEE. To control MEE, 16 (69.6%) patients had to increase maintenance steroid dose and 9 (39.1%) patients experienced recurrent MEE whenever maintenance dose was tapered. Conclusions MEE is a common but frequently neglected condition in EGPA which is often intractable. The maintenance steroid dose should be adequately adjusted to control MEE and to prevent from progressive hearing loss. Novel biologic agents possibly have a role in controlling MEE in EGPA.
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Thornton JL, Anbuhl KL, Tollin DJ. Temporary Unilateral Hearing Loss Impairs Spatial Auditory Information Processing in Neurons in the Central Auditory System. Front Neurosci 2021; 15:721922. [PMID: 34790088 PMCID: PMC8591253 DOI: 10.3389/fnins.2021.721922] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/29/2021] [Indexed: 11/18/2022] Open
Abstract
Temporary conductive hearing loss (CHL) can lead to hearing impairments that persist beyond resolution of the CHL. In particular, unilateral CHL leads to deficits in auditory skills that rely on binaural input (e.g., spatial hearing). Here, we asked whether single neurons in the auditory midbrain, which integrate acoustic inputs from the two ears, are altered by a temporary CHL. We introduced 6 weeks of unilateral CHL to young adult chinchillas via foam earplug. Following CHL removal and restoration of peripheral input, single-unit recordings from inferior colliculus (ICC) neurons revealed the CHL decreased the efficacy of inhibitory input to the ICC contralateral to the earplug and increased inhibitory input ipsilateral to the earplug, effectively creating a higher proportion of monaural responsive neurons than binaural. Moreover, this resulted in a ∼10 dB shift in the coding of a binaural sound location cue (interaural-level difference, ILD) in ICC neurons relative to controls. The direction of the shift was consistent with a compensation of the altered ILDs due to the CHL. ICC neuron responses carried ∼37% less information about ILDs after CHL than control neurons. Cochlear peripheral-evoked responses confirmed that the CHL did not induce damage to the auditory periphery. We find that a temporary CHL altered auditory midbrain neurons by shifting binaural responses to ILD acoustic cues, suggesting a compensatory form of plasticity occurring by at least the level of the auditory midbrain, the ICC.
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Affiliation(s)
- Jennifer L Thornton
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Kelsey L Anbuhl
- Center for Neural Science, New York University, New York, NY, United States
| | - Daniel J Tollin
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, United States
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Intracochlear Pressures in Simulated Otitis Media With Effusion: A Temporal Bone Study. Otol Neurotol 2019; 39:e585-e592. [PMID: 29912830 DOI: 10.1097/mao.0000000000001869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS Simulated otitis media with effusion reduces intracochlear pressures comparable to umbo velocity. BACKGROUND Otitis media with effusion is a common cause of temporary hearing loss, particularly in children, producing deficits of 30 to 40 dB. Previous studies measured the effects of simulated effusion on ossicular mechanics; however, no studies have measured cochlear stimulation directly. Here, we compare pressures in the scala vestibuli and tympani to umbo velocity, before and after induction of simulated effusion in cadaveric human specimens. METHODS Eight cadaveric, hemi-cephalic human heads were prepared with complete mastoidectomies. Intracochlear pressures were measured with fiber optic pressure probes, and umbo velocity measured via laser Doppler vibrometry (LDV). Stimuli were pure tones (0.1-14 kHz) presented in the ear canal via a custom speculum sealed with a glass cover slip. Effusion was simulated by filling the mastoid cavity and middle ear space with water. RESULTS Acoustic stimulation with middle ear effusion resulted in decreased umbo velocity up to ∼26 dB, whereas differential pressure (PDiff) at the base of the cochlea decreased by only ∼16 dB. CONCLUSION Simulating effusion leads to a frequency-dependent reduction in intracochlear sound pressure levels consistent with audiological presentation and prior reports. Results reveal that intracochlear pressure measurements (PSV and PST) decrease less than expected, and less than the decrease in PDiff. The observed decrease in umbo velocity is greater than in the differential intracochlear pressures, suggesting that umbo velocity overestimates the induced conductive hearing loss. These results suggest that an alternate sound conduction pathway transmits sound to the inner ear during effusion.
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Trevino M, Lobarinas E, Maulden AC, Heinz MG. The chinchilla animal model for hearing science and noise-induced hearing loss. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3710. [PMID: 31795699 PMCID: PMC6881193 DOI: 10.1121/1.5132950] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 05/07/2023]
Abstract
The chinchilla animal model for noise-induced hearing loss has an extensive history spanning more than 50 years. Many behavioral, anatomical, and physiological characteristics of the chinchilla make it a valuable animal model for hearing science. These include similarities with human hearing frequency and intensity sensitivity, the ability to be trained behaviorally with acoustic stimuli relevant to human hearing, a docile nature that allows many physiological measures to be made in an awake state, physiological robustness that allows for data to be collected from all levels of the auditory system, and the ability to model various types of conductive and sensorineural hearing losses that mimic pathologies observed in humans. Given these attributes, chinchillas have been used repeatedly to study anatomical, physiological, and behavioral effects of continuous and impulse noise exposures that produce either temporary or permanent threshold shifts. Based on the mechanistic insights from noise-exposure studies, chinchillas have also been used in pre-clinical drug studies for the prevention and rescue of noise-induced hearing loss. This review paper highlights the role of the chinchilla model in hearing science, its important contributions, and its advantages and limitations.
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Affiliation(s)
- Monica Trevino
- School of Behavioral and Brain Sciences, Callier Center, The University of Texas at Dallas, 1966 Inwood Road, Dallas, Texas 75235, USA
| | - Edward Lobarinas
- School of Behavioral and Brain Sciences, Callier Center, The University of Texas at Dallas, 1966 Inwood Road, Dallas, Texas 75235, USA
| | - Amanda C Maulden
- Department of Speech, Language, and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, Indiana 47907, USA
| | - Michael G Heinz
- Weldon School of Biomedical Engineering, Purdue University, 715 Clinic Drive, West Lafayette, Indiana 47907, USA
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Banakis Hartl RM, Greene NT, Benichoux V, Dondzillo A, Brown AD, Tollin DJ. Establishing an Animal Model of Single-Sided Deafness in Chinchilla lanigera. Otolaryngol Head Neck Surg 2019; 161:1004-1011. [PMID: 31570054 DOI: 10.1177/0194599819877649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES (1) To characterize changes in brainstem neural activity following unilateral deafening in an animal model. (2) To compare brainstem neural activity from unilaterally deafened animals with that of normal-hearing controls. STUDY DESIGN Prospective controlled animal study. SETTING Vivarium and animal research facilities. SUBJECTS AND METHODS The effect of single-sided deafness on brainstem activity was studied in Chinchilla lanigera. Animals were unilaterally deafened via gentamycin injection into the middle ear, which was verified by loss of auditory brainstem responses (ABRs). Animals underwent measurement of ABR and local field potential in the inferior colliculus. RESULTS Four animals underwent chemical deafening, with 2 normal-hearing animals as controls. ABRs confirmed unilateral loss of auditory function. Deafened animals demonstrated symmetric local field potential responses that were distinctly different than the contralaterally dominated responses of the inferior colliculus seen in normal-hearing animals. CONCLUSION We successfully developed a model for unilateral deafness to investigate effects of single-sided deafness on brainstem plasticity. This preliminary investigation serves as a foundation for more comprehensive studies that will include cochlear implantation and manipulation of binaural cues, as well as functional behavioral tests.
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Affiliation(s)
- Renee M Banakis Hartl
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Nathaniel T Greene
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Anna Dondzillo
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Andrew D Brown
- Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Daniel J Tollin
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA.,Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
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Surface Motion of Tympanic Membrane in a Chinchilla Model of Acute Otitis Media. J Assoc Res Otolaryngol 2018; 19:619-635. [PMID: 30191424 DOI: 10.1007/s10162-018-00683-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/12/2018] [Indexed: 12/27/2022] Open
Abstract
The conductive hearing loss caused by acute otitis media (AOM) is commonly related to a reduction of the tympanic membrane (TM) mobility in response to sound stimuli. However, spatial alterations of the TM surface motion associated with AOM have rarely been addressed. In this study, the TM surface motion was determined using scanning laser Doppler vibrometry (SLDV) in a chinchilla model of AOM. The AOM was established by transbullar injection of nontypeable Haemophilus influenzae. The TM surface vibration was measured in control (uninfected) animals and two AOM groups of animals: 4 days (4D) and 8 days (8D) post inoculation. To quantify the effect of middle ear pressure in those infected ears, the SLDV measurement was first conducted in unopened AOM ears and then in middle ear pressure released ears. Results showed that middle ear infection generally reduced the TM displacement across the entire surface, but the reduction in the umbo displacement over the time course, from 4 to 8 days post inoculation, was less than the reduction in the displacement at the center of each quadrant. The presence of middle ear fluid shifted the occurrence of traveling-wave-like motion on the TM surface to lower frequencies. The observation of the spatial variations of TM surface motion from this study will help refine our understanding of the middle ear sound transmission characteristics in relation to AOM.
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Alper CM, Luntz M, Takahashi H, Ghadiali SN, Swarts JD, Teixeira MS, Csákányi Z, Yehudai N, Kania R, Poe DS. Panel 2: Anatomy (Eustachian Tube, Middle Ear, and Mastoid-Anatomy, Physiology, Pathophysiology, and Pathogenesis). Otolaryngol Head Neck Surg 2017; 156:S22-S40. [PMID: 28372527 DOI: 10.1177/0194599816647959] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective In this report, we review the recent literature (ie, past 4 years) to identify advances in our understanding of the middle ear-mastoid-eustachian tube system. We use this review to determine whether the short-term goals elaborated in the last report were achieved, and we propose updated goals to guide future otitis media research. Data Sources PubMed, Web of Science, Medline. Review Methods The panel topic was subdivided, and each contributor performed a literature search within the given time frame. The keywords searched included middle ear, eustachian tube, and mastoid for their intersection with anatomy, physiology, pathophysiology, and pathology. Preliminary reports from each panel member were consolidated and discussed when the panel met on June 11, 2015. At that meeting, the progress was evaluated and new short-term goals proposed. Conclusions Progress was made on 13 of the 20 short-term goals proposed in 2011. Significant advances were made in the characterization of middle ear gas exchange pathways, modeling eustachian tube function, and preliminary testing of treatments for eustachian tube dysfunction. Implications for Practice In the future, imaging technologies should be developed to noninvasively assess middle ear/eustachian tube structure and physiology with respect to their role in otitis media pathogenesis. The new data derived from these structure/function experiments should be integrated into computational models that can then be used to develop specific hypotheses concerning otitis media pathogenesis and persistence. Finally, rigorous studies on medical or surgical treatments for eustachian tube dysfunction should be undertaken.
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Affiliation(s)
- Cuneyt M Alper
- 1 Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.,2 Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,3 Clinical and Translational Science Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Michal Luntz
- 4 Department of Otolaryngology Head and Neck Surgery, Bnai Zion Medical Center; Technion-The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Haruo Takahashi
- 5 Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Samir N Ghadiali
- 6 Department of Biomedical Engineering, Ohio University, Columbus, Ohio, USA.,7 Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Ohio University, Columbus, Ohio, USA
| | - J Douglas Swarts
- 2 Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Miriam S Teixeira
- 2 Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Zsuzsanna Csákányi
- 8 Department of Pediatric Otorhinolaryngology, Heim Pal Children's Hospital, Budapest, Hungary
| | - Noam Yehudai
- 4 Department of Otolaryngology Head and Neck Surgery, Bnai Zion Medical Center; Technion-The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel
| | - Romain Kania
- 9 Department of Otorhinolaryngology-Head and Neck Surgery, Lariboisière Hospital, Diderot University, University Paris Sorbonne, Paris, France
| | - Dennis S Poe
- 10 Department of Otology and Laryngology, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA.,11 Department of Otolaryngology and Communications Enhancement, Boston Children's Hospital, Boston, Massachusetts, USA
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Krzyżak A, Zagólski O, Pawełek M, Stręk P. Paediatric otitis media with effusion is connected to deficits in music perception. LOGOP PHONIATR VOCO 2017; 43:42-46. [PMID: 28385090 DOI: 10.1080/14015439.2017.1312514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE This study tested the hypothesis that children with otitis media with effusion (OME) attending a primary school are at risk of impairment of their musical skills. OME is characterized as an inflammation with accumulation of secretion in the tympanic cavity, leading to conductive hearing loss. METHOD Perception of music in children is assessed using the Montreal Battery of Evaluation of Music Abilities (MBEMA). Listeners are required to judge whether two successive melodies are the same or different on tests of scale, contour, interval and rhythm. They are also queried by a memory test. A total of 92 children (49 girls and 43 boys), aged 6.0-8.0 years (mean 7.3, SD 0.7), attending a music school, were examined using the MBEMA. Twenty-three children were allocated to the OME group, while the remaining 69 to the control group. Age and gender distribution did not differ between children with OME and the controls. All participants had normal bone conduction hearing thresholds. The conductive hearing loss of the children with OME did not exceed 40 dB at any frequency. Their OME was bilateral and had lasted 3-9 months. RESULTS The obtained scale, rhythm and total MBEMA scores were higher in the control group than in the OME group, with statistically significant differences for scale and rhythm scores. CONCLUSIONS OME can influence music perception in children at the beginning of their school education. OME correlates with both pitch- and rhythm-related aspects of music perception.
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Affiliation(s)
- Anna Krzyżak
- a Faculty of Philology , Pedagogical University of Kraków , Poland
| | - Olaf Zagólski
- b Department of Otorhinolaryngology , St. John Grande's Hospital , Kraków , Poland
| | - Michał Pawełek
- c Composition, Interpretation and Musical Education Faculty , Academy of Music in Kraków , Poland
| | - Paweł Stręk
- d Department of Otorhinolaryngology , Collegium Medicum Jagiellonian University , Kraków , Poland
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Air-Bone Gaps Contribute to Functional Hearing Preservation in Cochlear Implantation. Otol Neurotol 2016; 37:1255-62. [DOI: 10.1097/mao.0000000000001171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liang J, Luo H, Yokell Z, Nakmali DU, Gan RZ, Lu H. Characterization of the nonlinear elastic behavior of chinchilla tympanic membrane using micro-fringe projection. Hear Res 2016; 339:1-11. [PMID: 27240479 DOI: 10.1016/j.heares.2016.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 04/01/2016] [Accepted: 05/08/2016] [Indexed: 11/29/2022]
Abstract
The mechanical properties of an intact, full tympanic membrane (TM) inside the bulla of a fresh chinchilla were measured under quasi-static pressure from -1.0 kPa to 1.0 kPa applied on the TM lateral side. Images of the fringes projected onto the TM were acquired by a digital camera connected to a surgical microscope and analyzed using a phase-shift method to reconstruct the surface topography. The relationship between the applied pressure and the resulting volume displacement was determined and analyzed using a finite element model implementing a hyperelastic 2(nd)-order Ogden model. Through an inverse method, the best-fit model parameters for the TM were determined to allow the simulation results to agree with the experimental data. The nonlinear stress-strain relationship for the TM of a chinchilla was determined up to an equibiaxial tensile strain of 31% experienced by the TM in the experiments. The average Young's modulus of the chinchilla TM from ten bullas was determined as approximately 19 MPa.
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Affiliation(s)
- Junfeng Liang
- Department of Mechanical Engineering, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Huiyang Luo
- Department of Mechanical Engineering, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Zachary Yokell
- School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA
| | - Don U Nakmali
- School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA
| | - Rong Zhu Gan
- School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA
| | - Hongbing Lu
- Department of Mechanical Engineering, The University of Texas at Dallas, Richardson, TX 75080, USA.
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Ravicz ME, Chien WW, Rosowski JJ. Restoration of middle-ear input in fluid-filled middle ears by controlled introduction of air or a novel air-filled implant. Hear Res 2015; 328:8-23. [PMID: 26121946 DOI: 10.1016/j.heares.2015.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/01/2015] [Accepted: 06/22/2015] [Indexed: 11/17/2022]
Abstract
The effect of small amounts of air on sound-induced umbo velocity in an otherwise saline-filled middle ear (ME) was investigated to examine the efficacy of a novel balloon-like air-filled ME implant suitable for patients with chronically non-aerated MEs. In this study, air bubbles or air-filled implants were introduced into saline-filled human cadaveric MEs. Umbo velocity, a convenient measure of ME response, served as an indicator of hearing sensitivity. Filling the ME with saline reduced umbo velocity by 25-30 dB at low frequencies and more at high frequencies, consistent with earlier work (Ravicz et al., Hear. Res. 195: 103-130 (2004)). Small amounts of air (∼30 μl) in the otherwise saline-filled ME increased umbo velocity substantially, to levels only 10-15 dB lower than in the dry ME, in a frequency- and location-dependent manner: air in contact with the tympanic membrane (TM) increased umbo velocity at all frequencies, while air located away from the TM increased umbo velocity only below about 500 Hz. The air-filled implant also affected umbo velocity in a manner similar to an air bubble of equivalent compliance. Inserting additional implants into the ME had the same effect as increasing air volume. These results suggest these middle-ear implants would significantly reduce conductive hearing loss in patients with chronically fluid-filled MEs.
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Affiliation(s)
- Michael E Ravicz
- Eaton-Peabody Laboratory, Massachusetts Eye & Ear Infirmary, 243 Charles St., Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA.
| | - Wade W Chien
- Eaton-Peabody Laboratory, Massachusetts Eye & Ear Infirmary, 243 Charles St., Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA
| | - John J Rosowski
- Eaton-Peabody Laboratory, Massachusetts Eye & Ear Infirmary, 243 Charles St., Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA 02115, USA
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13
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Harrington M. All ears. Lab Anim (NY) 2014; 43:189. [DOI: 10.1038/laban.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Guan X, Chen Y, Gan RZ. Factors affecting loss of tympanic membrane mobility in acute otitis media model of chinchilla. Hear Res 2014; 309:136-46. [PMID: 24406734 DOI: 10.1016/j.heares.2013.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 12/18/2013] [Accepted: 12/26/2013] [Indexed: 11/20/2022]
Abstract
Recently we reported that middle ear pressure (MEP), middle ear effusion (MEE), and ossicular changes each contribute to the loss of tympanic membrane (TM) mobility in a guinea pig model of acute otitis media (AOM) induced by Streptococcus pneumoniae (Guan and Gan, 2013). However, it is not clear how those factors vary along the course of the disease and whether those effects are reproducible in different species. In this study, a chinchilla AOM model was produced by transbullar injection of Haemophilus influenzae. Mobility of the TM at the umbo was measured by laser vibrometry in two treatment groups: 4 days (4D) and 8 days (8D) post inoculation. These time points represent relatively early and later phases of AOM. In each group, the vibration of the umbo was measured at three experimental stages: unopened, pressure-released, and effusion-removed ears. The effects of MEP and MEE and middle ear structural changes were quantified in each group by comparing the TM mobility at one stage with that of the previous stage. Our findings show that the factors affecting TM mobility do change with the disease time course. The MEP was the dominant contributor to reduction of TM mobility in 4D AOM ears, but showed little effect in 8D ears when MEE filled the tympanic cavity. MEE was the primary factor affecting TM mobility loss in 8D ears, but affected the 4D ears only at high frequencies. After the release of MEP and removal of MEE, residual loss of TM mobility was seen mainly at low frequencies in both 4D and 8D ears, and was associated with middle ear structural changes. Our findings establish that the factors contributing to TM mobility loss in the chinchilla ear were similar to those we reported previously for the guinea pig ears with AOM. Outcomes did not appear to differ between the two major bacterial species causing AOM in these animal models.
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Affiliation(s)
- Xiying Guan
- School of Aerospace and Mechanical Engineering and Bioengineering Center, University of Oklahoma, 865 Asp Avenue, Room 200, Norman, OK 73019, USA
| | - Yongzheng Chen
- School of Aerospace and Mechanical Engineering and Bioengineering Center, University of Oklahoma, 865 Asp Avenue, Room 200, Norman, OK 73019, USA
| | - Rong Z Gan
- School of Aerospace and Mechanical Engineering and Bioengineering Center, University of Oklahoma, 865 Asp Avenue, Room 200, Norman, OK 73019, USA.
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