Finite element analysis of the middle ear transfer functions and related pathologies

Mechanical Effects of Medical Device Attachment to Human Tympanic Membrane

PURPOSE

Several treatment methods for hearing disorders rely on attaching medical devices to the tympanic membrane. This study aims to systematically analyze the effects of the material and geometrical properties and location of the medical devices attached to the tympanic membrane on middle-ear vibrations.

METHODS

A finite-element model of the human middle ear was employed to simulate the effects of attachment of medical devices. Various types of material and geometrical properties, locations, and modeling scenarios were investigated for the medical device.

RESULTS

The attachment of the device magnifies the effects of anti-resonances of the middle ear. Additionally, the variations of the material properties of the device significantly alter the middle-ear resonance frequency while changes in the umbo and stapes footplate motions are negligible at frequencies above 5 kHz. Furthermore, modeling the device as a point mass cannot accurately represent the implanted middle-ear behavior. The variations of the diameter and height of the medical device have negligible effects on the middle-ear vibrations at frequencies below 200 Hz but can have considerable impacts at higher frequencies. The effects of changing the device height were negligible at frequencies above 2 kHz. We also discuss the effects of medical device attachment on the vibration patterns of the tympanic membrane as well as the impacts of the variations of the location of the device on the stapes footplate responses.

CONCLUSION

The findings of our study aid the development and optimization of new therapeutic devices, attached to the tympanic membrane, to have the least adverse effects on middle-ear vibrations.

Mechanical effect of reconstructed shapes of autologous ossicles on middle ear acoustic transmission

Conductive hearing loss is caused by a variety of defects, such as chronic otitis media, osteosclerosis, and malformation of the ossicles. In such cases, the defective bones of the middle ear are often surgically reconstructed using artificial ossicles to increase the hearing ability. However, in some cases, the surgical procedure does not result in increased hearing, especially in a difficult case, for example, when only the footplate of the stapes remains and all of the other bones are destroyed. Herein, the appropriate shapes of the reconstructed autologous ossicles, which are suitable for various types of middle-ear defects, can be determined by adopting an updating calculation based on a method that combines numerical prediction of the vibroacoustic transmission and optimization. In this study, the vibroacoustic transmission characteristics were calculated for bone models of the human middle ear by using the finite element method (FEM), after which Bayesian optimization (BO) was applied. The effect of the shape of artificial autologous ossicles on the acoustic transmission characteristics of the middle ear was investigated with the combined FEM and BO method. The results suggested that the volume of the artificial autologous ossicles especially has a great influence on the numerically obtained hearing levels.

Finite-Element Modelling Based on Optical Coherence Tomography and Corresponding X-ray MicroCT Data for Three Human Middle Ears

PURPOSE

Optical coherence tomography (OCT) is an emerging imaging modality which is non-invasive, can be employed in vivo, and can record both anatomy and vibrations. The purpose here is to explore the application of finite-element (FE) modelling to OCT data.

METHODS

We recorded vibrations for three human cadaver middle ears using OCT. We also have X-ray microCT images from the same ears. Three FE models were built based on geometries obtained from the microCT images. The material properties and boundary conditions of the models were obtained from previously reported studies.

RESULTS

Tympanic-membrane (TM) vibration patterns were computed for the three models and compared with the patterns measured using OCT. Frequency responses were also computed for all three models for several locations in the middle ear and compared with the OCT displacements and with the literature. The three models were compared with each other in terms of geometry and function. Parameter sensitivity analyses were done and the results were compared among the models and with the literature. The simulated TM displacement patterns are qualitatively similar to the OCT results. The simulated displacements are closer to the OCT results for 500 Hz and 1 kHz but the differences are greater at 2 kHz.

CONCLUSION

This study provides an initial look at the combined use of OCT measurements and FE modelling based on subject-specific anatomy. The geometries and parameters of the existing FE models could be modified for individual patients in the future to help identify abnormalities in the middle ear.

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.

Rabbit tympanic membrane thickness distribution obtained via optical coherence tomography

Knowing the precise tympanic membrane (TM) thickness variation is crucial in understanding the functional properties of the TM and has a significant effect on the accuracy of computational models. Using optical coherence tomography, we imaged five left and five right TMs of domestic New Zealand rabbits. From these data, ten thickness distribution maps were computed. Although inter-specimen variability is present, similar features could be observed in all samples: The rabbit TM is thickest around the umbo, with values of 150 ± 32 µm. From the umbo towards the TM annulus, the thickness gradually decreases down to 38 ± 7 µm around the midway location, but increases up to 54 ± 19 µm at the TM annulus. The thickness values at the umbo are comparable to literature data for humans, but the rabbit TM is thinner at the TM annulus and in-between the umbo and annulus. Moreover, the rabbit TM thickness distribution is highly symmetrical, which is not the case for the human TM. The results improve our general understanding of TM structure in rabbits and may improve numerical models of TM dynamical behavior.

A comprehensive finite-element human ear model to estimate noise-induced hearing loss associated with occupational noise exposure

BACKGROUND AND OBJECTIVE

Noise is a common occupational and environmental hazard; however, little is known about the use of computational tools to quantitively analyze data on basilar membrane (BM) damage in noise-induced hearing loss (NIHL). Here, we established a comprehensive three-dimensional finite-element human ear model to quantify the impact of noise exposure on BM and perilymph fluid.

METHODS

We used auditory risk units (ARUs) to evaluate the BM damage for subjects (3 men and 5 women; mean age, 32.75 ± 8.86 years; age range, 24-44 years). A 90-dB sound pressure level (SPL) was normally applied at the external auditory canal (EAC) entrance to simulate sound transmission from the EAC to the cochlea at frequencies of 0.2-10.0 kHz.

RESULTS

The pressure distribution of perilymph fluid is totally different on frequency responses under low and high sound-evoked (0.013-10.0 kHz). The highest ARUs were 18.479% at the distance of 1 mm from the base, and the second-highest to fourth-highest ARUs occurred at distances of 5-7 mm from the base, where their ARUs were 9.749%, 9.176%, and 11.231%. The total of the ARUs reached 81.956% at external frequencies' sounds of 3.2-5.0 kHz. Among these, the 3.8-kHz and 3.6-kHz frequencies yielded the highest and second-highest ARUs of 20.325% and 19.873%, respectively.

CONCLUSIONS

This study would inform our understanding of NIHL associated with occupational noise exposure. We present a FE modelling and describe how it might provide a unique way to unravel mechanisms that drive NIHL due to loud noises.

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.

Effects of age-related tympanic-membrane material properties on sound transmission in the middle ear in a three-dimensional finite-element model

BACKGROUND AND OBJECTIVES

The Young's modulus of the tympanic membrane (TM) is an important modeling parameter in computer simulations of the sound transmission in the ear. Understanding the material mechanics of the TM is essential to improve the coupling between the tympanic membrane and the auditory ossicles. However, the impact of the age-related Young's modulus of the TM on sound transmission is not well known. The objective of this study was to use a comprehensive finite element (FE) model to assess the impact of Young's modulus on sound transmission from the ear canal to the stapes footplate over acoustic frequencies.

METHODS

The FE model of the ear canal, the middle ear, and the inner ear, was constructed. The model was constructed with identical geometries and boundary conditions, but with three different Young's moduli for the TMs. The auditory ossicles, suspensory ligaments and tendons, and manubrium were also modeled as isotropic elastic materials. Beside, we evaluated the age-related Young's moduli of the TMs on sound transmission with the FE element fluid-structural interaction (FSI) model under acoustic loading conditions.

RESULTS

The impact of the age-related Young's moduli on the sound pressure distributions in the ear canal was significant over two frequency ranges of 1.4-3.2 and 8.6-10 kHz. Meanwhile, the significant differences of the displacement of the stapes occurred at around 1.6 kHz, where the displacement of the stapes decreased from 0.352 nm to 0.287 nm.

CONCLUSIONS

The FSI model could demonstrate the influence of Young's modulus of the TM on the transfer of sound-induced vibrations form the ear canal to the stapes footplate. The FE model may provide appropriate information to the medical device development of artificial ossicles and hearing aids.

Material Identification on Thin Shells Using the Virtual Fields Method, Demonstrated on the Human Eardrum

Characterization of material parameters from experimental data remains challenging, especially on biological structures. One of such techniques allowing for the inverse determination of material parameters from measurement data is the virtual fields method (VFM). However, application of the VFM on general structures of complicated shape has not yet been extensively investigated. In this paper, we extend the framework of the VFM method to thin curved solids in three-dimensional, commonly denoted shells. Our method is then used to estimate the Young's modulus and hysteretic damping of the human eardrum. By utilizing Kirchhoff plate theory, we assume that the behavior of the shell varies linearly through the thickness. The total strain of the shell can then be separated in a bending and membrane strain. This in turn allowed for an application of the VFM based only on data of the outer surface of the shell. We validated our method on simulated and experimental data of a human eardrum made to vibrate at certain frequencies. It was shown that the identified material properties were accurately determined based only on data from the outer surface and are in agreement with literature. Additionally, we observed that neither the bending nor the membrane strain in an human eardrum can be neglected and both contribute significantly to the total strain found experimentally.

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.

Auditory ossicles in ScanningElectron Microscopy

<b>Introduction: </b>Knowledge about the physiology of a healthy middle ear is essential for understanding the activity and mechanics of the ear as well as the basics of ossiculoplasty. Trauma of the epithelial lining of the tympanic cavity as well as the ossicular chain may be the result of chronic inflammation and surgery. Depending on the observed changes of the middle ear lining, there are several types of distinguished chronic inflammatory changes: simple, with cholesteatoma, with the formation of inflammatory granulation tissue, in course of specific diseases. <br><b>Purpose: </b>The aim of the article is presentation of the microstructure and vasculature of the ossicular chain in the Scanning Electron Microscope. Particular attention is drawn to the anatomical aspects of the structure and connections of auditory ossicles as vital elements for reconstruction of the conduction system of the middle ear. <br><b>Material and method: </b>The analysis covered auditory ossicles standardly removed in accordance with the methodology of the investigated surgical procedures. The preparations were evaluated in a scanning electron microscope. <br><b>Results: </b>The exposure of bone surface promotes deep erosion. The advanced process of destruction of bone surface in the case of chronic otitis media correlates with a significant degree of damage to both the lining covering the auditory ossicles and that surrounding articular surfaces. <br><b>Conclusions: </b>(1) The ossicles in the image of the Scanning Electron Microscope are covered with lining. It passes from the surface of the ossicles to the vascular bundles, forming vascular sheaths; (2) Damage to lining continuity on the surface of the auditory ossicles promotes the rapid destruction of bone tissue in the inflammatory process; (3) The dimensions of the individual ossicles are respectively: malleus - 8.36 +/- 0.01, incus - 8.14 +/- 0.0, stapes - 3.23 +/- 0.01 mm. Behavior of the anatomical length of ossicular chain during tympanoplasty appears to be essential to maintaining adequate vibration amplitude of the conductive system of the middle ear.

Analysing wideband absorbance immittance in normal and ears with otitis media with effusion using machine learning

Wideband Absorbance Immittance (WAI) has been available for more than a decade, however its clinical use still faces the challenges of limited understanding and poor interpretation of WAI results. This study aimed to develop Machine Learning (ML) tools to identify the WAI absorbance characteristics across different frequency-pressure regions in the normal middle ear and ears with otitis media with effusion (OME) to enable diagnosis of middle ear conditions automatically. Data analysis included pre-processing of the WAI data, statistical analysis and classification model development, and key regions extraction from the 2D frequency-pressure WAI images. The experimental results show that ML tools appear to hold great potential for the automated diagnosis of middle ear diseases from WAI data. The identified key regions in the WAI provide guidance to practitioners to better understand and interpret WAI data and offer the prospect of quick and accurate diagnostic decisions.

Numerical analysis of the effects of ossicular chain malformations on bone conduction stimulation

To assess the effects of ossicular chain malformations on the performance of bone conduction hearing aids, a human ear finite-element model that includes an ear canal, a middle ear, and a spiral cochlea incorporating the third windows was established. This finite element model was built based on micro-computed tomography scanning and reverse modelling techniques, and the reliability of the finite element model was verified by comparison with reported experimental data. Based on this model, two main types of ossicular chain malformations, i.e., the incudostapedial disconnection and the ossicles fixation, were simulated, and their influences on bone conduction were analyzed by comparing the trans-cochlear-partition differential pressures. The results indicate that the incudostapedial disconnection mainly deteriorates the bone conduction response at mid frequencies. The stapes fixation has the largest effect among the ossicles fixation with the bone conduction stimulation, which also mainly decreases the mid-frequency response of the bone conduction, especially at 2 kHz. As the speech intelligibility has the most important frequency range at the range between 1 kHz and 2.5 kHz, the mid-frequency deterioration caused by ossicular chain malformations should be compensated in optimizing the design of the bone conduction hearing aids. For treating patients with the ossicular chain malformations, especially for the patients who suffer from the stapes fixation, the output of bone conduction hearing aids' actuator in the middle frequency band should be improved.

Analysis of the Human Middle Ear Dynamics Through Multibody Modeling

The dynamics of the human middle ear (ME) has been studied in the past using several computational and experimental approaches in order to observe the effect on hearing of different conditions, such as conductive disease, corrective surgery, or implantation of a middle ear prosthesis. Multibody (MB) models combine the analysis of flexible structures with rigid body dynamics, involving fewer degrees-of-freedom (DOF) than finite element (FE) models, but a more detailed description than traditional 1D lumped parameter (LP) models. This study describes the reduction of a reference FE model of the human middle ear to a MB model and compares the results obtained considering different levels of model simplification. All models are compared by means of the frequency response of the stapes velocity versus sound pressure at the tympanic membrane (TM), as well as the system natural frequencies and mode shapes. It can be seen that the flexibility of the ossicles has a limited impact on the system frequency response function (FRF) and modes, and the stiffness of the tendons and ligaments only plays a role when above certain levels. On the other hand, the restriction of the stapes footplate movement to a piston-like behavior can considerably affect the vibrational modes, while constraints to the incudomalleolar joint (IMJ) and incudostapedial joint (ISJ) can have a strong impact on the system FRF.

A Preliminary Prototype High-Speed Feedback Control of an Artificial Cochlear Sensory Epithelium Mimicking Function of Outer Hair Cells

A novel feedback control technique for the local oscillation amplitude in an artificial cochlear sensory epithelium that mimics the functions of the outer hair cells in the cochlea is successfully developed and can be implemented with a control time on the order of hundreds of milliseconds. The prototype artificial cochlear sensory epithelium was improved from that developed in our previous study to enable the instantaneous determination of the local resonance position based on the electrical output from a bimorph piezoelectric membrane. The device contains local patterned electrodes deposited with micro electro mechanical system (MEMS) technology that is used to detect the electrical output and oscillate the device by applying local electrical stimuli. The main feature of the present feedback control system is the principle that the resonance position is recognized by simultaneously measuring the local electrical outputs of all of the electrodes and comparing their magnitudes, which drastically reduces the feedback control time. In this way, it takes 0.8 s to control the local oscillation of the device, representing the speed of control with the order of one hundred times relative to that in the previous study using the mechanical automatic stage to scan the oscillation amplitude at each electrode. Furthermore, the intrinsic difficulties in the experiment such as the electrical measurement against the electromagnetic noise, adhesion of materials, and fatigue failure mechanism of the oscillation system are also shown and discussed in detail based on the many scientific aspects. The basic knowledge of the MEMS fabrication and the experimental measurement would provide useful suggestions for future research. The proposed preliminary prototype high-speed feedback control can aid in the future development of fully implantable cochlear implants with a wider dynamic range.

Measurement of Wideband Absorbance as a Test for Otosclerosis

The purpose of this study was to investigate the effectiveness of wideband energy absorbance in diagnosing otosclerosis by comparing the differences in acoustic absorbance between otosclerotic and normal ears. Exactly 90 surgically confirmed otosclerotic ears were included in the test group. The control group consisted of 126 matched normal-hearing subjects. The Titan hearing test platform (Interacoustics) was used for absorbance and acoustic immittance tests. Energy absorbance, measured at tympanometric peak pressure, was analyzed in the range 226–8000 Hz. Differences between normal and otosclerotic ears were analyzed in quarter-octave bands. Wideband absorbance, i.e., absorbance averaged over the 226–2000 Hz band, and resonance frequency were calculated and compared between normal and otosclerotic ears. Significant differences between the absorbance of normal and otosclerotic ears were found, especially at low and middle frequencies. No significant effect of ear side or gender was observed. For average wideband absorbance and resonance frequency, less pronounced (although significant) differences were found between normal and otosclerotic ears. Measurement of peak-pressure energy absorbance, averaged over a frequency band around 650 Hz, provides a valid criterion in testing for otosclerosis. The test is highly effective, with a sensitivity and specificity of over 85% and area under receiver operating characteristic curve above 0.9. Average wideband absorbance can also be used, but its effectiveness is lower. Other immittance-related measures are considerably less effective.

A study on the effect of ligament and tendon detachment on human middle ear sound transfer using mathematic model

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.

Biocompatibility of Poly(acrylonitrile-butadiene-styrene) Nanocomposites Modified with Silver Nanoparticles

We evaluated the biological, mechanical, and surface properties of polymer nanocomposites manufactured via plastics processing, extrusion, and injection moulding. The aim of this study was to identify the interaction of fibroblasts and osteoblasts with materials intended for middle ear implants. We examined if silver nanoparticles (AgNPs) may change the mechanical parameters of the polymer nanocomposites. In our study, the biostable polymer of thermoplastic acrylonitrile-butadiene-styrene (ABS) copolymer was used. Silver nanoparticles were applied as a modifier. We discuss surface parameters of the materials, including wettability and roughness, and evaluated the microstructure. The mechanical parameters, such as the Young's modulus and tensile strength, were measured. Cytotoxicity tests were conducted on two cell lines: Hs680.Tr human fibroblasts and Saos-2 human osteoblasts. Cell viability, proliferation, and morphology in direct contact with nanocomposites were tested. Based on the results, the incorporated modifier was found to affect neither the number of osteoblasts nor the fibroblast cells. However, the addition of AgNPs had a relatively small effect on the cytotoxicity of the materials. A slight increase in the cytotoxicity of the test materials was observed with respect to the control, with the cytotoxicity of the materials tending to decrease after seven days for osteoblast cells, whereas it remained steady for fibroblasts. Based on optical microscope observation, the shape and morphology of the adhered cells were evaluated. After seven days of culture, fibroblasts and osteoblasts were properly shaped and evenly settled on the surface of both the pure polymer and the silver nanoparticle-modified composite. Water droplet tests demonstrated increased hydrophilicity when adding the AgNPs to ABS matrices, whereas roughness tests did not show changes in the surface topography of the investigated samples. The 0.5% by weight incorporation of AgNPs into ABS matrices did not influence the mechanical properties.

Biocompatible Nanocomposite Implant with Silver Nanoparticles for Otology-In Vivo Evaluation

The aim of this work was to investigate of biocompatibility of polymeric implants modified with silver nanoparticles (AgNPs). Middle ear prostheses (otoimplants) made of the (poly)acrylonitrile butadiene styrene (ABS) and ABS modified with silver nanoparticles were prepared through extrusion and injection moulding process. The obtained prostheses were characterized by SEM-EDX, micro-CT and mechanical tests, confirming their proper shape, good AgNPs homogenization and mechanical parameters stability. The biocompatibility of the implants was evaluated in vivo on rats, after 4, 12, 24 and 48 weeks of implantation. The tissue-healing process and cytotoxicity of the implants were evaluated on the basis of microscopic observations of the materials morphology after histochemical staining with cytochrome c oxidase (OCC) and acid phosphatase (AP), as well as via micro-tomography (ex vivo). The in vivo studies confirmed biocompatibility of the implants in the surrounding tissue environment. Both the pure ABS and nanosilver-modified ABS implants exhibited a distinct decrease in the area of granulation tissue which was replaced with the regenerating muscle tissue. Moreover, a slightly smaller area of granulation tissue was observed in the surroundings of the silver-doped prosthesis than in the case of pure ABS prosthesis. The kinetics of silver ions releasing from implants was investigated by ICP-MS spectrometry. The measurement confirmed that concentration of the silver ions increased within the implant’s immersion period. Our results showed that middle ear implant with the nanoscale modification is biocompatible and might be used in ossicular reconstruction.

Human ossicular-joint flexibility transforms the peak amplitude and width of impulsive acoustic stimuli

The role of the ossicular joints in the mammalian middle ear is still debated. This work tests the hypothesis that the two synovial joints filter potentially damaging impulsive stimuli by transforming both the peak amplitude and width of these impulses before they reach the cochlea. The three-dimensional (3D) velocity along the ossicular chain in unaltered cadaveric human temporal bones (N = 9), stimulated with acoustic impulses, is measured in the time domain using a Polytec (Waldbronn, Germany) CLV-3D laser Doppler vibrometer. The measurements are repeated after fusing one or both of the ossicular joints with dental cement. Sound transmission is characterized by measuring the amplitude, width, and delay of the impulsive velocity profile as it travels from the eardrum to the cochlea. On average, fusing both ossicular joints causes the stapes velocity amplitude and width to change by a factor of 1.77 (p = 0.0057) and 0.78 (p = 0.011), respectively. Fusing just the incudomalleolar joint has a larger effect on amplitude (a factor of 2.37), while fusing just the incudostapedial joint decreases the stapes velocity on average. The 3D motion of the ossicles is altered by fusing the joints. Finally, the ability of current computational models to predict this behavior is also evaluated.

Transient response of the human ear to impulsive stimuli: A finite element analysis

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.

A technical review and evaluation of implantable sensors for hearing devices

Most commercially available cochlear implants and hearing aids use microphones as sensors for capturing the external sound field. These microphones are in general located in an external element, which is also responsible for processing the sound signal. However, the presence of the external element is the cause of several problems such as discomfort, impossibility of being used during physical activities and sleeping, and social stigma. These limitations have driven studies with the goal of developing totally implantable hearing devices, and the design of an implantable sensor has been one of the main challenges to be overcome. Different designs of implantable sensors can be found in the literature and in some commercial implantable hearing aids, including different transduction mechanisms (capacitive, piezoelectric, electromagnetic, etc), configurations microphones, accelerometers, force sensor, etc) and locations (subcutaneous or middle ear). In this work, a detailed technical review of such designs is presented and a general classification is proposed. The technical characteristics of each sensors are presented and discussed in view of the main requirements for an implantable sensor for hearing devices, including sensitivity, internal noise, frequency bandwidth and energy consumption. The feasibility of implantation of each sensor is also evaluated and compared.

Frequency sensitivity in mammalian hearing from a fundamental nonlinear physics model of the inner ear

A dominant view holds that the outer and middle ear are the determining factors for the frequency dependence of mammalian hearing sensitivity, but this view has been challenged. In the ensuing debate, there has been a missing element regarding in what sense and to what degree the biophysics of the inner ear might contribute to this frequency dependence. Here, we show that a simple model of the inner ear based on fundamental physical principles, reproduces, alone, the experimentally observed frequency dependence of the hearing threshold. This provides direct cochlea modeling support of the possibility that the inner ear could have a substantial role in determining the frequency dependence of mammalian hearing.

Dynamic property changes in stapedial annular ligament associated with acute otitis media in the chinchilla

Located at the end of the ossicular chain, the stapedial annular ligament (SAL) serves as a closed yet mobile boundary between the cochlear fluid and stapes footplate. It is unclear how SAL properties change with acute otitis media (AOM). This paper reports the measurements of SAL dynamic properties in chinchilla AOM model using dynamic mechanical analyzer (DMA) and frequency-temperature superposition (FTS) principle. AOM was analyzed in two infection groups: 4 days (4D) and 8 days (8D) post induction. SAL specimens were measured using DMA at three temperatures: 5, 25, and 37°C. To extend the testing frequencies to higher levels, FTS principle was employed. Then generalized Maxwell model was utilized to define the constitutive equations of the SAL. The complex shear moduli were obtained from seven samples of control, 4D, and 8D groups. Results show that the storage and loss shear moduli of SALs decreased due to AOM. The storage moduli for 4D and 8D ears were similar below 100Hz, and the loss modulus for 4D was significantly larger than 8D across the entire frequency range. This study reports data that contributes to ear biomechanics and improves understanding on the effects of AOM in middle ear tissues.

The effect of actuator and its coupling conditions on eardrum-stimulated middle ear implants: A numerical analysis

Consisting of the actuator and coupling layer, a finite element model of the human middle ear was used to analyze the effect of the actuator and its coupling conditions on the performance of the eardrum-stimulated middle ear implants. This model which was based on the right ear of a healthy adult was built via microcomputed tomography imaging and the technique of reverse engineering. Based on this finite element model, the linear viscoelasticity of the human middle ear soft tissues and three-layer structure of the eardrum pars tensa which was orthotropic were considered. The validity of the model was verified by comparing the model calculated results with experimental data. After that, the influence of the three main design parameters of the actuator and two aspects of the coupling layer were investigated by the finite element model. The results show that (1) the manubrium tip is the optimal position for the actuator to stimulate; (2) the increased cross-section of the actuator would worsen its hearing compensation performance, especially in the low frequencies; (3) both the patients’ residual hearing and the actuator’s hearing compensation performance at high frequencies will be deteriorated with the increase in the actuator’s mass; and (4) a coupling layer with a small Young’s modulus and an area approximating 80% of the eardrum would reduce the stress of the eardrum effectively.

Numerical evaluation of implantable hearing devices using a finite element model of human ear considering viscoelastic properties

Finite element method was employed in this study to analyze the change in performance of implantable hearing devices due to the consideration of soft tissues' viscoelasticity. An integrated finite element model of human ear including the external ear, middle ear and inner ear was first developed via reverse engineering and analyzed by acoustic-structure-fluid coupling. Viscoelastic properties of soft tissues in the middle ear were taken into consideration in this model. The model-derived dynamic responses including middle ear and cochlea functions showed a better agreement with experimental data at high frequencies above 3000 Hz than the Rayleigh-type damping. On this basis, a coupled finite element model consisting of the human ear and a piezoelectric actuator attached to the long process of incus was further constructed. Based on the electromechanical coupling analysis, equivalent sound pressure and power consumption of the actuator corresponding to viscoelasticity and Rayleigh damping were calculated using this model. The analytical results showed that the implant performance of the actuator evaluated using a finite element model considering viscoelastic properties gives a lower output above about 3 kHz than does Rayleigh damping model. Finite element model considering viscoelastic properties was more accurate to numerically evaluate implantable hearing devices.

Predictions of middle-ear and passive cochlear mechanics using a finite element model of the pediatric ear

A finite element (FE) model was developed based on histological sections of a temporal bone of a 4-year-old child to simulate middle-ear and cochlear function in ears with normal hearing and otitis media. This pediatric model of the normal ear, consisting of an ear canal, middle ear, and spiral cochlea, was first validated with published energy absorbance (EA) measurements in young children with normal ears. The model was used to simulate EA in an ear with middle-ear effusion, whose results were compared to clinical EA measurements. The spiral cochlea component of the model was constructed under the assumption that the mechanics were passive. The FE model predicted middle-ear transfer functions between the ear canal and cochlea. Effects of ear structure and mechanical properties of soft tissues were compared in model predictions for the pediatric and adult ears. EA responses are predicted to differ between adult and pediatric ears due to differences in the stiffness and damping of soft tissues within the ear, and any residual geometrical differences between the adult ear and pediatric ear at age 4 years. The results have significance for predicting effects of otitis media in children.

Elastic Properties of the Annular Ligament of the Human Stapes--AFM Measurement

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.

Dynamic properties of human stapedial annular ligament measured with frequency-temperature superposition

Stapedial annular ligament (SAL) is located at the end of human ear ossicular chain and provides a sealed but mobile boundary between the stapes footplate and cochlear fluid. Mechanical properties of the SAL directly affect the acoustic-mechanical transmission of the middle ear and the changes of SAL mechanical properties in diseases (e.g., otosclerosis) may cause severe conductive hearing loss. However, the mechanical properties of SAL have only been reported once in the literature, which were obtained under quasi-static condition (Gan, R. Z., Yang, F., Zhang, X., and Nakmali, D., 2011, "Mechanical Properties of Stapedial Annular Ligament," Med. Eng. Phys., 33, pp. 330-339). Recently, the dynamic properties of human SAL were measured in our lab using dynamic-mechanical analyzer (DMA). The test was conducted at the frequency range from 1 to 40 Hz at three different temperatures: 5 °C, 25 °C, and 37 °C. The frequency-temperature superposition (FTS) principle was applied to extend the testing frequency range to a much higher level. The generalized Maxwell model was employed to describe the constitutive relation of the SAL. The storage shear modulus G' and the loss shear modulus G" were obtained from seven specimens. The mean storage shear modulus was 31.7 kPa at 1 Hz and 61.9 kPa at 3760 Hz. The mean loss shear modulus was 1.1 kPa at 1 Hz and 6.5 kPa at 3760 Hz. The dynamic properties of human SAL obtained in this study provide a better description of the damping behavior of soft tissues than the classic Rayleigh type damping, which was widely used in the published ear models. The data reported in this study contribute to ear biomechanics and will improve the accuracy of finite element (FE) model of the human ear.

Viscoelastic properties of the human tympanic membrane studied with stroboscopic holography and finite element modeling

A new anatomically-accurate Finite Element (FE) model of the tympanic membrane (TM) and malleus was combined with measurements of the sound-induced motion of the TM surface and the bony manubrium, in an isolated TM-malleus preparation. Using the results, we were able to address two issues related to how sound is coupled to the ossicular chain: (i) Estimate the viscous damping within the tympanic membrane itself, the presence of which may help smooth the broadband response of a potentially highly resonant TM, and (ii) Investigate the function of a peculiar feature of human middle-ear anatomy, the thin mucosal epithelial fold that couples the mid part of the human manubrium to the TM. Sound induced motions of the surface of ex vivo human eardrums and mallei were measured with stroboscopic holography, which yields maps of the amplitude and phase of the displacement of the entire membrane surface at selected frequencies. The results of these measurements were similar, but not identical to measurements made in intact ears. The holography measurements were complemented by laser-Doppler vibrometer measurements of sound-induced umbo velocity, which were made with fine-frequency resolution. Comparisons of these measurements to predictions from a new anatomically accurate FE model with varied membrane characteristics suggest the TM contains viscous elements, which provide relatively low damping, and that the epithelial fold that connects the central section of the human manubrium to the TM only loosely couples the TM to the manubrium. The laser-Doppler measurements in two preparations also suggested the presence of significant variation in the complex modulus of the TM between specimens. Some animations illustrating the model results are available at our website (www.uantwerp.be/en/rg/bimef/downloads/tympanic-membrane-motion).

Energy localization and frequency analysis in the locust ear

Animal ears are exquisitely adapted to capture sound energy and perform signal analysis. Studying the ear of the locust, we show how frequency signal analysis can be performed solely by using the structural features of the tympanum. Incident sound waves generate mechanical vibrational waves that travel across the tympanum. These waves shoal in a tsunami-like fashion, resulting in energy localization that focuses vibrations onto the mechanosensory neurons in a frequency-dependent manner. Using finite element analysis, we demonstrate that two mechanical properties of the locust tympanum, distributed thickness and tension, are necessary and sufficient to generate frequency-dependent energy localization.

Experimental measurement of tympanic membrane response for finite element model validation of a human middle ear

The middle ear consists of a tympanic membrane, ligaments, tendons, and three ossicles. An important function of the tympanic membrane is to deliver exterior sound stimulus to the ossicles and inner ear. In this study, the responses of the tympanic membrane in a human ear were measured and compared with those of a finite element model of the middle ear. A laser Doppler vibrometer (LDV) was used to measure the dynamic responses of the tympanic membrane, which had the measurement point on the cone of light of the tympanic membrane. The measured subjects were five Korean male adults and a cadaver. The tympanic membranes were stimulated using pure-tone sine waves at 18 center frequencies of one-third octave band over a frequency range of 200 Hz ~10 kHz with 60 and 80 dB sound pressure levels. The measured responses were converted into the umbo displacement transfer function (UDTF) with a linearity assumption. The measured UDTFs were compared with the calculated UDTFs using a finite element model for the Korean human middle ear. The finite element model of the middle ear consists of three ossicles, a tympanic membrane, ligaments, and tendons. In the finite element model, the umbo displacements were calculated under a unit sound pressure on the tympanic membrane. The UDTF of the finite element model exhibited good agreement with that of the experimental one in low frequency range, whereas in higher frequency band, the two response functions deviated from each other, which demonstrates that the finite element model should be updated with more accurate material properties and/or a frequency dependent material model.

Full-field thickness distribution of human tympanic membrane obtained with optical coherence tomography

The full-field thickness distribution, three-dimensional surface model and general morphological data of six human tympanic membranes are presented. Cross-sectional images were taken perpendicular through the membranes using a high-resolution optical coherence tomography setup. Five normal membranes and one membrane containing a pathological site are included in this study. The thickness varies strongly across each membrane, and a great deal of inter-specimen variability can be seen in the measurement results, though all membranes show similar features in their respective relative thickness distributions. Mean thickness values across the pars tensa ranged between 79 and 97 μm; all membranes were thinnest in the central region between umbo and annular ring (50-70 μm), and thickness increased steeply over a small distance to approximately 100-120 μm when moving from the central region either towards the peripheral rim of the pars tensa or towards the manubrium. Furthermore, a local thickening was noticed in the antero-inferior quadrant of the membranes, and a strong linear correlation was observed between inferior-posterior length and mean thickness of the membrane. These features were combined into a single three-dimensional model to form an averaged representation of the human tympanic membrane. 3D reconstruction of the pathological tympanic membrane shows a structural atrophy with retraction pocket in the inferior portion of the pars tensa. The change of form at the pathological site of the membrane corresponds well with the decreased thickness values that can be measured there.

A three-dimensional finite element model of round window membrane vibration before and after stapedotomy surgery

Piston stapes prostheses are implanted in patients with refractory conductive or mixed hearing loss due to stapes otosclerosis to stimulate the perilymph with varying degrees of success. The overclosure effect described by the majority of researchers affects mainly low and medium frequencies, and a large number of patients report a lack of satisfactory results for frequencies above 2 kHz. The mechanics of perilymph stimulation with the piston have not been studied in a systematic manner. The objective of this study was to assess the influence of stapedotomy surgery on round window membrane vibration and to estimate the postoperative outcomes using the finite element (FE) method. The study hypothesis is that the three-dimensional FE model developed of the human inner ear, which simulates the round window (RW) membrane vibration, can be used to assess the influence of stapedotomy on auditory outcomes achieved after the surgical procedure. An additional objective of the study was to enable the simulation of RW membrane vibration after stapedotomy using a new type of stapes prosthesis currently under investigation at Warsaw University of Technology. A three-dimensional finite element (FE) model of the human inner ear was developed and validated using experimental data. The model was then used to simulate the round window membrane vibration before and after stapedotomy surgery. Functional alterations of the RW membrane vibration were derived from the model and compared with the results of experimental measurements from temporal bones of a human cadaver. Piston stapes prosthesis implantation causes an approximately fivefold (14 dB) lower amplitude of the RW membrane vibrations compared with normal anatomical conditions. A satisfactory agreement between the FE model and the experimental data was found. The new prosthesis caused an increase of 20–30 dB in the RW displacement amplitude compared with the 0.4-mm piston prosthesis. In all frequencies, the FE model predicted a RW displacement curve that was above the experimental curves for the normal ear. The stapedotomy can be well simulated by the FE model to predict the auditory outcomes achieved following this otosurgery procedure. The 3D FE model developed in this study may be used to optimize the geometry of a new type of stapes prosthesis in order to achieve a similar sound transmission through the inner ear as for a normal middle ear. This should provide better auditory outcomes for patients with stapedial otosclerosis.

Dynamic properties of human tympanic membrane based on frequency-temperature superposition

The human tympanic membrane (TM) transfers sound in the ear canal into the mechanical vibration of the ossicles in the middle ear. The dynamic properties of TM directly affect the middle ear transfer function. The static or quasi-static mechanical properties of TM were reported in the literature, but the dynamic properties of TM over the auditory frequency range are very limited. In this paper, a new method was developed to measure the dynamic properties of human TM using the Dynamic-Mechanical Analyzer (DMA). The test was conducted at the frequency range of 1-40 Hz at three different temperatures: 5, 25, and 37 °C. The frequency-temperature superposition was applied to extend the testing frequency range to a much higher level (at least 3800 Hz). The generalized linear solid model was employed to describe the constitutive relation of the TM. The storage modulus E' and the loss modulus E″ were obtained from 11 specimens. The mean storage modulus was 15.1 MPa at 1 Hz and 27.6 MPa at 3800 Hz. The mean loss modulus was 0.28 MPa at 1 Hz and 4.1 MPa at 3800 Hz. The results show that the frequency-temperature superposition is a feasible approach to study the dynamic properties of the ear soft tissues. The dynamic properties of human TM obtained in this study provide a better description of the damping behavior of ear tissues. The properties can be transferred into the finite element model of the human ear to replace the Rayleigh type damping. The data reported here contribute to the biomechanics of the middle ear and improve the accuracy of the FE model for the human ear.

Mechanical properties of human tympanic membrane in the quasi-static regime from in situ point indentation measurements

The tympanic membrane is a key component of the human auditory apparatus. Good estimates of tympanic membrane mechanical properties are important to obtain realistic models of middle ear mechanics. Current literature values are almost all derived from direct mechanical tests on cut-out strips. For a biomedical specimen like the tympanic membrane, it is not always possible to harvest strips of uniform and manageable geometry and well-defined size suitable for such mechanical tests. In this work, elastic and viscoelastic properties of human tympanic membrane were determined through indentation testing on the tympanic membrane in situ. Indentation experiments were performed on three specimens with a custom-built apparatus that was also used in previously published works. Two types of indentation tests were performed on each specimen: (i) sinusoidal indentation at 0.2 Hz yielding the quasi-static Young's modulus and (ii) step indentation tests yielding viscoelastic properties in the quasi-static regime (0-20 Hz). In the cyclic indentation experiments (type i), the indentation depth and resulting needle force were recorded. The unloaded shape of the tympanic membrane and the membrane thickness were measured and used to create a specimen-specific finite element model of the experiment. The Young's modulus was then found through optimization of the error between model and experimental data; the values that were found for the three different samples are 2.1 MPa, 4.4 MPa and 2.3 MPa. A sensitivity analysis showed that these values are very sensitive to the thickness used in the models. In the step indentation tests (type ii), force relaxation was measured during 120 s and the relaxation curves were fitted with a 5 parameter Maxwell viscoelastic model. The relaxation curves in the time domain were transformed to complex moduli in the frequency domain, yielding viscoelastic properties in the quasi-static regime only.