The human round window – a perilymph pressure regulator?On a novel mechanoreceptor‐like neuron in the human round window membrane

Membrane curvature and connective fiber alignment in guinea pig round window membrane

The round window membrane (RWM) covers an opening between the perilymph fluid-filled inner ear space and the air-filled middle ear space. As the only non-osseous barrier between these two spaces, the RWM is an ideal candidate for aspiration of perilymph for diagnostics purposes and delivery of medication for treatment of inner ear disorders. Routine access across the RWM requires the development of new surgical tools whose design can only be optimized with a thorough understanding of the RWM's structure and properties. The RWM possesses a layer of collagen and elastic fibers so characterization of the distribution and orientation of these fibers is essential. Confocal and two-photon microscopy were conducted on intact RWMs in a guinea pig model to characterize the distribution of collagen and elastic fibers. The fibers were imaged via second-harmonic-generation, autofluorescence, and Rhodamine B staining. Quantitative analyses of both fiber orientation and geometrical properties of the RWM uncovered a significant correlation between mean fiber orientations and directions of zero curvature in some portions of the RWM, with an even more significant correlation between the mean fiber orientations and linear distance along the RWM in a direction approximately parallel to the cochlear axis. The measured mean fiber directions and dispersions can be incorporated into a generalized structure tensor for use in the development of continuum anisotropic mechanical constitutive models that in turn will enable optimization of surgical tools to access the cochlea. STATEMENT OF SIGNIFICANCE: The Round Window Membrane (RWM) is the only non-osseous barrier separating the middle and inner ear spaces, and thus is an ideal portal for medical access to the cochlea. An understanding of RWM structure and mechanical response is necessary to optimize the design of surgical tools for this purpose. The RWM geometry and the connective fiber orientation and dispersion are measured via confocal and 2-photon microscopy. A region of the RWM geometry is characterized as a hyperbolic paraboloid and another region as a tapered parabolic cylinder. Predominant fiber directions correlate well with directions of zero curvature in the hyperbolic paraboloid region. Overall fiber directions correlate well with position along a line approximately parallel to the central axis of the cochlea's spiral.

Investigating the Geometry and Mechanical Properties of Human Round Window Membranes Using Micro-Fringe Projection

HYPOTHESIS

The geometry and the mechanical property of the round window membrane (RWM) have a fundamental impact on the function of cochlea.

BACKGROUND

Understanding the mechanical behavior of RWM is important for cochlear surgery and design for the cochlear implant. Although the anatomy of RWM has been widely studied and described in the literature, argument remains regarding the true shape of RWM. The mechanical properties of RWM are also scarcely reported due to the difficulty of the measurement of the small size RWM.

METHODS

In this paper, micro-fringe projection was used to reconstruct the 3-dimensional geometries of 14 RWMs. Mechanical properties of the RWMs were subsequently measured using finite element (FE) model and an inverse method. The three-dimensional surface topographies and the curvatures of the two major directions reconstructed from the micro-fringe projection both demonstrated wide variations among samples.

RESULTS

The diameters of the RWMs vary from 1.65 to 2.2 mm and the curvatures vary from -0.97 to 3.76 mm-1. The nonlinear elasticity parameters in the Ogden model for each sample was measured and the average effective Young's modulus is approximately 1.98 MPa.

CONCLUSION

The geometries and mechanical properties of the human RWM measured in the work could potentially be applied to surgery design and on modeling analysis for the cochlea.

In-vitro perforation of the round window membrane via direct 3-D printed microneedles

The cochlea, or inner ear, is a space fully enclosed within the temporal bone of the skull, except for two membrane-covered portals connecting it to the middle ear space. One of these portals is the round window, which is covered by the Round Window Membrane (RWM). A longstanding clinical goal is to reliably and precisely deliver therapeutics into the cochlea to treat a plethora of auditory and vestibular disorders. Standard of care for several difficult-to-treat diseases calls for injection of a therapeutic substance through the tympanic membrane into the middle ear space, after which a portion of the substance diffuses across the RWM into the cochlea. The efficacy of this technique is limited by an inconsistent rate of molecular transport across the RWM. A solution to this problem involves the introduction of one or more microscopic perforations through the RWM to enhance the rate and reliability of diffusive transport. This paper reports the use of direct 3D printing via Two-Photon Polymerization (2PP) lithography to fabricate ultra-sharp polymer microneedles specifically designed to perforate the RWM. The microneedle has tip radius of 500 nm and shank radius of 50 μ m, and perforates the guinea pig RWM with a mean force of 1.19 mN. The resulting perforations performed in vitro are lens-shaped with major axis equal to the microneedle shank diameter and minor axis about 25% of the major axis, with mean area 1670 μ m2. The major axis is aligned with the direction of the connective fibers within the RWM. The fibers were separated along their axes without ripping or tearing of the RWM suggesting the main failure mechanism to be fiber-to-fiber decohesion. The small perforation area along with fiber-to-fiber decohesion are promising indicators that the perforations would heal readily following in vivo experiments. These results establish a foundation for the use of Two-Photon Polymerization lithography as a means to fabricate microneedles to perforate the RWM and other similar membranes.

Optimization of 3D-Visualization of Micro-Anatomical Structures of the Human Inner Ear in Osmium Tetroxide Contrast Enhanced Micro-CT Scans

Introduction: Knowledge of the neuro-anatomical architecture of the inner ear contributes to the improvement and development of cochlear and vestibular implants. The present knowledge is mainly based on two-dimensional images (histology) or derived models that simplify the complexity of this architecture. This study investigated the feasibility of visualizing relevant neuro-anatomical structures of the inner ear in a dynamic three-dimensional reproduction, using a combination of staining, micro-CT imaging and an image processing algorithm. Methods: Four fresh cadaveric temporal bones were postfixed with osmium tetroxide (OsO4) and decalcified with EDTA. Micro-CT was used for scanning at 10 μm (4 scans) and 5.5 μm (1 scan) voxel resolution. A new image processing algorithm was developed and the scans were visualized in open source software. Results: OsO4 enhanced the contrast in all scans and the visualization was substantially improved by the image processing algorithm. The three-dimensional renderings provided detailed visualization of the whole inner ear. Details were visible up to the size of individual neurons, nerve crossings and the specific neuro-anatomical structures such as the tunnel of Corti. Conclusion: The combination of OsO4, micro-CT and the proposed image processing algorithm provides an accurate and detailed visualization of the three-dimensional micro-anatomy of the human inner ear.

Human cochlea: anatomical characteristics and their relevance for cochlear implantation

This is a review of the anatomical characteristics of human cochlea and the importance of variations in this anatomy to the process of cochlear implantation (CI). Studies of the human cochlea are essential to better comprehend the physiology and pathology of man's hearing. The human cochlea is difficult to explore due to its vulnerability and bordering capsule. Inner ear tissue undergoes quick autolytic changes making investigations of autopsy material difficult, even though excellent results have been presented over time. Important issues today are novel inner ear therapies including CI and new approaches for inner ear pharmacological treatments. Inner ear surgery is now a reality, and technical advancements in the design of electrode arrays and surgical approaches allow preservation of remaining structure/function in most cases. Surgeons should aim to conserve cochlear structures for future potential stem cell and gene therapies. Renewal interest of round window approaches necessitates further acquaintance of this complex anatomy and its variations. Rough cochleostomy drilling at the intricate "hook" region can generate intracochlear bone-dust-inducing fibrosis and new bone formation, which could negatively influence auditory nerve responses at a later time point. Here, we present macro- and microanatomic investigations of the human cochlea viewing the extensive anatomic variations that influence electrode insertion. In addition, electron microscopic (TEM and SEM) and immunohistochemical results, based on specimens removed at surgeries for life-threatening petroclival meningioma and some well-preserved postmortal tissues, are displayed. These give us new information about structure as well as protein and molecular expression in man. Our aim was not to formulate a complete description of the complex human anatomy but to focus on aspects clinically relevant for electric stimulation, predominantly, the sensory targets, and how surgical atraumaticity best could be reached.