Estimation of the Young's modulus of the human pars tensa using in-situ pressurization and inverse finite-element analysis

Experimental Study of Needle Insertion into Gerbil Tympanic Membrane

The perforation characteristics and fracture-related mechanical properties of the tympanic membrane (TM) greatly affect surgical procedures like myringotomy and tympanostomy performed on the middle ear. We analyzed the most important features of the gerbil TM perforation using an experimental approach that was based on force measurement during a 2-cycle needle insertion/extraction process. Fracture energy, friction energy, strain energy, and hysteresis loss were taken into consideration for the analysis of the different stages of needle insertion and extraction. The results demonstrated that (1) although the TM shows viscoelastic behavior, the contribution of hysteresis loss was negligible compared to other irreversible dissipated energy components (i.e., fracture energy and friction energy). (2) The TM puncture force did not substantially change during the first hours after animal death, but interestingly, it increased after 1 week due to the drying effects of soft tissue. (3) The needle geometry affected the crack length and the most important features of the force-displacement plot for the needle insertion process (puncture force, puncture displacement, and jump-in force) increased with increasing needle diameter, whereas the insertion velocity only changed the puncture and jump-in forces (both increased with increasing insertion velocity) and did not have a noticeable effect on the puncture displacement. (4) The fracture toughness of the gerbil TM was almost independent of the needle geometry and was found to be around 0.33 ± 0.10 kJ/m2.

Inaccuracies of deterministic finite-element models of human middle ear revealed by stochastic modelling

For over 40 years, finite-element models of the mechanics of the middle ear have been mostly deterministic in nature. Deterministic models do not take into account the effects of inter-individual variabilities on middle-ear parameters. We present a stochastic finite-element model of the human middle ear that uses variability in the model parameters to investigate the uncertainty in the model outputs (umbo, stapes, and tympanic-membrane displacements). We demonstrate: (1) uncertainties in the model parameters can be magnified by more than three times in the umbo and stapes footplate responses at frequencies above 2 kHz; (2) middle-ear models are biased and they distort the output distributions; and (3) with increased frequency, the highly-uncertain regions spatially spread out on the tympanic membrane surface. Our results assert that we should be mindful when using deterministic finite-element middle-ear models for critical tasks such as novel device developments and diagnosis.

Mammalian middle ear mechanics: A review

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.

Statistical analysis of the human middle ear mechanical properties

Many experimental data on the human middle ear (ME) mechanics and dynamics can be found in the literature. Nevertheless, discussions about the uncertainties of these data are scarce. The present study compiles experimental data on the mechanical properties of the human ME. The summary statistics of mean and standard deviation of the data were collected and the coefficients of variation were computed and pooled. Moreover, the linear correlation and distribution were assessed for the ossicles' mass. Results show that, generally, the uncertainties of the stiffness properties of the tympanic membrane, ligaments, and tendons are larger than the uncertainties of the ossicles' mass. In addition, the uncertainties of the ME response vary across frequency. The vibration measures, such as the stapes' velocity normalized by the sound pressure at the tympanic membrane, are more uncertain than ME input impedance and reflectance. It is expected that the results presented in this study will provide the basis for the development of probabilistic models of the human ME.

Parameter Identification From Normal and Pathological Middle Ears Using a Tailored Parameter Identification Algorithm

Current clinical practice is often unable to identify the causes of conductive hearing loss in the middle ear with sufficient certainty without exploratory surgery. Besides the large uncertainties due to interindividual variances, only partially understood cause-effect principles are a major reason for the hesitant use of objective methods such as wideband tympanometry in diagnosis, despite their high sensitivity to pathological changes. For a better understanding of objective metrics of the middle ear, this study presents a model that can be used to reproduce characteristic changes in metrics of the middle ear by altering local physical model parameters linked to the anatomical causes of a pathology. A finite-element model is, therefore, fitted with an adaptive parameter identification algorithm to results of a temporal bone study with stepwise and systematically prepared pathologies. The fitted model is able to reproduce well the measured quantities reflectance, impedance, umbo and stapes transfer function for normal ears and ears with otosclerosis, malleus fixation, and disarticulation. In addition to a good representation of the characteristic influences of the pathologies in the measured quantities, a clear assignment of identified model parameters and pathologies consistent with previous studies is achieved. The identification results highlight the importance of the local stiffness and damping values in the middle ear for correct mapping of pathological characteristics and address the challenges of limited measurement data and wide parameter ranges from the literature. The great sensitivity of the model with respect to pathologies indicates a high potential for application in model-based diagnosis.

Structural stiffening in the human middle ear due to static pressure: Finite-element analysis of combined static and dynamic middle-ear behavior

The vibration response of the middle ear (ME) to sound changes when static pressure gradients are applied across the tympanic membrane (TM). To date, it has not been well understood which mechanisms lead to these changes in ME vibration response. In this study, a 3D finite-element model of the human ME was developed that simulates the sound-induced ME vibration response when positive and negative static pressures of up to 4 kPa are applied to the TM. Hyperelasticity of the soft-tissue components was considered to simulate large deformations under static pressure. Some ME components were treated as viscoelastic materials to capture the difference between their static and dynamic stiffness, which was needed to replicate both static and dynamic ME behavior. The change in dynamic stiffness with static preload was simulated by linearization of the hyperelastic constitutive model around the predeformed state. For the preloaded harmonic response, we found that the statically deformed ME geometry introduced asymmetry in the vibration loss between positive and negative pressure, which was due to the TM cone shape. As opposed to previous assumptions, the prestress in the ME due to static pressure had a substantial impact on the vibration response. We also found that material nonlinearity led to a higher stiffening at the umbo but a less pronounced stiffening at the footplate compared to the linear elastic condition. The results suggest that flexibility of the incudomalleolar joint (IMJ) enhances the decoupling of static umbo and footplate displacements, and that viscosity and viscoelasticity of the IMJ could play a role in the transfer of sound-induced vibrations from the umbo to the footplate. The components of the incudostapedial joint had minimal effect on ME mechanical behavior.

High-resolution imaging of the human incudostapedial joint using synchrotron-radiation phase-contrast imaging

The incudostapedial joint (ISJ) of the middle ear is important for proper transmission of sound energy to the cochlea. Recently, the biomechanics of the ISJ have been investigated using finite-element (FE) modelling, using simplified geometry. The objective of the present study was to investigate the feasibility of synchrotron-radiation phase-contrast imaging (SR-PCI) in visualising the ISJ ultrastructure. Three human cadaveric ISJs were dissected and scanned using SR-PCI at 0.9 µm isotropic voxel size. One of the samples was previously scanned at 9 µm voxel size. The images were visually compared and contrast-to-noise ratios (CNRs) were calculated (of both bone and soft tissues) for quantitative comparisons. The ISJ ultrastructure as well as adjacent bone and soft tissues were clearly visible in images with a 0.9 µm voxel size. The CNRs of the 0.9 µm images were relatively lower than those of the 9 µm scans, while the ratio of bone to soft tissue CNRs were higher, indicating better discernibility of bone from soft tissue in the 0.9 µm scans. This study was the first known attempt to image the ISJ ultrastructure using an SR-PCI scanner at submicron voxel size and results suggest that this method was successful. Future studies are needed to optimise the contrast and test the feasibility of imaging the ISJ in situ. LAY DESCRIPTION: The human middle ear consists of the eardrum, three small bones (the malleus, incus and stapes) and two joints connecting the bones (the incudostapedial joint and the incudomallear joint). The role of the middle ear is to amplify and transfer sound energy to the cochlea, the end organ of hearing. The incudostapedial joint (ISJ) of the middle ear is a synovial joint which is important for proper transmission of sound energy to the cochlea. Similar to other synovial joints it consists of meniscus, fluid and articulating surfaces. Recently, the biomechanics of the ISJ have been investigated using computational models, using grossly simplified geometry. Synchrotron radiation phase contrast imaging (SR-PCI) is a high-resolution imaging technique used to visualise small structures in three dimensions. The objective of the present study was to investigate the feasibility of using SR-PCI in visualising the ISJ ultrastructure. Three human cadaveric ISJs were dissected and scanned using SR-PCI at 0.9 µm isotropic voxel size. One of the samples was previously scanned at 9 µm voxel size. The images were both qualitatively and quantitatively compared. This study was the first known attempt to image the ISJ ultrastructure using an SR-PCI scanner at submicron voxel size and results suggest that this method was successful. Future studies are needed to optimise the contrast and feasibility of imaging the ISJ in situ.

The effect of blast overpressure on the mechanical properties of the human tympanic membrane

The rupture of the tympanic membrane (TM) is one of the major indicators for blast injuries due to the vulnerability of TM under exposure to blast overpressure. The mechanical properties of the human TM exhibit a significant change after it is exposed to such a high intensity blast. To date, the published data were obtained from measurement on TM strips cut from a TM following an exposure to blast overpressure. The dissection of a TM for preparation of strip samples can induce secondary damage to the TM and thus potentially lead to data not representative of the blast damage. In this paper, we conduct mechanical testing on the full TM in a human temporal bone. A bulging experiment on the entire TM is carried out on each sample prepared from a temporal bone following the exposure to blast three times at a pressure level slightly below the TM rupture threshold. Using a micro-fringe projection method, the volume displacement is obtained as a function of pressure, and their relationship is modeled in the finite element analysis to determine the mechanical properties of the post-blast human TMs, the results of which are compared with the control TMs without an exposure to the blast. It is found that Young's modulus of human TM decreases by approximately 20% after exposure to multiple blast waves. The results can be used in the human ear simulation models to assist the understanding of the effect of blast overpressure on hearing loss.

The effects of varying tympanic-membrane material properties on human middle-ear sound transmission in a three-dimensional finite-element model

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 (P_EC), and middle-ear pressure gain (MEG), i.e., cochlear-vestibule pressure (P_V) normalized by P_EC. The mass, Young's modulus (E_TM), and shear modulus (G_TM) 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 E_TM boosts high frequencies and attenuates low and mid frequencies, especially with a bony TM annulus and when G_TM varies in proportion to E_TM, as for an isotropic material. Increasing G_TM 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.