The onset of nonlinear growth of middle-ear responses to high intensity sounds

Insights into Human Middle Ear Implants: Uncovered Bistability

This study delves into the intricate mechanics of human middle ear implants by examining a lumped parameter model with five degrees of freedom to estimate sound transfer. The ASTM standard, recognized globally as a benchmark, served as a reference for analysis, ensuring test accuracy and providing a comprehensive evaluation framework. To assess the implant's usability, numerical simulations were conducted and compared against both the ASTM standard and the experimental results obtained from temporal bone studies. This investigation uncovered the bistability of periodic responses induced by the implant, prompting an analysis of the bistability in periodic solutions and the creation of basins of attraction for various initial conditions. The discovery of new solutions underscores this study's significance in the operation and reliability of implants. Consequently, this research not only enhances the theoretical comprehension of the system, but also holds promise for practical applications in the design and optimization of middle ear implants that transfer energy to the stapes and the cochlea.

Frequency dependence and harmonic distortion of stapes displacement and intracochlear pressure in response to very high level sounds

Previous reports have suggested that intracochlear pressures (PIC) measured at the base of the cochlea increase directly proportionally with stapes displacement (DStap) in response to moderately high (<130 dB SPL) level sounds. Consistent with this assumption, we have reported that for low frequency sounds (<1 kHz), stapes displacement and intracochlear pressures increase linearly with sound pressure level (SPL) for moderately high levels (<130 dB SPL), but saturate at higher exposure levels (>130 dB SPL). However, the magnitudes of each response were found to be frequency dependent, thus the relationship between DStap and PIC may vary at higher frequencies or higher levels. In order to further examine this frequency and level dependence, measurements of DStap and PIC were made in cadaveric human temporal bones prepared with a mastoidectomy and extended facial recess to expose the ossicular chain. PIC was measured in scala vestibuli (PSV) and scala tympani (PST) simultaneously with SPL in the external auditory canal (PEAC) and laser Doppler vibrometry (LDV) measurements of stapes velocity (VStap). Consistent with prior reports, DStap and PSV increased proportionally with sound pressure level in the ear canal up to a frequency-dependent saturation point, above which both DStap and PSV showed a distinct deviation from proportionality with PEAC, suggesting that their relationship may remain constant at these high frequencies. Likewise, while the asymptotic value, and SPL at which saturation occurred were frequency dependent in both DStap and PSV, the reduction in gain with increasing SPL above this level was constant above this level at all frequencies, and the magnitude of responses at harmonics of the driving frequency increased with increasing level, consistent with harmonic distortion via peak clipping. Importantly, this nonlinear distortion shifts the energy arriving at the inner ear to higher frequencies than are present in incident stimulus, thus exposing the high frequency sensitive components of the auditory system to more noise than would be expected from measurement of that stimulus on its own. Overall, responses suggest that the cochlear representation of very high-level air conducted stimuli is limited by nonlinearities in the middle ear, and that this peak limiting leads to increased high frequency cochlear exposures than are present in the driving stimulus.

Dynamic X-ray Microtomography vs. Laser-Doppler Vibrometry: A Comparative Study

Purpose

There are challenges in understanding the biomechanics of the human middle ear, and established methods for studying this system show significant limitations. In this study, we evaluate a novel dynamic imaging technique based on synchrotron X-ray microtomography designed to assess the biomechanical properties of the human middle ear by comparing it to laser-Doppler vibrometry (LDV).

Methods

We examined three fresh-frozen temporal bones (TB) using dynamic synchrotron-based X-ray microtomography for 256 Hz and 512 Hz, stimulated at 110 dB and 120 dB SPL. In addition, we performed measurements on these TBs using 1D LDV, a well-established method.

Results

The normalized displacement values (μm/Pa) at the umbo and the posterior crus of the stapes are consistent or within 5-10 dB differences between all LDV and dynamic microtomography measurements and previously reported literature references. In general, the overall behavior is similar between the two measurement techniques.

Conclusion

In conclusion, our results demonstrate the suitability of dynamic synchrotron-based X-ray microtomography in studying the middle ear's biomechanics. However, this study shows that better standardization regarding acoustic stimulation and measurement points is needed to better compare the two measurement techniques.

Validity of the 1984 Interim Guidelines on Airborne Ultrasound and Gaps in the Current Knowledge

ABSTRACT

Airborne ultrasound is used for various purposes both in industrial and public settings, as well as being produced as a by-product by a range of sources. The International Radiation Protection Association (IRPA) published interim guidelines on limiting human exposure to airborne ultrasound in 1984, based on the limited scientific evidence that was available at that time. In order to investigate whether research since 1984 requires the development of revised exposure guidelines we considered (a) within the context of ultrasound exposure the relevance to health of the biological endpoints/mechanisms listed in the IRPA guidelines, (b) the validity of the exposure limits, and (c) whether there are biological endpoints/mechanisms not covered in the guidelines. The analysis of the available evidence showed that the biological endpoints that form the basis of the guidelines are relevant to health and the guidelines provide limits of exposure based on the evidence that was available at the time. However, the IRPA limits and their associated dosimetry were based on limited evidence, which may not be considered as scientifically substantiated. Further, there is no substantiated evidence of biological endpoints/mechanisms not covered by the IRPA guidelines. These two observations could mean that IRPA's limits are too low or too high. Research since the IRPA guidelines has made some improvements in the knowledge base, but there are still significant data gaps that need to be resolved before a formal revision of the guidelines can be made by ICNIRP, including research needs related to health outcomes and improved dosimetry. This statement makes a number of recommendations for future research on airborne ultrasound.

Measuring the Acoustic Reflex through the Tympanic Membrane

INTRODUCTION

The acoustic reflex is the active response of the middle ear to loud sounds, altering the mechanical transfer function of the acoustic energy into the inner ear. Our goal was to observe the effect of the acoustic reflex on the tympanic membrane by identifying a significant nonlinear increase in membrane oscillations.

METHODS

By using interferometric spectrally encoded endoscopy, we record the membrane oscillations over time in response to a loud, 200-ms-long acoustic stimulus.

RESULTS

A gradual reflex activation is measured between approximately 40 and 100 ms, manifested as a linear 42% increase in the umbo oscillation amplitude.

CONCLUSION

The measured oscillations correlate well with those expected from a mechanical model of a damped harmonic oscillator, and the results of this work demonstrate the potential of interferometric spectrally encoded endoscopy to observe unique dynamical processes in the tympanic membrane and in the middle ear.

The human middle ear in motion: 3D visualization and quantification using dynamic synchrotron-based X-ray imaging

The characterization of the vibrations of the middle ear ossicles during sound transmission is a focal point in clinical research. However, the small size of the structures, their micrometer-scale movement, and the deep-seated position of the middle ear within the temporal bone make these types of measurements extremely challenging. In this work, dynamic synchrotron-based X-ray phase-contrast microtomography is used on acoustically stimulated intact human ears, allowing for the three-dimensional visualization of entire human eardrums and ossicular chains in motion. A post-gating algorithm is used to temporally resolve the fast micromotions at 128 Hz, coupled with a high-throughput pipeline to process the large tomographic datasets. Seven ex-vivo fresh-frozen human temporal bones in healthy conditions are studied, and the rigid body motions of the ossicles are quantitatively delineated. Clinically relevant regions of the ossicular chain are tracked in 3D, and the amplitudes of their displacement are computed for two acoustic stimuli.

Use of simulated data to explore the application of optical coherence tomography for classifying middle-ear pathologies

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.

Finite element modelling of the human middle ear using synchrotron-radiation phase-contrast imaging

Finite element (FE) models of the middle ear often lack accurate geometry of soft tissue structures, such as the suspensory ligaments, as they can be difficult to discern using conventional imaging modalities, such as computed tomography. Synchrotron-radiation phase-contrast imaging (SR-PCI) is a non-destructive imaging modality that has been shown to produce excellent visualization of soft tissue structures without the need for extensive sample preparation. The objectives of the investigation were to firstly use SR-PCI to create and evaluate a biomechanical FE model of the human middle ear that includes all soft tissue structures, and secondly, to investigate how modelling assumptions and simplifications of ligament representations affect the simulated biomechanical response of the FE model. The FE model included the suspensory ligaments, ossicular chain, tympanic membrane, the incudostapedial and incudomalleal joints, and the ear canal. Frequency responses obtained from the SR-PCI-based FE model agreed well with published laser doppler vibrometer measurements on cadaveric samples. Revised models with exclusion of the superior malleal ligament (SML), simplification of the SML, and modification of the stapedial annular ligament were studied, as these revised models represented modelling assumptions that have been made in literature.

Real-time measurement of stapes motion and intracochlear pressure during blast exposure

Blast-induced auditory injury is primarily caused by exposure to an overwhelming amount of energy transmitted into the external auditory canal, the middle ear, and then the cochlea. Quantification of this energy requires real-time measurement of stapes footplate (SFP) motion and intracochlear pressure in the scala vestibuli (Psv). To date, SFP and Psv have not been measured simultaneously during blast exposure, but a dual-laser experimental approach for detecting the movement of the SFP was reported by Jiang et al. (2021). In this study, we have incorporated the measurement of Psv with SFP motion and developed a novel approach to quantitatively measure the energy flux entering the cochlea during blast exposure. Five fresh human cadaveric temporal bones (TBs) were used in this study. A mastoidectomy and facial recess approach were performed to identify the SFP, followed by a cochleostomy into the scala vestibuli (SV). The TB was mounted to the "head block", a fixture to simulate a real human skull, with two pressure sensors - one inserted into the SV (Psv) and another in the ear canal near the tympanic membrane (P1). The TB was exposed to the blast overpressure (P0) around 4 psi or 28 kPa. Two laser Doppler vibrometers (LDVs) were used to measure the movements of the SFP and TB (as a reference). The LDVs, P1, and Psv signals were triggered by P0 and recorded simultaneously. The results include peak values for Psv of 100.8 ± 51.6 kPa (mean ± SD) and for SFP displacement of 72.6 ± 56.4 μm, which are consistent with published experimental results and finite element modeling data. Most of the P0 input energy flux into the cochlea occurred within 2 ms and resulted in 10-70 μJ total energy entering the cochlea. Although the middle ear pressure gain was close to that measured under acoustic stimulus conditions, the nonlinear behavior of the middle ear was observed from the elevated cochlear input impedance. For the first time, SFP movement and intracochlear pressure Psv have been successfully measured simultaneously during blast exposure. This study provides a new methodology and experimental data for determining the energy flux entering the cochlea during a blast, which serves as an injury index for quantifying blast-induced auditory damage.