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Lobato LC, Paul S, Cordioli JA. Stochastic modeling of the human middle ear dynamics under pathological conditions. Comput Biol Med 2024; 179:108802. [PMID: 38959526 DOI: 10.1016/j.compbiomed.2024.108802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 06/24/2024] [Accepted: 06/24/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Although the dynamics of the middle ear (ME) have been modeled since the mid-twentieth century, only recently stochastic approaches started to be applied. In this study, a stochastic model of the ME was utilized to predict the ME dynamics under both healthy and pathological conditions. METHODS The deterministic ME model is based on a lumped-parameter representation, while the stochastic model was developed using a probabilistic non-parametric approach that randomizes the deterministic model. Subsequently, the ME model was modified to represent the ME under pathological conditions. Furthermore, the simulated data was used to develop a classifier model of the ME condition based on a machine learning algorithm. RESULTS The ME model under healthy conditions exhibited good agreement with statistical experimental results. The ranges of probabilities from models under pathological conditions were qualitatively compared to individual experimental data, revealing similarities. Moreover, the classifier model presented promising results. DISCUSSION The results aimed to elucidate how the ME dynamics, under different conditions, can overlap across various frequency ranges. Despite the promising results, improvements in the stochastic and classifier models are necessary. Nevertheless, this study serves as a starting point that can yield valuable tools for researchers and clinicians.
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Affiliation(s)
- Lucas C Lobato
- Acoustic and Vibration Laboratory, Federal University of Santa Catarina, Florianopolis, 88040-900, Brazil.
| | - Stephan Paul
- Acoustic and Vibration Laboratory, Federal University of Santa Catarina, Florianopolis, 88040-900, Brazil
| | - Júlio A Cordioli
- Acoustic and Vibration Laboratory, Federal University of Santa Catarina, Florianopolis, 88040-900, Brazil
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Roychowdhury P, Castillo‐Bustamante M, Polanik MD, Kozin ED, Remenschneider AK. Ossicular joint histopathology in cases of age-related hearing loss. Laryngoscope Investig Otolaryngol 2024; 9:e1197. [PMID: 38362192 PMCID: PMC10866602 DOI: 10.1002/lio2.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 10/12/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024] Open
Abstract
Objectives Age-related hearing loss (presbycusis) is a prevalent condition traditionally attributed to inner ear dysfunction. Little is known about age-related changes in the ossicular joints or their contribution to presbycusis. Herein, we performed an otopathologic evaluation of the ossicular joints in cases of presbycusis without a clear sensorineural explanation. Methods Histopathologic analysis of the incudomallear (IM) and incudostapedial (IS) joints was performed in specimens from the National Temporal Bone Registry with audiometrically confirmed presbycusis but without histologically observed sensorineural, strial, or mixed features; deemed cases of "indeterminate" presbycusis. Specimens identified as "indeterminate" presbycusis (IP, n = 18) were compared to specimens with histologically confirmed sensorineural presbycusis (n = 16) and strial presbycusis (n = 11). Presbycutic specimens were also compared to age-matched controls (n = 9) and young controls (n = 14). Results The synovial space at the center of the IM joint was wider in the IP group (194 ± 36.8 μm) compared to age-matched controls (138 ± 36.5 μm), young controls (149 ± 32.2 μm), and ears with sensorineural presbycusis (148 ± 52.7 μm) (p < .05). The synovial space within the IS joint was wider in the IP group (105 ± 33.0 μm) when compared to age-matched controls (57.9 ± 13.1 μm) and ears with sensorineural presbycusis (62.3 ± 31.2 μm) (p < .05). Conclusion IP ears have wider IM and IS joints when compared to ears with sensorineural presbycusis and age-matched controls. Findings point to a potential middle ear source of high frequency conductive hearing loss in a subset of presbycutic ears. Level of Evidence Retrospective study.
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Affiliation(s)
- Prithwijit Roychowdhury
- Department of Otolaryngology‐Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Melissa Castillo‐Bustamante
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Marc D. Polanik
- Department of Otolaryngology‐Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
- Department of Otolaryngology‐Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Elliott D. Kozin
- Department of Otolaryngology‐Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - Aaron K. Remenschneider
- Department of Otolaryngology‐Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
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Golabbakhsh M, Funnell WRJ. Use of simulated data to explore the application of optical coherence tomography for classifying middle-ear pathologies. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:2790-2799. [PMID: 37916864 DOI: 10.1121/10.0022051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/08/2023] [Indexed: 11/03/2023]
Abstract
Optical coherence tomography (OCT) vibrometry is a non-invasive tool for functional imaging of the middle ear. It provides spatially resolved vibrational responses and also anatomical images of the same ear. Our objective here was to explore the potential of OCT vibration measurements at the incus, as well as at the umbo, to distinguish among middle-ear disorders. Our approach was to build finite-element models of normal and pathological ears, generate large amounts of synthetic data, and then classify the simulated data into normal and pathological groups using a decision tree based on features extracted from simulated vibration magnitudes. We could distinguish between normal ears and ears with incudomallear joint (IMJ) disarticulation or stapes fixation, with the sensitivity and specificity both being 1.0; distinguish between stapes fixation and IMJ disarticulation with a sensitivity of 0.900 and a specificity of 0.889; and distinguish ears with ISJ disarticulation from normal ears with a sensitivity of 0.784 and a specificity of 0.872. Less extreme pathologies were also simulated. The results suggest that the vibration measurements within the middle ear that can be provided by OCT (e.g., at the incus) may be very valuable for diagnosis.
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Affiliation(s)
- Marzieh Golabbakhsh
- Department of BioMedical Engineering, McGill University, Montréal, Québec, Canada
| | - W Robert J Funnell
- Department of BioMedical Engineering, McGill University, Montréal, Québec, Canada
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Han H, Wang L, Zhu Y, Liu Z, Sun Y, Wang J, Wang L, Xiang S, Shi H, Ding Q. Finite element analysis of conductive hearing loss caused by fixation and detachment of ligament and tendon in the middle ear. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 236:107540. [PMID: 37086583 DOI: 10.1016/j.cmpb.2023.107540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/23/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The fixation of ligament and tendon of the middle ear often occurs after chronic otitis media surgery. However, there are relatively few studies on the effect of ligament and tendon on sound transmission in the human middle ear. Here, the finite element model and lumped parameter model are used to study the effect of ligament and tendon fixation and detachment on sound transmission in human ear. METHODS In this paper, the finite element model including the external auditory canal, middle ear and simplified inner ear is used to calculate and compare the middle ear frequency response of the normal and tympanosclerosis under pure tone stimulation. In addition, the lumped parametric model is taken into account to illustrate the effect of ligament and tendon stiffness on the human ear transmission system. RESULTS The results indicate that the motion of the tympanic membrane and stapes is reduced by ligament and tendon fixation. Although ligament and tendon detachment have a limited effect in the piston-motion direction, the stability of motion in the plane perpendicular to the piston-motion direction is significantly reduced. Most significantly, the ligament and tendon fixation cause a hearing effect of about 18 dB, which is greater in the plane perpendicular to the piston-motion direction after ligament and tendon detachment than in the piston-motion direction. CONCLUSIONS In this study, the calculation accuracy of the lumped parameter and the finite element model is studied, and the effect of ligament and tendon on hearing loss is further explored through the finite element model with high calculation accuracy, which is helpful to understand the role of ligament and tendon in the sound transmission mechanism of the human middle ear. The study of ligament and tendon on conductive hearing loss provides a reference for clinical treatment of tympanosclerosis.
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Affiliation(s)
- Hongge Han
- Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China
| | - Liang Wang
- Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China
| | - Yueting Zhu
- Department of Otolaryngology, Head and Neck Surgery, Tianjin Children's Hospital, Tianjin University, Tianjin 300400, China
| | - Zhanli Liu
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, China
| | - Yongtao Sun
- Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China.
| | - Jie Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100730, China; Beijing Engineering Research Center of Audiological Technology, Beijing 100730, China
| | - Lele Wang
- Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China
| | - Shuyi Xiang
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, China
| | - Huibin Shi
- School of Aerospace Engineering, Tsinghua University, Beijing 100084, China
| | - Qian Ding
- Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China
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Ugarteburu M, Withnell RH, Cardoso L, Carriero A, Richter CP. Mammalian middle ear mechanics: A review. Front Bioeng Biotechnol 2022; 10:983510. [PMID: 36299283 PMCID: PMC9589510 DOI: 10.3389/fbioe.2022.983510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
The middle ear is part of the ear in all terrestrial vertebrates. It provides an interface between two media, air and fluid. How does it work? In mammals, the middle ear is traditionally described as increasing gain due to Helmholtz’s hydraulic analogy and the lever action of the malleus-incus complex: in effect, an impedance transformer. The conical shape of the eardrum and a frequency-dependent synovial joint function for the ossicles suggest a greater complexity of function than the traditional view. Here we review acoustico-mechanical measurements of middle ear function and the development of middle ear models based on these measurements. We observe that an impedance-matching mechanism (reducing reflection) rather than an impedance transformer (providing gain) best explains experimental findings. We conclude by considering some outstanding questions about middle ear function, recognizing that we are still learning how the middle ear works.
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Affiliation(s)
- Maialen Ugarteburu
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Robert H. Withnell
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, United States
| | - Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Alessandra Carriero
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
- *Correspondence: Alessandra Carriero, ; Claus-Peter Richter,
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, United States
- Department of Communication Sciences and Disorders, Northwestern University, Chicago, IL, United States
- The Hugh Knowles Center, Northwestern University, Chicago, IL, United States
- *Correspondence: Alessandra Carriero, ; Claus-Peter Richter,
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Yao W, Gao L, Su J, Karpeta N, Xie W, Duan M. Effects of lesions of the organ of corti on hearing. Acta Otolaryngol 2022; 142:118-126. [PMID: 35098870 DOI: 10.1080/00016489.2022.2027517] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Lesions causing changes in the microstructure of the organ of Corti may lead to hearing impairment. AIMS/OBJECTIVES The aim of this study was to investigate the effect of various structural lesions on the organ of Corti and the auditory function. METHODS A finite element method of the cochlea and the organ of Corti were established based on computed tomography scanning and anatomical data. We evaluated the accuracy of the model by comparing the simulation results to reported experimental data. We simulated and analyzed the impact of the lesions on the sound-sensing function of the cochlea by adjusting the biomaterial parameters of each component of the cochlea. RESULTS In the explored frequency range, the stereocilia and outer hair cells and basilar membrane sclerosis resulted in 23.4%, 47.2%, and 57.8% reduction of basilar membrane displacement, respectively. Lesions of the basilar membrane and stereocilia and outer hair cells in the Corti caused a hearing response curve shift to higher frequencies and a decrease of the amplitude of the basilar membrane. CONCLUSIONS AND SIGNIFICANCE Lesions of the internal structure of the Corti cause diminished movement of basement membrane and decreased sensorial function, which ultimately lead to hearing loss.
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Affiliation(s)
- Wenjuan Yao
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, P.R. China
| | - Lei Gao
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, P.R. China
| | - Jiangtao Su
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
| | - Niki Karpeta
- Division of ENT section, Department of Clinical Science, Intervention and Technology and Department of Otolaryngology Head and Neck & Audiology and Neurotology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Wen Xie
- Department of Otolaryngology, Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Maoli Duan
- Division of ENT section, Department of Clinical Science, Intervention and Technology and Department of Otolaryngology Head and Neck & Audiology and Neurotology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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ZHAO ZHENGSHAN, YAO WENJUAN, WANG JIAKUN, ZHOU LEI, HUANG XINSHENG. MECHANISM OF SENSORINEURAL HEARING LOSS CAUSED BY TYPICAL SCLEROSIS OF COCHLEA. J MECH MED BIOL 2021. [DOI: 10.1142/s0219519422500026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is difficult to measure the cochlea directly because of the ethical problems and the complexity of cochlear structure. Therefore, finite element model (FEM) can be used as an effective alternative research method. An accurate FEM of the human ear can not only help people understand the mechanisms of sound transmission, but also effectively assess the effects of otologic diseases and guide research on the treatment of hearing loss. In this paper, a three-dimensional (3D) FEM of the human normal cochlea is proposed to study the changes in the biomechanical behavior of the cochlear sensory structure caused by the anterior fissure sclerosis and bottom-turn and apex-turn ossification of the cochlear window. The degree and harm of hearing loss caused by diseases are quantitatively predicted, which can deepen the understanding of the biomechanical mechanism of cochlea, and provide theoretical basis for clinical medicine.
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Affiliation(s)
- ZHENGSHAN ZHAO
- School of Mechanics and Engineering Science, Shanghai University, Shanghai 200072, P. R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai 200072, P. R. China
| | - WENJUAN YAO
- School of Mechanics and Engineering Science, Shanghai University, Shanghai 200072, P. R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai 200072, P. R. China
| | - JIAKUN WANG
- School of Mechanics and Engineering Science, Shanghai University, Shanghai 200072, P. R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai 200072, P. R. China
| | - LEI ZHOU
- Otorhinolaryngology-Head and Neck Surgery Department, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, P. R. China
| | - XINSHENG HUANG
- Otorhinolaryngology-Head and Neck Surgery Department, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, P. R. China
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Santos A, Gradela A, Faria M. Anatomical and morphometric study of goat middle ear ossicles (Capra aegagrus hircus). ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The social and economic roles of goat farming in Northeastern Brazil, allied to the fact that the use of goat middle ear ossicles for research and human ear surgery training has not yet been proposed, justify the study of their applicability as an experimental model. The middle ears of 19 goats (Capra aegagrus hircus) from the bone collection of the Laboratory and Didactic Anatomy Museum of Domestic and Wild Animals of the Federal University of Vale do São Francisco (UNIVASF) were dissected. The malleus, incus, and stapes were evaluated regarding their macroscopic morphology and biometry (length, width, and height). Ossicle morphology was similar to sheep, human, and bovine morphology. The malleus was 1.3 times heavier and 2.2 times longer than the incus, and 9.0 times heavier and 3.7 times longer than the stapes. The size relationship was positive between the stapes and the malleus and negative between the stapes and the incus. It is concluded that the middle ear size and the anatomical similarities with human ossicles make goats a useful model for experimental scientific studies, reconstructive surgery practice of the ossicular chain, and human ear surgery training.
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Affiliation(s)
- A.C. Santos
- Universidade Federal do Vale do São Francisco, Brazil
| | - A. Gradela
- Universidade Federal do Vale do São Francisco, Brazil
| | - M.D. Faria
- Universidade Federal do Vale do São Francisco, Brazil
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Brister EY, Withnell RH, Shevchenko P, Richter CP. Are suspensory ligaments important for middle ear reconstruction? PLoS One 2021; 16:e0255821. [PMID: 34428235 PMCID: PMC8384183 DOI: 10.1371/journal.pone.0255821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/25/2021] [Indexed: 11/18/2022] Open
Abstract
As the resolution of 3D printing techniques improves, the possibility of individualized, 3-ossicle constructions adds a new dimension to middle ear prostheses. In order to optimize these designs, it is essential to understand how the ossicles and ligaments work together to transmit sound, and thus how ligaments should be replicated in a middle ear reconstruction. The middle ear ligaments are thought to play a significant role in maintaining the position of the ossicles and constraining axis of rotation. Paradoxically, investigations of the role of ligaments to date have shown very little impact on middle ear sound transmission. We explored the role of the two attachments in the gerbil middle ear analogous to human ligaments, the posterior incudal ligament and the anterior mallear process, severing both attachments and measuring change in hearing sensitivity. The impact of severing the attachments on the position of the ossicular chain was visualized using synchrotron microtomography imaging of the middle ear. In contrast to previous studies, a threshold change on the order of 20 dB across a wide range of frequencies was found when both ligaments were severed. Concomitantly, a shift in position of the ossicles was observed from the x-ray imaging and 3D renderings of the ossicular chain. These findings contrast with previous studies, demonstrating that these ligaments play a significant role in the transmission of sound through the middle ear. It appears that both mallear and incudal ligaments must be severed in order to impair sound transmission. The results of this study have significance for middle ear reconstructive surgery and the design of 3D-printed three-ossicle biocompatible prostheses.
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Affiliation(s)
- Eileen Y. Brister
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Speech, Language, and Hearing Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Robert H. Withnell
- Department of Speech, Language, and Hearing Sciences, Indiana University, Bloomington, Indiana, United States of America
| | - Pavel Shevchenko
- Advanced Photon Source, Argonne National Lab, Lemont, Illinois, United States of America
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, United States of America
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, United States of America
- The Hugh Knowles Center, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
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Roychowdhury P, Castillo-Bustamante M, Polanik M, Kozin ED, Remenschneider AK. Histopathology of the Incudomalleolar Joint in Cases of "Indeterminate" Presbycusis. Otolaryngol Head Neck Surg 2021; 165:701-704. [PMID: 33618567 DOI: 10.1177/0194599821993813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LEVEL OF EVIDENCE Retrospective study.
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Affiliation(s)
- Prithwijit Roychowdhury
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Melissa Castillo-Bustamante
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA
| | - Marc Polanik
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Elliott D Kozin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA
| | - Aaron K Remenschneider
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Evaluation of Artificial Fixation of the Incus and Malleus With Minimally Invasive Intraoperative Laser Vibrometry (MIVIB) in a Temporal Bone Model. Otol Neurotol 2020; 41:45-51. [PMID: 31664003 DOI: 10.1097/mao.0000000000002444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A significant number of adults suffer from conductive hearing loss due to chronic otitis media, otosclerosis, or other pathologies. An objective measurement of ossicular mobility is needed to avoid unnecessarily invasive middle ear surgery and to improve hearing outcomes. METHODS Minimally invasive intraoperative laser vibrometry provides a method that is compatible with middle ear surgery, where the tympanic membrane is elevated. The ossicles were driven by a floating mass transducer and their mobility was measured using a laser Doppler vibrometer. Utilising this method, we assessed both the absolute velocities of the umbo and incus long process as well as the incus-to-umbo velocity ratio during artificial fixation of the incus alone or incus and malleus together. RESULTS The reduction of absolute velocities was 8 dB greater at the umbo and 17 dB at the incus long process for incus-malleus fixations when compared with incus fixation alone. Incus fixation alone resulted in no change to the incus-to-umbo velocity ratio where incus-malleus fixations reduced this ratio (-11 dB). The change in incus velocity was shown to be the most suitable parameter to distinguish between incus fixation and incus-malleus fixation. When the whole frequency range was analyzed, one could also differentiate these two fixations from previously published stapes fixation, where the higher frequencies were less affected. CONCLUSION Minimally invasive intraoperative laser vibrometry provides a promising objective analysis of ossicular mobility that would be useful intraoperatively.
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Rusinek R, Szymanski M, Zablotni R. Biomechanics of the Human Middle Ear with Viscoelasticity of the Maxwell and the Kelvin-Voigt Type and Relaxation Effect. MATERIALS 2020; 13:ma13173779. [PMID: 32867099 PMCID: PMC7503984 DOI: 10.3390/ma13173779] [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: 07/17/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022]
Abstract
The middle ear is one of the smallest biomechanical systems in the human body and is responsible for the hearing process. Hearing is modelled in different ways and by various methods. In this paper, three-degree-of-freedom models of the human middle ear with different viscoelastic properties are proposed. Model 1 uses the Maxwell type viscoelasticity, Model 2 is based on the Kelvin–Voigt viscoelasticity, and Model 3 uses the Kelvin–Voigt viscoelasticity with relaxation effect. The primary aim of the study is to compare the models and their dynamic responses to a voice excitation. The novelty of this study lies in using different models of viscoelasticity and relaxation effect that has been previously unstudied. First, mathematical models of the middle ear were built, then they were solved numerically by the Runge–Kutta procedure and finally, numerical results were compared with those obtained from experiments carried out on the temporal bone with the Laser Doppler Vibrometer. The models exhibit differences in the natural frequency and amplitudes near the second resonance. All analysed models can be used for modelling the rapidly changing processes that occur in the ear and to control active middle ear implants.
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Affiliation(s)
- Rafal Rusinek
- Department of Applied Mechanics, Mechanical Engineering Faculty, Lublin University of Technology, 20-618 Lublin, Poland;
- Correspondence:
| | - Marcin Szymanski
- Department of Otolaryngology Head and Neck Surgery, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Robert Zablotni
- Department of Applied Mechanics, Mechanical Engineering Faculty, Lublin University of Technology, 20-618 Lublin, Poland;
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Effect of chronic suppurative otitis media on distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies. The Journal of Laryngology & Otology 2019; 133:995-1004. [PMID: 31630702 DOI: 10.1017/s0022215119002123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Detection and valid measurements of distortion product otoacoustic emissions are not influenced by cochlear status alone, but also by middle-ear status. There is a need to understand the use of ultra-high frequency distortion product otoacoustic emissions in cases of abnormal distortion product otoacoustic emission findings for conventional frequencies related to the middle-ear condition. METHOD The present study investigated distortion product otoacoustic emission input-output functions in conventional and ultra-high frequencies in: 37 adults with chronic suppurative otitis media (clinical group) and 37 adults with normal hearing sensitivity (control group). RESULTS There were significant reductions in distortion product otoacoustic emission amplitude and mean signal-to-noise ratio in the clinical group compared to the control group, especially for conventional frequencies. CONCLUSION There was a significant reduction in the rate of ears with measurable distortion product otoacoustic emissions in the clinical group, especially for conventional frequencies. The effect of chronic suppurative otitis media was more pronounced in the conventional frequency range compared to the smaller effect seen in the ultra-high frequency range.
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Zhan KY, Mattingly JK, Adunka OF. Isolated malleus fixation: A pediatric case series. Int J Pediatr Otorhinolaryngol 2019; 124:1-5. [PMID: 31136915 DOI: 10.1016/j.ijporl.2019.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/19/2019] [Accepted: 05/19/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The goal of this review was to review our series of isolated malleus fixation in pediatric patients, a rare entity causing conductive hearing loss. Malleolar fixation is poorly described in this patient population. METHODS A retrospective review of pediatric tympanoplasties by the senior author over a four-year period was performed. Only cases with isolated fixation of the malleus were reviewed. Primary outcome of interest was post-operative hearing. Paired t-tests were used to calculate pre- and post-operative hearing outcomes. RESULTS Five cases were analyzed. Mean age at time of surgery was 9.1 years (range 4.4-16.0 years). Average follow-up after surgery was 13.9 months (range 4.4-31.2 months). Patients were otherwise healthy and typically presented after a failed school hearing test despite previously good hearing. Three out of five cases showed radiographic evidence of bony fixation (60%) on computerized tomography (CT). Otoscopy was unremarkable in all cases. Average procedure time was 41.2 min and consisted of transcanal tympanoplasty with excision of fixed bony segment. A significant improvement in both pre- and post-operative air bone gaps was observed (p = 0.005)., with average ABG of 14.75 dB. CONCLUSIONS Isolated pediatric malleolar fixation is an uncommon cause of pediatric conductive hearing loss. CT scan is useful for identifying this abnormality, and surgical correction results in improved post-operative hearing outcomes, potentially obviating the need for hearing amplification.
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Affiliation(s)
- Kevin Y Zhan
- Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA
| | - Jameson K Mattingly
- Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA
| | - Oliver F Adunka
- Department of Otolaryngology - Head & Neck Surgery, Division of Pediatric Otology & Hearing Program, Nationwide Children's Hospital, Columbus, OH, USA; Department of Otolaryngology - Head & Neck Surgery, Division of Otology, Neurotology & Cranial Base Surgery, The Ohio State University, Columbus, OH, USA.
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Xie P, Peng Y, Hu J, Yi S. A study on the effect of ligament and tendon detachment on human middle ear sound transfer using mathematic model. Proc Inst Mech Eng H 2019; 233:784-792. [PMID: 31165672 DOI: 10.1177/0954411919853364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The objective of this study is to investigate the effects of ligament and tendon detachment on human middle ear sound transfer. For this purpose, a geometric human middle ear model was reconstructed based on the computed tomography scanning data of the temporal bones from healthy adult volunteers. For the ear model, pars tensa was assumed to be fit for a 5-parameter Maxwell model and inverse method was used to obtain the necessary coefficients. Furthermore, frequency response method was implemented to investigate the vibration behaviors of tympanic membrane umbo and stapes footplate under an acoustic stimulus of 90 dB within 0.2-8 kHz. Meanwhile, nine patterns of fractured ligaments and tendons, whose effects on the middle ear sound transfer function were simulated by setting free the nodes of the ligaments and tendons of interest. The results indicate that the displacement of tympanic membrane umbo and stapes footplate as well as the velocity transfer function lies within the bounds of the published experimental data. The detachments of ligaments or tendons except for lateral mallear ligament may incur both gains as much as 15 dB and losses of -8 dB in the velocity of stapes footplate at low frequencies (f≤ 1 kHz), while no significant changes were observed at high frequencies (f > 1 kHz). However, detachment of the ligaments or tendons induces tiny changes in the displacement of stapes footplate at the frequencies of 0.2-8 kHz.
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Affiliation(s)
- Pengpeng Xie
- 1 Key Laboratory of Traffic Safety on Track (Central South University), Ministry of Education, School of Traffic & Transportation Engineering, Central South University, Changsha, China.,2 Joint International Research Laboratory of Key Technology for Rail Traffic Safety, Central South University, Changsha, China
| | - Yong Peng
- 1 Key Laboratory of Traffic Safety on Track (Central South University), Ministry of Education, School of Traffic & Transportation Engineering, Central South University, Changsha, China.,3 National & Local Joint Engineering Research Center of Safety Technology for Rail Vehicle, Central South University, Changsha, China
| | - Junjiao Hu
- 4 Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shengen Yi
- 5 Research Laboratory of Hepatobiliary Diseases General Surgical Department, The Second Xiangya Hospital, Central South University, Changsha, China
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Zhang J, Tian J, Ta N, Rao Z. Transient response of the human ear to impulsive stimuli: A finite element analysis. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 143:2768. [PMID: 29857768 DOI: 10.1121/1.5026240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Nowadays, the steady-state responses of human ear to pure tone stimuli have been widely studied. However, the temporal responses to transient stimuli have not been investigated systematically to date. In this study, a comprehensive finite element (FE) model of the human ear is used to investigate the transient characteristics of the human ear in response to impulsive stimuli. There are two types of idealized impulses applied in the FE analysis: the square wave impulse (a single positive pressure waveform) and the A-duration wave impulse (both of positive and negative pressure waveforms). The time-domain responses such as the displacements of the tympanic membrane (TM), the stapes footplate (SF), the basilar membrane (BM), the TM stress distribution, and the cochlea input pressure are derived. The results demonstrate that the TM motion has the characteristic of spatial differences, and the umbo displacement is smaller than other locations. The cochlea input pressure response is synchronized with the SF acceleration response while the SF displacement response appears with some time delay. The BM displacement envelope is relatively higher in the middle cochlea and every portion of BM vibrates at its best frequency approximately. The present results provide a good understanding of the transient response of the human ear.
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Affiliation(s)
- Jing Zhang
- Institute of Vibration, Shock and Noise, State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Jiabin Tian
- Institute of Vibration, Shock and Noise, State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Na Ta
- Institute of Vibration, Shock and Noise, State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Zhushi Rao
- Institute of Vibration, Shock and Noise, State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai 200240, China
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O'Connor KN, Cai H, Puria S. The effects of varying tympanic-membrane material properties on human middle-ear sound transmission in a three-dimensional finite-element model. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2017; 142:2836. [PMID: 29195482 PMCID: PMC5681352 DOI: 10.1121/1.5008741] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
An anatomically based three-dimensional finite-element human middle-ear (ME) model is used to test the sensitivity of ME sound transmission to tympanic-membrane (TM) material properties. The baseline properties produce responses comparable to published measurements of ear-canal input impedance and power reflectance, stapes velocity normalized by ear-canal pressure (PEC), and middle-ear pressure gain (MEG), i.e., cochlear-vestibule pressure (PV) normalized by PEC. The mass, Young's modulus (ETM), and shear modulus (GTM) of the TM are varied, independently and in combination, over a wide range of values, with soft and bony TM-annulus boundary conditions. MEG is recomputed and plotted for each case, along with summaries of the magnitude and group-delay deviations from the baseline over low (below 0.75 kHz), mid (0.75-5 kHz), and high (above 5 kHz) frequencies. The MEG magnitude varies inversely with increasing TM mass at high frequencies. Increasing ETM boosts high frequencies and attenuates low and mid frequencies, especially with a bony TM annulus and when GTM varies in proportion to ETM, as for an isotropic material. Increasing GTM on its own attenuates low and mid frequencies and boosts high frequencies. The sensitivity of MEG to TM material properties has implications for model development and the interpretation of experimental observations.
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Affiliation(s)
- Kevin N O'Connor
- Department of Mechanical Engineering, Stanford University, Stanford, California 94305, USA
| | - Hongxue Cai
- Department of Mechanical Engineering, Stanford University, Stanford, California 94305, USA
| | - Sunil Puria
- Department of Otology and Laryngology, Harvard Medical School, Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
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Tachos NS, Sakellarios AI, Rigas G, Isailovic V, Ni G, Bohnke F, Filipovic N, Bibas T, Fotiadis DI. Middle and inner ear modelling: from microCT images to 3D reconstruction and coupling of models. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:5961-5964. [PMID: 28269610 DOI: 10.1109/embc.2016.7592086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present finite element (FE) modeling approaches of ear mechanics including 3-dimensional (3D) reconstruction of the human middle and inner ear. Specifically, we demonstrate a semi-automatic methodology for the 3D reconstruction of the inner ear structures, a FE harmonic response model of the middle ear to predict the stapes footplate frequency response, a 2D FE slice model of the cochlea for the coupled response at the micromechanical level for either acoustic or electrical excitation and a coupled FE middle ear model with a simplified cochlea box model to simulate the basilar membrane velocity in response to acoustic excitation. The proposed methodologies are validated against experimental and literature data and the results are in good agreement.
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Peacock J, Dirckx J, von Unge M. Intraoperative assessment of ossicular fixation. Hear Res 2016; 340:99-106. [DOI: 10.1016/j.heares.2016.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 11/29/2022]
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20
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Spiridon IF, Sakellarios AI, Rigas GA, Tagaris A, Bellos CV, Bibas A, Bohnke F, Iliopoulou D, Koutsouris D, Fotiadis DI. Effect of modeling parameters on the frequency response of the middle ear by means of finite element analysis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:925-928. [PMID: 26736414 DOI: 10.1109/embc.2015.7318514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 3D finite element model of the human middle ear was developed for the investigation of the modeling parameters' effect on the frequency response. In this study, we incorporated realistic reconstructed geometries from microCT imaging data. The geometric representation of the stapedial annular ligament provided additional damping and the Rayleigh parameter β was adjusted to lower values in comparison to previous computational studies. The maximum displacement of the stapes footplate, equal to 0.168 μm, was observed at a frequency of 1050 Hz. The computational results were validated with experimental measurements. Good agreement is observed between our results and the experimental data and other finite element studies.
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Elastic Properties of the Annular Ligament of the Human Stapes--AFM Measurement. J Assoc Res Otolaryngol 2015; 16:433-46. [PMID: 26040214 DOI: 10.1007/s10162-015-0525-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 05/17/2015] [Indexed: 10/23/2022] Open
Abstract
Elastic properties of the human stapes annular ligament were determined in the physiological range of the ligament deflection using atomic force microscopy and temporal bone specimens. The annular ligament stiffness was determined based on the experimental load-deflection curves. The elastic modulus (Young's modulus) for a simplified geometry was calculated using the Kirchhoff-Love theory for thin plates. The results obtained in this study showed that the annular ligament is a linear elastic material up to deflections of about 100 nm, with a stiffness of about 120 N/m and a calculated elastic modulus of about 1.1 MPa. These parameters can be used in numerical and physical models of the middle and/or inner ear.
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22
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YAO WENJUAN, MA JIANWEI, LUO XUEMEI, LUO BOTE. NUMERICAL ANALYSIS OF TYMPANOSCLEROSIS AND TREATMENT EFFECT. J MECH MED BIOL 2014. [DOI: 10.1142/s0219519414500511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tympanosclerosis is a typical middle ear disease, which is one of the main causes of conduction deafness. We investigate the effects of tympanosclerosis and lesion excision on sound transmission of the human ear by using finite element technique. Based on CT scan images from Zhongshan Hospital of Fudan University on the normal human middle ear, numerical values of the CT scans were obtained by further processing of the images using a self-compiled program. The CT data of the right ear from a healthy volunteer were digitalized and imported into PATRAN software to reconstruct the finite element model of the ear by a self-compiling program. A frequency response analysis was made for the model, and comparative analysis was made between the calculated results and experimental data, which validated the model in this paper. The results show that the sclerosis of the ligaments and tensor muscle in the middle ear caused by force on the ossicles is larger than the normal ear and the amplitude of the stapes footplate is larger than the normal ear. This leads to a decrease of the final conductive hearing function. Furthermore, the excision of the stapes ligament and tensor tympani is good for the restoration of normal hearing. This paper provides new research perspective for clinical treatment.
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Affiliation(s)
- WENJUAN YAO
- Department of Civil Engineering, Shanghai University, Shanghai 200072, P. R. China
| | - JIANWEI MA
- Department of Civil Engineering, Shanghai University, Shanghai 200072, P. R. China
| | - XUEMEI LUO
- Department of Otorhinolaryngology, Zhongshan Hospital, Fudan University, Shanghai 200032, P. R. China
| | - BOTE LUO
- Department of Civil Engineering, Shanghai University, Shanghai 200072, P. R. China
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Stevens-Sparks C, Strain GM. The canine jaw-ear connection: The malleomandibular and tympanomandibular ligaments. Anat Rec (Hoboken) 2014; 297:876-91. [PMID: 24488755 DOI: 10.1002/ar.22882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 05/20/2013] [Accepted: 12/19/2013] [Indexed: 11/06/2022]
Abstract
In the human, two ligaments derived from the first embryonic pharyngeal (branchial) arch that unite the mandible and temporomandibular joint (TMJ) with the middle ear have been identified as the discomalleolar ligament (DML) and sphenomandibular ligament (SML), also known as the malleomandibular ligament (MML), anterior ligament of the malleus (AML), and tympanomandibular ligament (TML). Neither of these structures has been previously described in the dog. The homologue of the human sphenomandibular ligament (SML) exists in the dog and is represented as a fibrous remnant of Meckel's cartilage. In the newborn puppy, the ligament is a true malleomandibular ligament (MML), extending from the medial mandible to the rostral process of the malleus with no intermittent attachments. In the adult dog, the ligament is entrapped within a bony passageway, likely due to the development and ossification of the tympanic bulla, making it difficult to grossly view the complete course of the ligament. The majority of the ligamentous fibers attach near the tympanic bulla in the adult dog, thus this portion of the ligament has been named the tympanomandibular ligament (TML). Those fibers of the ligament not attaching near the tympanic bulla appear to continue through a canal, located between the tympanic annulus and the surrounding tympanic bone, to become continuous with a connective tissue sheet within the cavity of the middle ear that has attachments to the malleus and incus. Tension on the adult canine TML did not result in movement of the malleus.
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Affiliation(s)
- Cathryn Stevens-Sparks
- Department of Comparative Biomedical Sciences, Louisiana State University School of Veterinary Medicine, Skip Bertman Dr., Baton Rouge, Los Angeles
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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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Abstract
CONCLUSION In the presence of simulated congenital aural atresia with fixation of the ossicular chain to the surrounding bone, access to the chain for placement of a middle ear prosthesis using the rotating burr is not associated with significant stapes movement that would cause vibrational trauma to the cochlea. OBJECTIVES To determine the energy transmitted to the cochlea while drilling the mastoid in an ear with simulated congenital aural atresia and fixation of the ossicular chain to the surrounding bone. METHODS Eight human cadaveric temporal bones were used. Cement was placed in the external auditory canal and on the incudomalleolar joint and surrounding epitympanum, to simulate congenital aural atresia and ossicular fixation, respectively. Stapes vibration was measured with the Laser Doppler Vibrometer using acoustic then drill stimulation by touching the wall of the epitympanum with a running burr. RESULTS Using acoustic stimulation, all bones showed frequency-specific reduction of stapes motion of up to 17 dB with fixation of the ossicular chain to the surrounding bone. There was no measurable stapes motion when the external auditory canal was filled with cement. On drill stimulation, there was no difference in stapes velocity between the normal bone and the bone with simulated congenital aural atresia.
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Affiliation(s)
- Nwaneka Eze
- Hearing Implant Centre, St Thomas Hospital , London , UK
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Voss SE, Nakajima HH, Huber AM, Shera CA. Function and Acoustics of the Normal and Diseased Middle Ear. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/978-1-4614-6591-1_4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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Volandri G, Di Puccio F, Forte P, Manetti S. Model-oriented review and multi-body simulation of the ossicular chain of the human middle ear. Med Eng Phys 2012; 34:1339-55. [PMID: 22472525 DOI: 10.1016/j.medengphy.2012.02.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Revised: 02/09/2012] [Accepted: 02/20/2012] [Indexed: 12/26/2022]
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Abstract
AbstractObjective:To assess results of malleostapedotomy using a Fisch Storz titanium piston with at least 10 months’ follow up.Methods:Using a prospective database, the indications, surgical technique, and pre- and post-operative audiometric data for 60 patients undergoing malleostapedotomy between 2002 and 2010 were evaluated. Diagnoses and primary and revision surgeries were compared with reference to the literature.Results:Sixty endaural malleostapedotomies were performed, 28 as a primary intervention and 32 as revision surgery. In 68 per cent, the underlying pathology was otosclerosis. The most common reason for revision surgery (i.e. in 59 per cent) was prosthesis dysfunction. Overall, the mean air–bone gap (0.5–3 kHz) for the primary intervention and revision surgery groups was 9.4 and 11.3 dB, respectively; an air–bone gap of less than 20 dB was obtained in 100 and 81 per cent of patients, respectively. There was no significant audiological difference between the primary and revision surgeries groups, and no deafness.Conclusion:Malleostapedotomy shows comparable results to standard incus-stapedotomy and may be preferable in the presented situations.
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Schwab SA, Eberle S, Adamietz B, Kuefner MA, Kramer M, Uder M, Lell M. Comparison of 128-section single-shot technique with conventional spiral multisection CT for imaging of the temporal bone. AJNR Am J Neuroradiol 2012; 33:E55-60. [PMID: 21454412 DOI: 10.3174/ajnr.a2420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Computed tomography is an essential modality for imaging of the temporal bone. Newest generation scanners allow the coverage of large examination volumes with a single gantry rotation. The objective of this study was to compare a 128-section SST (1 single rotation of the x-ray tube) with conventional spiral MSCT (ultra-high-resolution mode) for imaging of the temporal bone. MATERIALS AND METHODS Fifty-four temporal bones in 27 patients were scanned with both a conventional MSCT and 128-section SST. After blinding and randomization of both examinations, 2 observers assessed the visualization of 38 anatomic structures (eg, various segments of the facial nerve canal, mallear ligaments) by using multiplanar reconstructions in the axial and coronal planes. The differences in evaluation scores obtained for the 2 techniques were analyzed by using a Wilcoxon signed rank test, with a P value of < .05 considered significant. For both methods, imaging time and radiation exposure were noted. RESULTS Overall visualization of anatomic structures did not differ significantly between the 2 techniques (P > .05). When we compared the anatomic structures separately, there was better visualization of the lateral mallear ligament with MSCT, whereas the cochlear septa were ranked higher with SST (P < .05). Imaging time and average DLP for MSCT were 12.3 seconds and 306 mGy cm, respectively; for SST, values they were 1 second and 64 mGy cm, respectively (ie, a dose reduction of 79%). CONCLUSIONS For imaging of the temporal bone with adequate diagnostic quality, 128-section SST can be used. The main advantages over MSCT are the dramatic reductions of imaging time and radiation exposure, which are particularly important when scanning uncooperative patients or children.
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Affiliation(s)
- S A Schwab
- Department of Radiology, University Hospital Erlangen-Nuremberg, Erlangen, Germany.
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Yao W, Li B, Huang X, Guo C, Luo X, Zhou W, Duan M. Restoring hearing using total ossicular replacement prostheses--analysis of 3D finite element model. Acta Otolaryngol 2012; 132:152-9. [PMID: 22201262 DOI: 10.3109/00016489.2011.633229] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS During total ossicular replacement surgery, a better auditory functional recovery is obtained when the stapes footplate is retained. Also, the best hearing restoration is obtained when the total ossicular replacement prosthesis (TORP) is placed onto the center of the stapes footplate during operation. OBJECTIVES The effects of TORPs connecting to different positions of the stapes footplate or oval window membrane on hearing restoration were investigated. METHODS A healthy volunteer's right ear was scanned to obtain the CT data, which were digitalized using a self-compiling program and imported into PATRAN software to establish a 3D finite element model, and a harmonic response analysis was carried out using NASTRAN software. Then the effect of TORPs connecting to different positions on the stapes footplate or oval window membrane was studied. RESULTS The displacement curve of the stapes footplate was in good agreement with that of the normal ear when the TORP was connected onto the center of the stapes footplate. The best hearing restoration was obtained when the TORP was placed onto the center of the stapes footplate. The displacement curve of the stapes footplate was basically equivalent to that of the normal ear when the TORP was connected onto the anterior site, while the displacement curve of the stapes footplate differed from that of the normal ear when the TORP was connected onto the posterior site. In addition, when the TORP was connected onto the oval window membrane, the displacement curve of the stapes footplate was different from that of the normal ear.
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Affiliation(s)
- Wenjuan Yao
- Department of Civil Engineering, Shanghai University, Shanghai, China
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Wang J, Zhao F, Li Y, Han D, Gong S, Zhao S, Zhang H. Effect of anterior tympanomeatal angle blunting on the middle ear transfer function using a finite element ear model. Med Eng Phys 2011; 33:1136-46. [PMID: 21658985 DOI: 10.1016/j.medengphy.2011.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 05/08/2011] [Accepted: 05/11/2011] [Indexed: 11/29/2022]
Abstract
The anterior tympanomeatal angle (ATA) blunting is clinically defined as a certain degree of the ATA obliteration due to excessive fibrous tissue formation, which is a relatively common complication of external auditory canal (EAC) related operations. The aim of this study was to examine the effect of ATA blunting on the middle ear transfer function using a finite element (FE) model. Results showed that the displacements at the tympanic membrane (TM), at the manubrium and at the stapes footplate, and also the ratio of stapes footplate velocity to the sound pressure in the EAC were decreased to various degrees from ATA blunting of Grades 1-4. This was more significant with TM thickening at the frequencies below 3.2kHz, particularly in Grades 3 and 4 when analyzing the anterior region of the TM. The phase differences of TM and stapes footplate increased with the ATA blunting from Grades 1 to 4 in relation to normal ATA. It is noteworthy that the vibration mode of the malleus does not show obvious change, compared to the displacement reduction at the TM with ATA blunting Grades 1-4. These results suggest that FE analysis of ATA blunting effect appears to be effective.
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Affiliation(s)
- Jie Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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32
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Biomechanics of the tympanic membrane. J Biomech 2011; 44:1219-36. [PMID: 21376326 DOI: 10.1016/j.jbiomech.2010.12.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 12/13/2010] [Accepted: 12/17/2010] [Indexed: 11/23/2022]
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Sencimen M, Varol A, Baykal B, Altug HA, Dogan N, Sahin S, Okcu KM, Yalcin B. Histological Characteristics of Ligaments between Middle Ear and Temporomandibular Joint. Eur J Dent 2009; 3:280-4. [PMID: 19826599 PMCID: PMC2761158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine histological aspects of the ligaments between the middle ear and temporomandibular joint and suppose a theoretical role of their structural characteristics on mobility of mallear ossicle. METHODS The ligaments were obtained by microdissection of middle cranial fossa on both sites of 15 cadavers fixed in formalin solution and were sectioned longitudinally (7-10 mum thickness). The sections were stained with Verhoff's Van Gieson's stain (VVG) for demonstration of elastic fibers and visualized at X2.5 and X10 magnifications under light microscopy. RESULTS Anterior mallear ligament (AML) and sphenomandibular ligaments (SML) were consisted of collagen fibres in analyzed specimens. The discomallear ligament (DML) was constituted of rich collagenous fibres. One specimen of DML harvested between petrotympanic fissure and retrodiscal-capsular intersection site contained elastic fibers dispersed in cotton-bowl appearance between collagen fibers. In the light of functional tests performed in previous studies, it could be extrapolated that presence of elastic fibers in the DML may prevent excessive forces conducted to mallear head by elongation of elastic fibers. CONCLUSIONS Collagenous fibres have no ability to stretch along their axis which may lack compensatory mechanism to prevent mallear head mobility.
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Affiliation(s)
- Metin Sencimen
- Department of Oral and Maxillofacial Surgery, Gulhane Military Medical Academy, Ankara, Turkey
| | - Altan Varol
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Baris Baykal
- Department of Histology, Gulhane Military Medical Academy, Ankara, Turkey
| | | | - Necdet Dogan
- Department of Oral and Maxillofacial Surgery, Gulhane Military Medical Academy, Ankara, Turkey
| | - Sermet Sahin
- Department of Periodontology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Kemal Murat Okcu
- Department of Oral and Maxillofacial Surgery, Gulhane Military Medical Academy, Ankara, Turkey
| | - Bulent Yalcin
- Department of Anatomy, Gulhane Military Medical Academy, Ankara, Turkey
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Zhao F, Koike T, Wang J, Sienz H, Meredith R. Finite element analysis of the middle ear transfer functions and related pathologies. Med Eng Phys 2009; 31:907-16. [PMID: 19643654 DOI: 10.1016/j.medengphy.2009.06.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 06/18/2009] [Accepted: 06/25/2009] [Indexed: 11/30/2022]
Affiliation(s)
- Fei Zhao
- Centre for Hearing and Balance Studies, University of Bristol, 5th Floor, 8 Woodland Road, Bristol BS8 1TN, UK.
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Wideband Energy Reflectance Measurements of Ossicular Chain Discontinuity and Repair in Human Temporal Bone. Ear Hear 2009; 30:391-400. [DOI: 10.1097/aud.0b013e3181a283ed] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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36
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Change of middle ear transfer function in otitis media with effusion model of guinea pigs. Hear Res 2008; 243:78-86. [PMID: 18586077 DOI: 10.1016/j.heares.2008.05.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2007] [Revised: 05/05/2008] [Accepted: 05/23/2008] [Indexed: 11/22/2022]
Abstract
Otitis media with effusion (OME) is an inflammatory disease of the middle ear that causes most cases of conductive hearing loss observed in the pediatric population. With the long term goal of evaluating middle ear function with OME, the aim of the current study was to create an animal model of OME in which middle ear transfer functions could be measured. In guinea pigs, OME was created by injecting lipopolysaccharide (LPS) into the middle ear. Evidence of OME was assessed by otoscopy, tympanometry, histology, and by measuring the volume of fluid in the middle ear. Vibrations of the umbo and round window membrane were measured with a laser Doppler vibrometer at frequency range of 200-40 kHz in three groups of 3, 7, and 14 days after injection of LPS. Changes in displacement of the umbo and round window membrane in response to 80 dB SPL sound in the ear canal were measured across the frequency range. Displacement of both the umbo and round window membrane was reduced at all time points following LPS injections. Further, the change of the displacement transmission ratio (DTR) from the tympanic membrane to the round window occurred mainly in chronic (e.g. 14 days post-LPS injection) OME ears. This study provides useful data for analyzing the change of middle ear transfer function in OME ears.
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