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Shimura T, Keskin Yilmaz N, Rajan D, Cureoglu S, Da Costa Monsanto R. Middle Ear Ossicular Joint Changes in Type 2 Diabetes Mellitus: A Histopathological Study. Laryngoscope 2024; 134:2871-2878. [PMID: 38174760 PMCID: PMC11078616 DOI: 10.1002/lary.31257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/20/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES Although previous research has indicated inner ear changes in diabetes mellitus (DM) patients, no prior study has explored the middle ear, particularly the ossicles and their joints, in DM patients. This study aimed to investigate whether type 2 DM is associated with middle ear changes, specifically affecting the ossicular chain and joints. METHODS This study included 47 ears from 25 patients with DM (male = 13, female = 12, age: 51.0 ± 20.5) and age- and sex-matched controls (male = 10, female = 10, age: 54.8 ± 15.9) (sex; p = 1.000, Age; p = 0.991). Otopathological evaluations of the auditory ossicles and incudomalleolar joint (IMJ) were performed using light microscopy. RESULTS In the IMJ of DM cases, malleus hyalinized cartilage (Malleus hC) and incus hyalinized cartilage (Incus hC) were significantly increased compared with control cases (Malleus hC; DM, 34.17 ± 9.71 μm vs. control 21.96 ± 4.16 μm, p < 0.001) (Incus hC; DM 35.11 ± 10.12 μm vs. control 22.42 ± 4.368 μm, p < 0.001). In addition, bone-line distance was significantly longer than in DM cases than control cases (DM 266.72 ± 59.11 μm vs. control 239.81 ± 35.56 μm p = 0.040). On the other hand, joint discus distance was longer in the control group than in DM cases (DM 96.84 ± 36.80 μm vs. Control 113.63 ± 23.81 μm, p = 0.001). CONCLUSIONS This study reveals a notable increase in the hyalinized cartilage layer and bone-line distance accompanied by reducing joint discus distance within the IMJ in DM cases. These findings suggest that DM may influence microjoints, such as the IMJ, and potentially impact auditory function. EVIDENCE LEVEL N/A Laryngoscope, 134:2871-2878, 2024.
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Affiliation(s)
- Tomotaka Shimura
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Otorhinolaryngology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Nevra Keskin Yilmaz
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Internal Medicine, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
| | - Dilshan Rajan
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Sebahattin Cureoglu
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Rafael Da Costa Monsanto
- Department of Otolaryngology Head & Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
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Remenschneider A, Cheng JT. Contemporary Mechanics of Conductive Hearing Loss. OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY--HEAD AND NECK SURGERY 2024; 35:2-10. [PMID: 38680732 PMCID: PMC11052546 DOI: 10.1016/j.otot.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The middle ear plays a critical role for the conversion of acoustic energy to mechanical vibrations that subsequently enter the cochlea. It is middle ear impedance matching through ossicular coupling that has enabled land-dwelling vertebrates to hear soft airborne sounds. Conductive hearing loss may result from damage to the delicate middle ear structures following infection, trauma or rapid pressure changes. An understanding of the mechanics of the middle ear significantly improves the oto-surgeon's ability to effectively diagnose conductive hearing loss, localize the responsible lesion and then effectively correct the conduction abnormality. This article reviews some of the basic knowledge of middle ear mechanics for sound transmission, highlights recent advances in developing new techniques to assist in diagnosis of middle ear disease, and finally sheds light on future research aimed at improving the diagnosis and management of middle ear pathology.
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Affiliation(s)
- Aaron Remenschneider
- Department of otolaryngology and Communication Enhancement, Boston Children’s Hospital, Boston, MA
- Department of otolaryngology, head and neck surgery, Harvard Medical School, Boston, MA
- Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA
| | - Jeffrey Tao Cheng
- Department of otolaryngology, head and neck surgery, Harvard Medical School, Boston, MA
- Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA
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Yazama H, Arii S, Kataoka H, Watanabe T, Kamitani R, Fujiwara K. In Vivo Measurement of Ear Ossicle and Bony Wall Vibration by Sound Stimulation of Cartilage Conduction. Audiol Res 2023; 13:495-505. [PMID: 37489380 PMCID: PMC10366828 DOI: 10.3390/audiolres13040044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/08/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
The cartilage-conduction pathway was recently proposed as a third auditory pathway; however, middle-ear vibrations have not yet been investigated in vivo. We aimed to measure the ossicles and bone vibration upon cartilage-conduction stimulation with a non-contact laser Doppler vibrometer. We recruited adult patients with normal ear structures who underwent cochlear implant surgery at our hospital between April 2020 and December 2022. For sound input, a cartilage-conduction transducer, custom-made by RION Corporation (Tokyo, Japan), was fixed to the surface of the tragus and connected to an audiometer to regulate the output. A posterior tympanotomy was performed and a laser beam was directed through the cavity to measure the vibration of the ossicles, cochlear promontory, and posterior wall of the external auditory canal. Five participants (three men, mean age: 56.4 years) were included. The mean hearing loss on the operative side was 96.3 dB HL in one patient, and that of the other patients was off-scale. The vibrations were measured at a sound input of 1 kHz and 60 dB. We observed vibrations of all three structures, demonstrating the existence of cartilage-conduction pathways in vivo. These results may help uncover the mechanisms of the cartilage-conduction pathway in the future.
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Affiliation(s)
- Hiroaki Yazama
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan
| | - Shiro Arii
- Kanki Rotordynamics Lab, 1646 Higashikanki-cyo, Kakogawa 675-0057, Japan
| | - Hideyuki Kataoka
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan
| | - Tasuku Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan
| | - Ryo Kamitani
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago 683-8504, Japan
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Garcia-Manrique J, Furlong C, Gonzalez-Herrera A, Cheng JT. Numerical model characterization of the sound transmission mechanism in the tympanic membrane from a high-speed digital holographic experiment in transient regime. Acta Biomater 2023; 159:63-73. [PMID: 36708849 DOI: 10.1016/j.actbio.2023.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/04/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
A methodology for the development of a finite element numerical model of the tympanic membrane (TM) based on experiments carried out in the time domain on a cadaveric human temporal bone is presented. Using a high-speed digital holographic (HDH) system, acoustically-induced transient displacements of the TM surface are obtained. The procedure is capable to generate and validate the finite element model of the TM by numerical and experimental data correlation. Reverse engineering approach is used to identify key material parameters that define the mechanical response of the TM. Finally, modal numerical simulations of the specimen are performed. Results show the feasibility of the methodology to obtain an accurate model of a specific specimen and to help interpret its behaviour with additional numerical simulations. STATEMENT OF SIGNIFICANCE: Improving knowledge of the dynamic behavior of the tympanic membrane is key to understanding the sound transmission system in human hearing and advance in the treatment of its pathologies. Recently we acquired a new tool to carry out experiments in transient regime by means of digital laser holography, capable of providing a large amount of information in a controlled transient test. In this work, these data are used to develop a methodology that generates a numerical model of the tympanic membrane based on numerical-experimental correlations. It is important to be able to develop models that fit specific patients. In this work, additional modal simulations are also presented that, in addition to validating the results, provide more information on the specimen.
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Affiliation(s)
- J Garcia-Manrique
- Department of Civil Engineering, Materials and Manufacturing, School of Engineering, University of Malaga, Spain; Eaton-Peabody Laboratory, Massachusetts Eye and Ear, Boston, MA, USA; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
| | - Cosme Furlong
- Center for Holographic Studies and Laser micro-mechaTronics (CHSLT), Worcester, MA, USA; Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA, USA
| | - A Gonzalez-Herrera
- Department of Civil Engineering, Materials and Manufacturing, School of Engineering, University of Malaga, Spain
| | - Jeffrey T Cheng
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear, Boston, MA, USA; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
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Hamra M, Fridman L, Shinnawi S, Vaizer MC, Yelin D. In vivo optical mapping of the tympanic membrane impulse response. Hear Res 2023; 431:108723. [PMID: 36870309 DOI: 10.1016/j.heares.2023.108723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 03/01/2023]
Abstract
The wide frequency range of the human hearing could be narrowed by various pathologies in the middle ear and in the tympanic membrane that lead to conductive hearing loss. Diagnosing such hearing problems is challenging, however, often relying on subjective hearing tests supported by functional tympanometry. Here we present a method for in vivo 2D mapping of the impulse response of the tympanic membrane, and demonstrate its potential on a healthy human volunteer. The imaging technique is based on interferometric spectrally encoded endoscopy, with a handheld probe designed to scan the human tympanic membrane within less than a second. The system obtains high-resolution 2D maps of key functional parameters including peak response, rise and decay times, oscillation bandwidth and resonance frequency. We also show that the system can identify abnormal regions in the membrane by detecting differences in the local mechanical parameters of the tissue. We believe that by offering a full 2D mapping of broad-bandwidth dynamics of the tympanic membrane, the presented imaging modality would be useful for effective diagnosis of conductive hearing loss in patients.
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Affiliation(s)
- Matan Hamra
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel
| | - Lidan Fridman
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel
| | - Shadi Shinnawi
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Mauricio Cohen Vaizer
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Dvir Yelin
- Faculty of Biomedical Engineering, Technion - Israel institute of Technology, Haifa 3200003, Israel.
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Liu Y, Wu C, Chen T, Shen Q, Xiong Y, Chen Z, Li C. Evaluation of acoustic changes in and the healing outcomes of rat eardrums with pars tensa and pars flaccida perforations. Laryngoscope Investig Otolaryngol 2022; 7:816-824. [PMID: 35734049 PMCID: PMC9194967 DOI: 10.1002/lio2.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objectives To systematically explore the differences in acoustic changes and healing outcomes of tympanic membranes (TMs) with pars flaccida perforation (PFP) and pars tensa perforation (PTP). Methods We created PFPs and PTPs of various sizes in Sprague–Dawley rats, and evaluated TM umbo velocity and hearing function using laser Doppler vibrometry and auditory brainstem response (ABR) measurement before and immediately after perforation. Two weeks later, hearing was reevaluated and TMs were investigated by immunohistochemical staining. Results Small PFPs and PTPs did not significantly affect umbo velocity and hearing function. Large PFPs increased umbo velocity loss at low frequency (1.5 kHz) and elevated ABR thresholds within 1–2 kHz. Large PTP caused significant velocity loss at low frequencies from 1.5 to 3.5 kHz and threshold elevations at full frequencies (1–2 kHz). Two weeks after the perforation, the hearing function of rats with healed PFPs recovered completely. However, high‐frequency hearing loss (16–32 kHz) persisted in rats with healed PTPs. Morphological staining revealed that no increase in the thickness and obvious increase in collagen I level of regenerated par flaccida; regenerated pars tensa exhibited obvious increase in thickness and increased collagen I, while the collagen II regeneration was limited with discontinuous and disordered structure in regenerated pars tensa. Conclusion The hearing loss caused by large PFP limits at low frequencies while large PTP can lead to hearing loss at wide range frequencies. PFP and PTP have different functional outcomes after spontaneous healing, which is determined by the discrepant structure reconstruction and collagen regeneration.
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Affiliation(s)
- Yaoqian Liu
- Otolaryngology Research Institute Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Cuiping Wu
- Otolaryngology Research Institute Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Tingting Chen
- Department of Hearing and Language Rehabilitation Zhejiang Chinese Medicine University Hangzhou China
| | - Qiyue Shen
- Department of Hearing and Language Rehabilitation Shanghai University of Traditional Chinese Medicine Shanghai China
| | - Yuanping Xiong
- Department of Otolaryngology Head and Neck Surgery First Affiliated Hospital of Nanchang University Nanchang China
| | - Zhengnong Chen
- Otolaryngology Research Institute Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
- Department of Otolaryngology‐Head and Neck Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
| | - Chunyan Li
- Otolaryngology Research Institute Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
- Department of Otolaryngology‐Head and Neck Surgery Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai China
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7
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Sackmann B, Eberhard P, Lauxmann M. Parameter Identification From Normal and Pathological Middle Ears Using a Tailored Parameter Identification Algorithm. J Biomech Eng 2022; 144:1119456. [PMID: 34505125 DOI: 10.1115/1.4052371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Indexed: 11/08/2022]
Abstract
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.
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Affiliation(s)
- Benjamin Sackmann
- Reutlingen Research Institute, Reutlingen University, Reutlingen 72762, Germany
| | - Peter Eberhard
- Institute of Engineering and Computational Mechanics, University of Stuttgart, Stuttgart 70569, Germany
| | - Michael Lauxmann
- School of Engineering, Reutlingen University, Reutlingen 72762, Germany
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Böck K, Böhnke F, Rahne T, Strenger T. Optical measurements of eardrum vibrations and sound propagation in the ear canal for the fitting of active middle ear implants. Acta Otolaryngol 2022; 142:140-153. [PMID: 35209792 DOI: 10.1080/00016489.2022.2038388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Middle ear implants (MEI) are for the medical rehabilitation of the hearing function in case of sound conduction hearing losses as well as cochlear hearing losses and their combinations. OBJECTIVES An objective tool to reach the best fitting of the external worn sound processors is essential for patients who do not want or cannot participate in the fitting process. METHODS In addition to Laser-Doppler-Vibrometry (LDV) measurement, the sound pressure was measured distant to the eardrum to attain additional information for comparison. Three groups of patients with different middle ear characteristics were examined. RESULTS Because of the large spreading of measuring results even within a patient group with similar eardrum and middle ear conditions it is difficult to develop characteristic diagrams which represent the mean values of eardrum displacements with different sound processor adjustments being the base for normative data courses. CONCLUSIONS AND SIGNIFICANCE The LDV measurements can be used as a tool for fitting sound processors by finding individual maximum eardrum velocities in the frequency range 125 Hz to 8 kHz. In comparison to acoustical measurements the optical measurements have advantages concerning lower variations of measurement values, higher spectral resolution, and robustness against disturbing acoustic noise, especially at low frequencies.
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Affiliation(s)
- Katja Böck
- Department of Otorhinolaryngology, Technical University Munich, Munich, Germany
| | - Frank Böhnke
- Department of Otorhinolaryngology, Technical University Munich, Munich, Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, University Hospital Halle (Saale), Halle, Germany
| | - Tobias Strenger
- Department of Otorhinolaryngology, University Hospital Augsburg, Augsburg, Germany
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9
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Tang H, Psota P, Rosowski JJ, Furlong C, Cheng JT. Analyses of the Tympanic Membrane Impulse Response Measured with High-Speed Holography. Hear Res 2021; 410:108335. [PMID: 34450569 DOI: 10.1016/j.heares.2021.108335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
The Tympanic Membrane (TM) transforms acoustic energy to ossicular vibration. The shape and the displacement of the TM play an important role in this process. We developed a High-speed Digital Holography (HDH) system to measure the shape and transient displacements of the TM induced by acoustic clicks. The displacements were further normalized by the measured shape to derive surface normal displacements at over 100,000 points on the TM surface. Frequency and impulse response analyses were performed at each TM point, which enable us to describe 2D surface maps of four new TM mechanical parameters. From frequency domain analyses, we describe the (i) dominant frequencies of the displacement per sound pressure based on Frequency Response Function (FRF) at each surface point. From time domain analyses, we describe the (ii) rising time, (iii) exponential decay time, and the (iv) root-mean-square (rms) displacement of the TM based on Impulse Response Function (IRF) at each surface point. The resultant 2D maps show that a majority of the TM surface has a dominant frequency of around 1.5 kHz. The rising times suggest that much of the TM surface is set into motion within 50 µs of an impulsive stimulus. The maps of the exponential decay time of the IRF illustrate spatial variations in damping, the least known TM mechanical property. The damping ratios at locations with varied dominant frequencies are quantified and compared.
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Affiliation(s)
- H Tang
- Center for Holographic Studies and Laser Micro-mechaTronics (CHSLT), Worcester Polytechnic Institute, Worcester, MA United States; Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA United States; Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA United States.
| | - P Psota
- Faculty of Mechatronics, Informatics and Interdisciplinary Studies, Technical University of Liberec, Liberec, Czech Republic
| | - J J Rosowski
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA United States; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - C Furlong
- Center for Holographic Studies and Laser Micro-mechaTronics (CHSLT), Worcester Polytechnic Institute, Worcester, MA United States; Mechanical Engineering Department, Worcester Polytechnic Institute, Worcester, MA United States; Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA United States; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
| | - J T Cheng
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA United States; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, United States
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Lui CG, Kim W, Dewey JB, Macías-Escrivá FD, Ratnayake K, Oghalai JS, Applegate BE. In vivo functional imaging of the human middle ear with a hand-held optical coherence tomography device. BIOMEDICAL OPTICS EXPRESS 2021; 12:5196-5213. [PMID: 34513251 PMCID: PMC8407818 DOI: 10.1364/boe.430935] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
We describe an optical coherence tomography and vibrometry system designed for portable hand-held usage in the otology clinic on awake patients. The system provides clinically relevant point-of-care morphological imaging with 14-44 µm resolution and functional vibratory measures with sub-nanometer sensitivity. We evaluated various new approaches for extracting functional information including a multi-tone stimulus, a continuous chirp stimulus, and alternating air and bone stimulus. We also explored the vibratory response over an area of the tympanic membrane (TM) and generated TM thickness maps. Our results suggest that the system can provide real-time in vivo imaging and vibrometry of the ear and could prove useful for investigating otologic pathology in the clinic setting.
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Affiliation(s)
- Christopher G. Lui
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - Wihan Kim
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- These authors contributed equally to this work
| | - James B. Dewey
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Frank D. Macías-Escrivá
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Kumara Ratnayake
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - John S. Oghalai
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
| | - Brian E. Applegate
- Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite 5708, Los Angeles, CA 90033, USA
- Department of Biomedical Engineering, University of Southern California, 1042 Downey Way, Denney Research Center (DRB) 140, Los Angeles, CA 90089, USA
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Masalski M, Wąż A, Błauciak P, Zatoński T, Morawski K. Handheld laser-fiber vibrometry probe for assessing auditory ossicles displacement. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-210077RR. [PMID: 34291616 PMCID: PMC8292735 DOI: 10.1117/1.jbo.26.7.077001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Measurements of auditory ossicles displacement are commonly carried out by means of laser-Doppler vibrometry (LDV), which is considered to be a gold standard. The limitation of the LDV method, especially for in vivo measurements, is the necessity to expose an object in a straight line to a laser beam operating from a distance. An alternative to this approach is the use of a handheld laser-fiber vibrometry probe (HLFVP) with a curved tip. AIM We evaluate the feasibility of an HLFVP with a curved tip for measuring sound-induced displacement of the auditory ossicles. APPROACH A handheld vibrometer probe guiding the laser beam with a fiber-optic cable was used for displacement measurements of the incus body and the posterior crus of the stapes. Tonal stimuli at frequencies of 0.5, 1, 2, and 4 kHz were presented by means of an insert earphone positioned in the outer ear canal. The probe was fixed at the measurement site using a tripod or hand-held by one of the two surgeons. RESULTS The measurements were carried out on six fresh temporal bones. Multivariate analysis of variance showed statistically significant differences for stimulus frequency (F3,143 = 29.37, p < 0.001, and η2 = 0.35), bone (F5,143 = 4.61, p = 0.001, and η2 = 0.01), and measurement site (F1,143 = 4.74, p = 0.03, and η2 = 0.02) in the absence of statistically significant differences for the probe fixation method (F2,143 = 0.15, p = 0.862, and η2 = 0.001). Standard deviations of the means were 6.9, 2.6, 1.9, and 0.6 nm / Pa for frequency, bone, site, and fixation, respectively. Ear transfer functions were found to be consistent with literature data. CONCLUSIONS The feasibility of applying HLFVP to measure the displacement of auditory ossicles has been confirmed. HLFVP offers the possibility of carrying out measurements at various angles; however, this needs to be standardized taking into account anatomical limitations and surgical convenience.
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Affiliation(s)
- Marcin Masalski
- Wroclaw Medical University, Department of Otolaryngology Head and Neck Surgery, Wroclaw, Poland
- Wroclaw University of Science and Technology, Department of Biomedical Engineering, Wroclaw, Poland
| | - Adam Wąż
- Wroclaw University of Science and Technology, Department of Field Theory, Electronic Circuits, and Optoelectronics, Wroclaw, Poland
| | | | - Tomasz Zatoński
- Wroclaw Medical University, Department of Otolaryngology Head and Neck Surgery, Wroclaw, Poland
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von Witzleben M, Stoppe T, Ahlfeld T, Bernhardt A, Polk M, Bornitz M, Neudert M, Gelinsky M. Biomimetic Tympanic Membrane Replacement Made by Melt Electrowriting. Adv Healthc Mater 2021; 10:e2002089. [PMID: 33506636 DOI: 10.1002/adhm.202002089] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/06/2021] [Indexed: 12/17/2022]
Abstract
The tympanic membrane (TM) transfers sound waves from the air into mechanical motion for the ossicular chain. This requires a high sensitivity to small dynamic pressure changes and resistance to large quasi-static pressure differences. The TM achieves this by providing a layered structure of about 100µm in thickness, a low flexural stiffness, and a high tensile strength. Chronically infected middle ears require reconstruction of a large area of the TM. However, current clinical treatment can cause a reduction in hearing. With the novel additive manufacturing technique of melt electrowriting (MEW), it is for the first time possible to fabricate highly organized and biodegradable membranes within the dimensions of the TM. Scaffold designs of various fiber composition are analyzed mechanically and acoustically. It can be demonstrated that by customizing fiber orientation, fiber diameter, and number of layers the desired properties of the TM can be met. An applied thin collagen layer seals the micropores of the MEW-printed membrane while keeping the favorable mechanical and acoustical characteristics. The determined properties are beneficial for implantation, closely match those of the human TM, and support the growth of a neo-epithelial layer. This proves the possibilities to create a biomimimetic TM replacement using MEW.
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Affiliation(s)
- Max von Witzleben
- Carl Gustav Carus Faculty of Medicine Center for Translational Bone, Joint and Soft Tissue Research Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Thomas Stoppe
- Carl Gustav Carus Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery Ear Research Center Dresden Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Tilman Ahlfeld
- Carl Gustav Carus Faculty of Medicine Center for Translational Bone, Joint and Soft Tissue Research Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Anne Bernhardt
- Carl Gustav Carus Faculty of Medicine Center for Translational Bone, Joint and Soft Tissue Research Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Marie‐Luise Polk
- Carl Gustav Carus Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery Ear Research Center Dresden Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Matthias Bornitz
- Carl Gustav Carus Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery Ear Research Center Dresden Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Marcus Neudert
- Carl Gustav Carus Faculty of Medicine Department of Otorhinolaryngology Head and Neck Surgery Ear Research Center Dresden Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
| | - Michael Gelinsky
- Carl Gustav Carus Faculty of Medicine Center for Translational Bone, Joint and Soft Tissue Research Technische Universität Dresden Fetscherstr. 74 Dresden 01307 Germany
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13
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Polk ML, Darbinjan A, Bornitz M, Seidler H, Bendas A, Zahnert T, Neudert M. Measurement of middle ear transfer function in temporal bones using electromagnetic excitation: Comparison to sound excitation and evaluation of influencing factors. Hear Res 2021; 405:108233. [PMID: 33915399 DOI: 10.1016/j.heares.2021.108233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/12/2021] [Accepted: 03/24/2021] [Indexed: 11/28/2022]
Abstract
Hearing a sound produces vibrations of the ossicles in the middle ear, which can be measured in the micrometer to nanometer range. Destruction of middle ear structures results most commonly from chronic inflammatory diseases. In these cases, passive and active middle ear implants are used for reconstruction of the ossicular chain. The positioning of the implants depends primarily on the surgeon's experience. So far, no objective assessment has been conducted to affirm if the chosen positioning is the best in each specific case. We have established a new method, allowing us to measure the middle ear transfer function (METF) intraoperatively. Using the new method, a magnet is placed on the umbo of the malleus handle and is stimulated by a coil positioned underneath the head. The resulting vibration is measured on the stapes footplate using Laser Doppler vibrometry (LDV). Acoustic and electromagnetic excitation show comparable METF in lower frequencies, which differ up to 10 dB in frequencies over 1 kHz. The position of the coil does not play a relevant part in the METF, whereas the location of the magnet on the tympanic membrane highly impacts the METF. This technique demonstrates reproducible results. Electromagnetic excitation is comparable to sound excitation and is suited for measuring the METF. A stable positioning of the magnet on the umbo is essential in order to acquire valid data.
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Affiliation(s)
- Marie-Luise Polk
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Alexander Darbinjan
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Matthias Bornitz
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Hannes Seidler
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Alexander Bendas
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Thomas Zahnert
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
| | - Marcus Neudert
- University Clinic Dresden, Department of Otolaryngology, Head and Neck Surgery, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany.
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14
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Roychowdhury P, Castillo-Bustamante M, Polanik M, Kozin ED, Remenschneider AK. Histopathology of the Incudomalleolar Joint in Cases of "Indeterminate" Presbycusis. Otolaryngol Head Neck Surg 2021; 165:701-704. [PMID: 33618567 DOI: 10.1177/0194599821993813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LEVEL OF EVIDENCE Retrospective study.
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Affiliation(s)
- Prithwijit Roychowdhury
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Melissa Castillo-Bustamante
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA
| | - Marc Polanik
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Elliott D Kozin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA
| | - Aaron K Remenschneider
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard University, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, UMASS Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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15
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Effects of Otosclerosis on Middle Ear Function Assessed With Wideband Absorbance and Absorbed Power. Ear Hear 2020; 42:547-557. [PMID: 33156125 DOI: 10.1097/aud.0000000000000968] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Wideband absorbance and absorbed power were evaluated in a group of subjects with surgically confirmed otosclerosis (Oto group), mean age 51.6 years. This is the first use of absorbed power in the assessment of middle ear disorders. Results were compared with control data from two groups of adults, one with normal hearing (NH group) mean age of 31 years, and one that was age- and sex-matched with the Oto group and had sensorineural hearing loss (SNHL group). The goal was to assess group differences using absorbance and absorbed power, to determine test performance in detecting otosclerosis, and to evaluate preoperative and postoperative test results. DESIGN Audiometric and wideband tests were performed over frequencies up to 8 kHz. The three groups were compared on wideband tests using analysis of variance to assess group mean differences. Receiver operating characteristic (ROC) curve analysis was also used to assess test accuracy at classifying ears as belonging to the Oto or control groups using the area under the ROC curve (AUC). A longitudinal design was used to compare preoperative and postoperative results at 3 and 6 months. RESULTS There were significant mean differences in the wideband parameters between the Oto and control groups with generally lower absorbance and absorbed power for the Oto group at ambient and tympanometric peak pressure (TPP) depending on frequency. The SNHL group had more significant differences with the Oto group than did the NH group in the high frequencies for absorbed power at ambient pressure and tympanometric absorbed power at TPP, as well as for the tympanometric tails. The greatest accuracy for classifying ears as being in the Oto group or a control group was for absorbed power at ambient pressure at 0.71 kHz with an AUC of 0.81 comparing the Oto and NH groups. The greatest accuracy for an absorbance measure was for the comparison between the Oto and NH groups for the peak-to-negative tail condition with an AUC of 0.78. In contrast, the accuracy for classifying ears into the control or Oto groups for static acoustic admittance at 226 Hz was near chance performance, which is consistent with previous findings. There were significant mean differences between preoperative and postoperative tests for absorbance and absorbed power. CONCLUSIONS Consistent with previous studies, wideband absorbance showed better sensitivity for detecting the effects of otosclerosis on middle ear function than static acoustic admittance at 226 Hz. This study showed that wideband absorbed power is similarly sensitive and may perform even better in some instances than absorbance at classifying ears as having otosclerosis. The use of a group that was age- and sex-matched to the Oto group generally resulted in greater differences between groups in the high frequencies for absorbed power, suggesting that age-related norms in adults may be useful for the wideband clinical applications. Absorbance and absorbed power appear useful for monitoring changes in middle ear function following surgery for otosclerosis.
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16
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Hamra M, Shinnawi S, Vaizer MC, Yelin D. Rapid imaging of tympanic membrane vibrations in humans. BIOMEDICAL OPTICS EXPRESS 2020; 11:6470-6479. [PMID: 33282502 PMCID: PMC7687925 DOI: 10.1364/boe.402097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 06/12/2023]
Abstract
Functional imaging of the human ear is an extremely challenging task because of its minute anatomic structures and nanometer-scale motion in response to sound. Here, we demonstrate noninvasive in vivo functional imaging of the human tympanic membrane under various acoustic excitations, and identify unique vibration patterns that vary between human subjects. By combining spectrally encoded imaging with phase-sensitive spectral-domain interferometry, our system attains high-resolution functional imaging of the two-dimensional membrane surface, within a fraction of a second, through a handheld imaging probe. The detailed physiological data acquired by the system would allow measuring a wide range of clinically relevant parameters for patient diagnosis, and provide a powerful new tool for studying middle and inner ear physiology.
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Affiliation(s)
- Matan Hamra
- Department of Biomedical Engineering, Technion-Israel institute of Technology, Haifa 3200003, Israel
| | - Shadi Shinnawi
- Department of Otolarynglogy Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Mauricio Cohen Vaizer
- Department of Otolarynglogy Head and Neck Surgery, Rambam Healthcare Campus, Haifa 3109601, Israel
| | - Dvir Yelin
- Department of Biomedical Engineering, Technion-Israel institute of Technology, Haifa 3200003, Israel
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17
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Evaluation of Artificial Fixation of the Incus and Malleus With Minimally Invasive Intraoperative Laser Vibrometry (MIVIB) in a Temporal Bone Model. Otol Neurotol 2020; 41:45-51. [PMID: 31664003 DOI: 10.1097/mao.0000000000002444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A significant number of adults suffer from conductive hearing loss due to chronic otitis media, otosclerosis, or other pathologies. An objective measurement of ossicular mobility is needed to avoid unnecessarily invasive middle ear surgery and to improve hearing outcomes. METHODS Minimally invasive intraoperative laser vibrometry provides a method that is compatible with middle ear surgery, where the tympanic membrane is elevated. The ossicles were driven by a floating mass transducer and their mobility was measured using a laser Doppler vibrometer. Utilising this method, we assessed both the absolute velocities of the umbo and incus long process as well as the incus-to-umbo velocity ratio during artificial fixation of the incus alone or incus and malleus together. RESULTS The reduction of absolute velocities was 8 dB greater at the umbo and 17 dB at the incus long process for incus-malleus fixations when compared with incus fixation alone. Incus fixation alone resulted in no change to the incus-to-umbo velocity ratio where incus-malleus fixations reduced this ratio (-11 dB). The change in incus velocity was shown to be the most suitable parameter to distinguish between incus fixation and incus-malleus fixation. When the whole frequency range was analyzed, one could also differentiate these two fixations from previously published stapes fixation, where the higher frequencies were less affected. CONCLUSION Minimally invasive intraoperative laser vibrometry provides a promising objective analysis of ossicular mobility that would be useful intraoperatively.
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18
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Boedts MJO. Tympanic Resonance Hypothesis. Front Neurol 2020; 11:14. [PMID: 32117001 PMCID: PMC7008469 DOI: 10.3389/fneur.2020.00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 01/07/2020] [Indexed: 11/13/2022] Open
Abstract
Seemingly unrelated symptoms in the head and neck region are eliminated when a patch is applied on specific locations on the Tympanic Membrane. Clinically, two distinct patient populations can be distinguished; cervical and masticatory muscle tensions are involved, and mental moods of anxiety or need. Clinical observations lead to the hypothesis of a “Tympanic Resonance Regulating System.” Its controller, the Trigeminocervical complex, integrates external auditory, somatosensory, and central impulses. It modulates auditory attention, and directs it toward unpredictable external or expected domestic and internal sounds: peripherally by shifting the resonance frequencies of the Tympanic Membrane; centrally by influencing the throughput of auditory information to the neural attention networks that toggle between scanning and focusing; and thus altering the perception of auditory information. The hypothesis leads to the assumption that the Trigeminocervical complex is composed of a dorsal component, and a ventral one which may overlap with the concept of “Trigeminovagal complex.” “Tympanic Dissonance” results in a host of local and distant symptoms, most of which can be attributed to activation of the Trigeminocervical complex. Diagnostic and therapeutic measures for this “Tympanic Dissonance Syndrome” are suggested.
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Affiliation(s)
- Michael J O Boedts
- Brai3n, Ghent, Belgium.,ENT Department, AZ Maria Middelares, Ghent, Belgium
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19
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Seong D, Kwon J, Jeon D, Wijesinghe RE, Lee J, Ravichandran NK, Han S, Lee J, Kim P, Jeon M, Kim J. In Situ Characterization of Micro-Vibration in Natural Latex Membrane Resembling Tympanic Membrane Functionally Using Optical Doppler Tomography. SENSORS (BASEL, SWITZERLAND) 2019; 20:E64. [PMID: 31877652 PMCID: PMC6982896 DOI: 10.3390/s20010064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/13/2019] [Accepted: 12/18/2019] [Indexed: 12/29/2022]
Abstract
Non-invasive characterization of micro-vibrations in the tympanic membrane (TM) excited by external sound waves is considered as a promising and essential diagnosis in modern otolaryngology. To verify the possibility of measuring and discriminating the vibrating pattern of TM, here we describe a micro-vibration measurement method of latex membrane resembling the TM. The measurements are obtained with an externally generated audio stimuli of 2.0, 2.2, 2.8, 3.1 and 3.2 kHz, and their respective vibrations based tomographic, volumetric and quantitative evaluations were acquired using optical Doppler tomography (ODT). The micro oscillations and structural changes which occurred due to diverse frequencies are measured with sufficient accuracy using a highly sensitive ODT system implied phase subtraction method. The obtained results demonstrated the capability of measuring and analyzing the complex varying micro-vibration of the membrane according to implied sound frequency.
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Affiliation(s)
- Daewoon Seong
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Jaehwan Kwon
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Deokmin Jeon
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Ruchire Eranga Wijesinghe
- Department of Biomedical Engineering, College of Engineering, Kyungil University, Gyeongsan 38428, Korea;
| | - Jaeyul Lee
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Naresh Kumar Ravichandran
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Sangyeob Han
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Junsoo Lee
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Pilun Kim
- School of Medicine, Institute of Biomedical Engineering, Kyungpook National University, Daegu 41944, Korea;
| | - Mansik Jeon
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
| | - Jeehyun Kim
- School of Electronics Engineering, College of IT engineering, Kyungpook National University, Daegu 41566, Korea; (D.S.); (J.K.); (D.J.); (J.L.); (N.K.R.); (S.H.); (J.L.)
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20
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Merchant GR, Siegel JH, Neely ST, Rosowski JJ, Nakajima HH. Effect of Middle-Ear Pathology on High-Frequency Ear Canal Reflectance Measurements in the Frequency and Time Domains. J Assoc Res Otolaryngol 2019; 20:529-552. [PMID: 31673928 PMCID: PMC6889121 DOI: 10.1007/s10162-019-00735-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 08/20/2019] [Indexed: 10/25/2022] Open
Abstract
The effects of middle-ear pathology on wideband acoustic immittance and reflectance at frequencies above 6-8 kHz have not been documented, nor has the effect of such pathologies on the time-domain reflectance. We describe an approach that utilizes sound frequencies as high as 20 kHz and quantifies reflectance in both the frequency and time domains. Experiments were performed with fresh normal human temporal bones before and after simulating various middle-ear pathologies, including malleus fixation, stapes fixation, and disarticulation. In addition to experimental data, computational modeling was used to obtain fitted parameter values of middle-ear elements that vary systematically due to the simulated pathologies and thus may have diagnostic implications. Our results demonstrate that the time-domain reflectance, which requires acoustic measurements at high frequencies, varies with middle-ear condition. Furthermore, the extended bandwidth frequency-domain reflectance data was used to estimate parameters in a simple model of the ear canal and middle ear that separates three major conductive pathologies from each other and from the normal state.
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Affiliation(s)
- Gabrielle R. Merchant
- Speech and Hearing Bioscience and Technology, Harvard Division of Medical Sciences (formerly the Harvard-MIT Division of Health Sciences and Technology), Cambridge, MA USA
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA USA
- Boys Town National Research Hospital, Omaha, NE USA
| | | | | | - John J. Rosowski
- Speech and Hearing Bioscience and Technology, Harvard Division of Medical Sciences (formerly the Harvard-MIT Division of Health Sciences and Technology), Cambridge, MA USA
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, MA USA
| | - Hideko H. Nakajima
- Speech and Hearing Bioscience and Technology, Harvard Division of Medical Sciences (formerly the Harvard-MIT Division of Health Sciences and Technology), Cambridge, MA USA
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, MA USA
- Department of Otology and Laryngology, Harvard Medical School, Boston, MA USA
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21
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Gladiné K, Dirckx JJJ. Strain distribution in rabbit eardrums under static pressure. Hear Res 2019; 381:107772. [PMID: 31398603 DOI: 10.1016/j.heares.2019.107772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/23/2019] [Accepted: 07/23/2019] [Indexed: 01/30/2023]
Abstract
Full-field strain maps of intact rabbit eardrums subjected to static pressures are presented. A stochastic intensity pattern was applied to 12 eardrums, and strain maps were measured at the medial site using a stereoscopic digital image correlation setup for pressures between -2 and 2 kPa. Ear canal overpressures induced circumferential orientated positive strains between manubrium and the eardrum border that increased almost linearly with pressure. Radially orientated negative strains were found at the border and manubrium. Ear canal underpressures caused negative circumferential strains between manubrium and the tympanic annulus but radially orientated positive strains at the borders. The magnitudes of these negative strains at underpressures were larger than those of positive strains at overpressures and were nonlinearly proportional to pressure. In three ears, strains were calculated with intact and removed cochlea. The effect of cochlea removal on the peak-to-peak strain was found to be no more than 3%.
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Affiliation(s)
- Kilian Gladiné
- University of Antwerp, Laboratory of Biophysics and Biomedical Physics, Groenenborgerlaan 171, 2020, Antwerp, Belgium.
| | - Joris J J Dirckx
- University of Antwerp, Laboratory of Biophysics and Biomedical Physics, Groenenborgerlaan 171, 2020, Antwerp, Belgium.
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22
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Nguyen VS, Rouxel D, Vincent B, Ducourneau J, Parietti-Winkler C. A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery. J Clin Monit Comput 2019; 34:827-832. [PMID: 31352626 DOI: 10.1007/s10877-019-00364-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/17/2019] [Indexed: 11/29/2022]
Abstract
To limit functional surgical failure and reduce the rate of revision surgery in case of surgical ossicular chain reconstruction, a piezoelectric device was developed for assessment of ossicular chain vibrations during the middle ear surgery. The device resembled a pen and consisted of a reusable main body and a disposable sensitive head including piezoelectric polymer sensor. Almost all of components of the device were made of polymer for light weight and for acoustic impedance matching to the middle ear system. Several frequencies can be analyzed simultaneously and several measures can be taken by time. The results showed that the device can record normal and reconstructed ossicular chain vibration in response to an acoustic stimulation, with similar results to those achieved by laser Doppler vibrometer. This light, handheld and low-cost device allows fast, easy and safe assessments of normal ossicular chain mobility and ossicular chain reconstruction efficiency. Primary pre-clinical trial showed very promising performance of the device that could be used to qualitatively control ossiculoplasty during real-time surgical procedure. Clinical assessments will be done to further evaluate the real-life performance of the device.
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Affiliation(s)
- Van Son Nguyen
- CNRS, Institut Jean Lamour, University of Lorraine, Nancy, France
| | - Didier Rouxel
- CNRS, Institut Jean Lamour, University of Lorraine, Nancy, France.
| | - Brice Vincent
- CNRS, Institut Jean Lamour, University of Lorraine, Nancy, France
| | - Joël Ducourneau
- Training Department in Hearing Aid, Faculty of Pharmacy, University of Lorraine, Nancy, France
| | - Cécile Parietti-Winkler
- ENT Department, Faculty of Medicine, University Hospital of Nancy, University of Lorraine, Nancy, France
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23
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Model-based hearing diagnostics based on wideband tympanometry measurements utilizing fuzzy arithmetic. Hear Res 2019; 378:126-138. [DOI: 10.1016/j.heares.2019.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 11/20/2022]
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24
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MacDougall D, Morrison L, Morrison C, Morris DP, Bance M, Adamson RBA. Optical Coherence Tomography Doppler Vibrometry Measurement of Stapes Vibration in Patients With Stapes Fixation and Normal Controls. Otol Neurotol 2019; 40:e349-e355. [DOI: 10.1097/mao.0000000000002193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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25
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Silverstein H, Smith J, Kellermeyer B. Stapes hypermobility as a possible cause of hyperacusis. Am J Otolaryngol 2019; 40:247-252. [PMID: 30502003 DOI: 10.1016/j.amjoto.2018.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Hyperacusis is a reduction of normal tolerances for everyday sounds. Although several publications have been produced demonstrating that minimally invasive surgical procedures may improve patient symptoms, the precise etiology of hyperacusis often remains elusive. This study describes 21 patients, 7 of whom stapes hypermobility is believed to be a mechanical genesis of their hyperacusis symptoms. STUDY DESIGN A prospective, repeated-measure single-arm design was used for this study. SETTING All patients were evaluated and treated at a tertiary level otologic referral center. SUBJECTS AND METHODS 21 patients (Cohort A) with severe hyperacusis underwent oval and round window reinforcement. Seven patients (Cohort B) intraoperatively appeared to have subjective hypermobility of the stapes. Additional reinforcement of the stapes superstructure was performed in these patients. RESULTS In Cohort A, loudness discomfort level (LDL) values improved on average from 72.7 dB to 81.9 dB. Hyperacusis questionnaire (HQ) scores improved from 30.1 to 14.7. Numeric Rating Scale scores (0-10) decreased from 8.5 to 4.0. In Cohort B, values similarly improved from an average of 72.4 dB to 88.2 dB. HQ scores improved from 35.8 to 18.9. Numeric Rating Scale scores fell from 10.0 to 3.7. Postoperatively there were no complaints of hearing loss. Sixteen out of 21(76%) reported improved quality of life and diminished symptoms of hyperacusis. CONCLUSION It is possible that patients suffering from hyperacusis may have a mechanical cause for their symptoms. Further research is necessary to clarify stapes mobility in patients with these symptoms. Excess temporalis tissue reinforcement of the stapes along with round window reinforcement shows promise as a minimally invasive surgical option for patients suffering from hyperacusis.
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Affiliation(s)
- Herbert Silverstein
- Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of America.
| | - Joshua Smith
- Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Brian Kellermeyer
- Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of America
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Cheng JT, Maftoon N, Guignard J, Ravicz ME, Rosowski J. Tympanic membrane surface motions in forward and reverse middle ear transmissions. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 145:272. [PMID: 30710932 PMCID: PMC6338545 DOI: 10.1121/1.5087134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Characterization of Tympanic Membrane (TM) surface motions with forward and reverse stimulation is important to understanding how the TM transduces acoustical and mechanical energy in both directions. In this paper, stroboscopic opto-electronic holography is used to quantify motions of the entire TM surface induced by forward sound and reverse mechanical stimulation in human cadaveric ears from 0.25 to 18.4 kHz. The forward sound stimulus was coupled to an anatomically realistic artificial ear canal that allowed optical access to the entire TM surface, and the reverse mechanical stimulus was applied to the body of the incus by a piezo-electric stimulator. The results show clear differences in TM surface motions evoked by the two stimuli. In the forward case, TM motion is dominated by standing-wave-like modal motions that are consistent with a relatively uniform sound-pressure load over the entire TM surface. With reverse mechanical stimulation, the TM surface shows more traveling waves, consistent with a localized mechanical drive applied to the manubrium embedded in the TM. With both stimuli, the manubrium moves less than the rest of the TM, consistent with the TM acting like a compliant membrane rather than a stiff diaphragm, and also consistent with catenary behavior due to the TM's curved shape.
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Affiliation(s)
- Jeffrey Tao Cheng
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
| | - Nima Maftoon
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
| | - Jérémie Guignard
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
| | - Michael E Ravicz
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
| | - John Rosowski
- Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, Massachusetts 02114, USA
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Ramier A, Cheng JT, Ravicz ME, Rosowski JJ, Yun SH. Mapping the phase and amplitude of ossicular chain motion using sound-synchronous optical coherence vibrography. BIOMEDICAL OPTICS EXPRESS 2018; 9:5489-5502. [PMID: 30460142 PMCID: PMC6238908 DOI: 10.1364/boe.9.005489] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 05/21/2023]
Abstract
The sound-driven vibration of the tympanic membrane and ossicular chain of middle-ear bones is fundamental to hearing. Here we show that optical coherence tomography in phase synchrony with a sound stimulus is well suited for volumetric, vibrational imaging of the ossicles and tympanic membrane. This imaging tool - OCT vibrography - provides intuitive motion pictures of the ossicular chain and how they vary with frequency. Using the chinchilla ear as a model, we investigated the vibrational snapshots and phase delays of the manubrium, incus, and stapes over 100 Hz to 15 kHz. The vibrography images reveal a previously undescribed mode of motion of the chinchilla ossicles at high frequencies.
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Affiliation(s)
- Antoine Ramier
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jeffrey Tao Cheng
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Michael E. Ravicz
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - John J. Rosowski
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Seok-Hyun Yun
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA
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Jeon D, Cho NH, Park K, Kim K, Jeon M, Jang JH, Kim J. In Vivo Vibration Measurement of Middle Ear Structure Using Doppler Optical Coherence Tomography: Preliminary Study. Clin Exp Otorhinolaryngol 2018; 12:40-49. [PMID: 30045616 PMCID: PMC6315208 DOI: 10.21053/ceo.2018.00185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/31/2018] [Indexed: 12/27/2022] Open
Abstract
Objectives Doppler optical coherence tomography (DOCT) is useful for both, the spatially resolved measurement of the tympanic membrane (TM) oscillation and high-resolution imaging. We demonstrated a new technique capable of providing real-time two-dimensional Doppler OCT image of rapidly oscillatory latex mini-drum and in vivo rat TM and ossicles. Methods Using DOCT system, the oscillation of sample was measured at frequency range of 1–4 kHz at an output of 15 W. After the sensitivity of the DOCT system was verified using a latex mini-drum consisting of a 100 μm-thick latex membrane, changes in displacement of the umbo and contacted area between TM and malleus in normal and pathologic conditions. Results The oscillation cycles of the mini-drum for stimulus frequencies were 1.006 kHz for 1 kHz, 2.012 kHz for 2kHz, and 3.912 kHz for 4 kHz, which means that the oscillation cycle of the mini-drum become short in proportional to the frequency of stimuli. The oscillation cycles of umbo area and the junction area in normal TM for frequencies of the stimuli showed similar integer ratio with the data of latex mini-drum for stimuli less than 4 kHz. In the case of middle ear effusion condition, the Doppler signal showed a tendency of attenuation in all frequencies, which was prominent at 1 kHz and 2 kHz. Conclusion The TM vibration under sound stimulation with frequencies from 1 kHz to 4 kHz in normal and pathologic conditions was demonstrated using signal demodulation method in in vivo condition. The OCT technology could be helpful for functional and structural assessment as an optional modality.
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Affiliation(s)
- Doekmin Jeon
- School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Nam Hyun Cho
- Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA.,Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary (MEEI), Boston, MA, USA
| | - Kibeom Park
- School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Kanghae Kim
- School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Mansik Jeon
- School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, Korea
| | - Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Jeehyun Kim
- School of Electronics Engineering, College of IT Engineering, Kyungpook National University, Daegu, Korea
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Mechanisms of Hearing Loss in a Guinea Pig Model of Superior Semicircular Canal Dehiscence. Neural Plast 2018; 2018:1258341. [PMID: 29853836 PMCID: PMC5941760 DOI: 10.1155/2018/1258341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/07/2018] [Indexed: 11/18/2022] Open
Abstract
Defective acoustic transmission in the cochlea is closely related with various auditory and vestibular symptoms. Among them, semicircular canal dehiscence (SCD) with a defective semicircular bone is typical. Currently, the pathogenesis of SCD is usually explained by the third window hypothesis; however, this hypothesis fails to explain the variability in the symptoms and signs experienced by superior SCD (SSCD) patients. We evaluated the mechanism of hearing loss in a guinea pig model of bony dehiscence with various sizes and locations along the superior semicircular canal. Auditory brainstem responses (ABRs) and laser Doppler velocimetry were used to measure hearing loss and vibration changes before and after fenestration, as well as after restorative patching. ABR thresholds at low frequencies (e.g., 1000 Hz) increased after fenestration and decreased back to the normal range after we repaired the defect. Energy leakage from the surgically introduced third window was detected in the range of 300–1500 Hz, accompanied by increased vibration at the umbo, stapes head, and the dehiscence site, while decreased vibration was observed at the round window membrane in the same frequency range. After the patching procedure, the deviant vibrations were recovered. The degree of postfenestration energy leakage was proportional to the size of fenestration and the proximity of the fenestration site to the oval window. These results suggest that the bony fenestration of the superior semicircular canal mimics the hearing loss pattern of patients with SSCD. The decrease in perilymph wave impedance likely accounts for the auditory changes.
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Huang PC, Chaney EJ, Shelton RL, Boppart SA. Magnetomotive Displacement of the Tympanic Membrane Using Magnetic Nanoparticles: Toward Enhancement of Sound Perception. IEEE Trans Biomed Eng 2018; 65:2837-2846. [PMID: 29993404 DOI: 10.1109/tbme.2018.2819649] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A novel hearing-aid scheme using magnetomotive nanoparticles (MNPs) as transducers in the tympanic membrane (TM) is proposed, aiming to noninvasively and directly induce a modulated vibration on the TM. METHODS In this feasibility study, iron oxide (Fe3O4) nanoparticles were applied on ex vivo rat TM tissues and allowed to diffuse over ∼2 h. Subsequently, magnetic force was exerted on the MNP-laden TM via a programmable electromagnetic solenoid to induce the magnetomotion. Optical coherence tomography (OCT), along with its phase-sensitive measurement capabilities, was utilized to visualize and quantify the nanometer-scale vibrations generated on the TM tissues. RESULTS The magnetomotive displacements induced on the TM were significantly greater than the baseline vibration of the TM without MNPs. In addition to a pure frequency tone, a chirped excitation and the corresponding spectroscopic response were also successfully generated and obtained. Finally, visualization of volumetric TM dynamics was achieved. CONCLUSION This study demonstrates the effectiveness of magnetically inducing vibrations on TMs containing iron oxide nanoparticles, manipulating the amplitude and the frequency of the induced TM motions, and the capability of assessing the magnetomotive dynamics via OCT. SIGNIFICANCE The results demonstrated here suggest the potential use of this noninvasive magnetomotive approach in future hearing aid applications. OCT can be utilized to investigate the magnetomotive dynamics of the TM, which may either enhance sound perception or magnetically induce the perception of sound without the need for acoustic speech signals.
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Strenger T, Brandstetter M, Stark T, Böhnke F. [New clinical applications for laser Doppler vibrometry in otology]. HNO 2018; 66:265-279. [PMID: 29417191 DOI: 10.1007/s00106-018-0473-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND An instrument to measure vibration in the middle ear needs to be sensitive enough to detect displacement on a nanometer scale, yet not affect the vibration itself. Numerous techniques have been described in the literature, but laser Doppler vibrometry (LDV) has nowadays become established as the standard method in hearing research. OBJECTIVE This article aims to present possible clinical applications of an LDV system in otology. MATERIALS AND METHODS A commercially available single-point vibrometer was used. Measurements were carried out both with the sensor head mounted on an operating microscope and as a handheld device with the sensor head manually inserted in the ear canal. For the latter, a custom-made unit containing an electrically tunable lens was attached to the sensor head. Middle ear vibrations were measured in a temporal bone model as well as in patients during and after implantation of a Vibrant Soundbridge (VSB; MED-EL Corp., Durham/NC, USA). RESULTS Different types of middle ear pathologies can be distinguished by the frequency response of the umbo. The LDV technique can be used for intraoperative quantification of the coupling quality of the VSB's Floating Mass Transducer (FMT; MED-EL) to the ossicle chain during VSB implantation. Postoperatively, the method serves as a follow-up testing tool if a deterioration in aided hearing threshold occurs. The measurement can reveal changes in the umbo transfer function, e. g., due to middle ear scarring or dislocation of the FMT. CONCLUSION Many clinical questions in otology can be addressed by LDV. However, due to the high acquisition costs of an LDV system, the relatively large instrumental setup, and the large inter-ear variability of middle-ear function, the technique has not (yet) become established in clinical routine.
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Affiliation(s)
- T Strenger
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum Augsburg (Süd), Sauerbruchstr. 6, 86179, Augsburg, Deutschland.
| | | | - T Stark
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Helios Klinikum München West, München, Deutschland
| | - F Böhnke
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Klinikum rechts der Isar der TU München, München, Deutschland
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Wales J, Gladiné K, Van de Heyning P, Topsakal V, von Unge M, Dirckx J. Minimally invasive laser vibrometry (MIVIB) with a floating mass transducer – A new method for objective evaluation of the middle ear demonstrated on stapes fixation. Hear Res 2018; 357:46-53. [DOI: 10.1016/j.heares.2017.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/08/2017] [Accepted: 11/15/2017] [Indexed: 12/30/2022]
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Kunimoto Y, Hasegawa K, Arii S, Kataoka H, Yazama H, Kuya J, Fujiwara K, Takeuchi H. Sequential motion of the ossicular chain measured by laser Doppler vibrometry. Acta Otolaryngol 2017; 137:1233-1237. [PMID: 28758555 DOI: 10.1080/00016489.2017.1357833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE In order to help a surgeon make the best decision, a more objective method of measuring ossicular motion is required. METHODS A laser Doppler vibrometer was mounted on a surgical microscope. To measure ossicular chain vibrations, eight patients with cochlear implants were investigated. To assess the motions of the ossicular chain, velocities at five points were measured with tonal stimuli of 1 and 3 kHz, which yielded reproducible results. The sequential amplitude change at each point was calculated with phase shifting from the tonal stimulus. Motion of the ossicular chain was visualized from the averaged results using the graphics application. RESULTS The head of the malleus and the body of the incus showed synchronized movement as one unit. In contrast, the stapes (incudostapedial joint and posterior crus) moved synchronously in opposite phase to the malleus and incus. The amplitudes at 1 kHz were almost twice those at 3 kHz. CONCLUSIONS Our results show that the malleus and incus unit and the stapes move with a phase difference.
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Affiliation(s)
- Yasuomi Kunimoto
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kensaku Hasegawa
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shiro Arii
- Department of Information and Knowledge Engineering, Graduate School of Engineering, Tottori University, Tottori, Japan
| | - Hideyuki Kataoka
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Hiroaki Yazama
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Junko Kuya
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Hiromi Takeuchi
- Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Wasson JD, Campbell L, Chambers S, Hampson A, Briggs RJS, O'Leary SJ. Effect of cochlear implantation on middle ear function: A three-month prospective study. Laryngoscope 2017; 128:1207-1212. [DOI: 10.1002/lary.26840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Joseph D. Wasson
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Luke Campbell
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Scott Chambers
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Amy Hampson
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Robert J. S. Briggs
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
| | - Stephen J. O'Leary
- Department of Otolaryngology; The University of Melbourne, Royal Victorian Eye and Ear Hospital; East Melbourne Victoria Australia
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Experimental Simulation of Clinical Borderline Situations in Temporal Bone Specimens After Ossiculoplasty. Ear Hear 2017; 39:131-138. [PMID: 28671917 DOI: 10.1097/aud.0000000000000472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES One reason for insufficient hearing improvement with a distinct air-bone gap after ossiculoplasty with implantation of partial or total ossicular replacement prostheses can be the dislocation or minimal shifting of the prosthesis. The aim of this study was the simulation of common clinical borderline situations with minimal shifting of the prosthesis in temporal bone specimens after ossiculoplasty. It was furthermore the goal to identify these specific situations through imaging by cone beam computed tomography (cbCT) and direct visual inspection using the operation microscope. Additionally, the functional status was evaluated using laser-Doppler vibrometry (LDV). DESIGN We used a total of four temporal bone specimens for this study. A reconstruction with a partial ossicular replacement prostheses was performed in three specimens and with a total ossicular replacement prostheses in one specimen, with good initial acoustic properties. Subsequently, one specific type of prosthesis failure was simulated in each specimen, respectively, by minimally shifting, tilting, or bending the prostheses from their initial positions. These changes were introduced step-by-step until a borderline situation just short of complete acoustic decoupling was reached. Each step was examined using both LDV and cbCT and observed through the operation microscope. RESULTS LDV was able to quantify the mechanic function of the ossicular chain after most of the manipulation steps by demonstrating the effect of any shifting of the prosthesis on the middle ear transfer function. However, in some situations, the middle ear transfer function was better with a visually more advanced failure of the prosthesis. In addition, cbCT showed most of the steps with excellent resolution and was able to delineate changes in soft tissue (e.g., cartilage covering). CONCLUSION cbCT seems to be a promising imaging technique for middle ear problems. As cbCT and LDV exhibited slightly different advantages and disadvantages regarding the demonstration of borderline situations, the combination of both techniques allowed for a more precise evaluation of middle ear reconstructions. Knowledge of the specific characteristics of these methods and their possible combination might help otologists and otosurgeons to refine indications for revision surgery and improve their personal patient counseling.
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Abstract
OBJECTIVES Ossicular discontinuity may be complete, with no contact between the disconnected ends, or partial, where normal contact at an ossicular joint or along a continuous bony segment of an ossicle is replaced by soft tissue or simply by contact of opposing bones. Complete ossicular discontinuity typically results in an audiometric pattern of a large, flat conductive hearing loss. In contrast, in cases where otomicroscopy reveals a normal external ear canal and tympanic membrane, high-frequency conductive hearing loss has been proposed as an indicator of partial ossicular discontinuity. Nevertheless, the diagnostic utility of high-frequency conductive hearing loss has been limited due to gaps in previous research on the subject, and clinicians often assume that an audiogram showing high-frequency conductive hearing loss is flawed. This study aims to improve the diagnostic utility of high-frequency conductive hearing loss in cases of partial ossicular discontinuity by (1) making use of a control population against which to compare the audiometry of partial ossicular discontinuity patients and (2) examining the correlation between high-frequency conductive hearing loss and partial ossicular discontinuity under controlled experimental conditions on fresh cadaveric temporal bones. Furthermore, ear-canal measurements of umbo velocity and wideband acoustic immittance measurements were investigated to determine the usefulness regarding diagnosis of ossicular discontinuity. DESIGN The authors analyzed audiograms from 66 patients with either form of surgically confirmed ossicular discontinuity and no confounding pathologies. The authors also analyzed umbo velocity (n = 29) and power reflectance (n = 12) measurements from a subset of these patients. Finally, the authors performed experiments on six fresh temporal bone specimens to study the differing mechanical effects of complete and partial discontinuity. The mechanical effects of these lesions were assessed via laser Doppler measurements of stapes velocity. In a subset of the specimen (n = 4), wideband acoustic immittance measurements were also collected. RESULTS (1) Calculations comparing the air-bone gap (ABG) at high and low frequencies show that when high-frequency ABGs are larger than low-frequency ABGs, the surgeon usually reported soft-tissue bands at the point of discontinuity. However, in cases with larger low-frequency ABGs and flat ABGs across frequencies, some partial discontinuities as well as complete discontinuities were reported. (2) Analysis of umbo velocity and power reflectance (calculated from wideband acoustic immittance) in patients reveal no significant difference across frequencies between the two types of ossicular discontinuities. (3) Temporal bone experiments reveal that partial discontinuity results in a greater loss in stapes velocity at high frequencies when compared with low frequencies, whereas with complete discontinuity, large losses in stapes velocity occur at all frequencies. CONCLUSION The clinical and experimental findings suggest that when encountering larger ABGs at high frequencies when compared with low frequencies, partial ossicular discontinuity should be considered in the differential diagnosis.
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A New Intraoperative Real-time Monitoring System for Reconstructive Middle Ear Surgery. Otol Neurotol 2016; 37:1601-1607. [DOI: 10.1097/mao.0000000000001222] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peacock J, Dirckx J, von Unge M. Intraoperative assessment of ossicular fixation. Hear Res 2016; 340:99-106. [DOI: 10.1016/j.heares.2016.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 11/29/2022]
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The Effect of Round Window Sealants on Delayed Hearing Loss in a Guinea Pig Model of Cochlear Implantation. Otol Neurotol 2016; 37:1024-31. [DOI: 10.1097/mao.0000000000001132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Controlled exploration of the effects of conductive hearing loss on wideband acoustic immittance in human cadaveric preparations. Hear Res 2016; 341:19-30. [PMID: 27496538 DOI: 10.1016/j.heares.2016.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 07/26/2016] [Accepted: 07/30/2016] [Indexed: 11/24/2022]
Abstract
Current clinical practice cannot distinguish, with any degree of certainty, the multiple pathologies that produce conductive hearing loss in patients with an intact tympanic membrane and a well-aerated middle ear without exploratory surgery. The lack of an effective non-surgical diagnostic procedure leads to unnecessary surgery and limits the accuracy of information available during pre-surgical consultations with the patient. A non-invasive measurement to determine the pathology responsible for a conductive hearing loss prior to surgery would be of great value. This work investigates the utility of wideband acoustic immittance (WAI), a non-invasive measure of middle-ear mobility, in the differential diagnosis of pathologies responsible for conductive hearing loss. We focus on determining whether power reflectance (PR), a derivative of WAI, is a possible solution to this problem. PR is a measure of the fraction of sound power reflected from the middle ear when a sound stimulus is presented to the ear canal. PR and other metrics of middle-ear performance (such as ossicular motion via laser Doppler vibrometry) were measured in well-controlled human temporal bone preparations with simulated pathologies. We report measurements before and after simulation of stapes fixation (n = 8), malleus fixation (n = 10), ossicular disarticulation (n = 10), and superior canal dehiscence (n = 8). Our results are consistent with the small set of previously published reflectance measurements made in temporal bones and patients. In this present study, these temporal bone experiments with different middle- and inner-ear pathologies were compared to the initial normal state by analyzing both WAI and ossicular motion, demonstrating that WAI can be a valuable tool in the diagnosis of conductive hearing loss.
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Allardyce BJ, Rajkhowa R, Dilley RJ, Xie Z, Campbell L, Keating A, Atlas MD, von Unge M, Wang X. Comparative acoustic performance and mechanical properties of silk membranes for the repair of chronic tympanic membrane perforations. J Mech Behav Biomed Mater 2016; 64:65-74. [PMID: 27479895 DOI: 10.1016/j.jmbbm.2016.07.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/13/2016] [Accepted: 07/14/2016] [Indexed: 11/26/2022]
Abstract
The acoustic and mechanical properties of silk membranes of different thicknesses were tested to determine their suitability as a repair material for tympanic membrane perforations. Membranes of different thickness (10-100μm) were tested to determine their frequency response and their resistance to pressure loads in a simulated ear canal model. Their mechanical rigidity to pressure loads was confirmed by tensile testing. These membranes were tested alongside animal cartilage, currently the strongest available myringoplasty graft as well as paper, which is commonly used for simpler procedures. Silk membranes showed resonant frequencies within the human hearing range and a higher vibrational amplitude than cartilage, suggesting that silk may offer good acoustic energy transfer characteristics. Silk membranes were also highly resistant to simulated pressure changes in the middle ear, suggesting they can resist retraction, a common cause of graft failure resulting from chronic negative pressures in the middle ear. Part of this strength can be explained by the substantially higher modulus of silk films compared with cartilage. This allows for the production of films that are much thinner than cartilage, with superior acoustic properties, but that still provide the same level of mechanical support as thicker cartilage. Together, these in vitro results suggest that silk membranes may provide good hearing outcomes while offering similar levels of mechanical support to the reconstructed middle ear.
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Affiliation(s)
| | - Rangam Rajkhowa
- Deakin University, Institute for Frontier Materials, Geelong, Australia
| | - Rodney J Dilley
- Ear Science Institute Australia and Ear Sciences Centre, School of Surgery, University of Western Australia, Australia
| | - Zhigang Xie
- Deakin University, Institute for Frontier Materials, Geelong, Australia
| | - Luke Campbell
- Department of Otolaryngology, University of Melbourne, Australia
| | - Adrian Keating
- School of Mechanical and Chemical Engineering, The University of Western Australia, Australia
| | - Marcus D Atlas
- Ear Science Institute Australia and Ear Sciences Centre, School of Surgery, University of Western Australia, Australia
| | - Magnus von Unge
- Dept. ENT, Akershus University Hospital and the University of Oslo, Oslo, Norway; Center for Clinical Research, Västerås, University of Uppsala, Sweden
| | - Xungai Wang
- Deakin University, Institute for Frontier Materials, Geelong, Australia.
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Park J, Cheng JT, Ferguson D, Maguluri G, Chang EW, Clancy C, Lee DJ, Iftimia N. Investigation of middle ear anatomy and function with combined video otoscopy-phase sensitive OCT. BIOMEDICAL OPTICS EXPRESS 2016; 7:238-50. [PMID: 26977336 PMCID: PMC4771445 DOI: 10.1364/boe.7.000238] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/09/2015] [Accepted: 12/17/2015] [Indexed: 05/20/2023]
Abstract
We report the development of a novel otoscopy probe for assessing middle ear anatomy and function. Video imaging and phase-sensitive optical coherence tomography are combined within the same optical path. A sound stimuli channel is incorporated as well to study middle ear function. Thus, besides visualizing the morphology of the middle ear, the vibration amplitude and frequency of the eardrum and ossicles are retrieved as well. Preliminary testing on cadaveric human temporal bone models has demonstrated the capability of this instrument for retrieving middle ear anatomy with micron scale resolution, as well as the vibration of the tympanic membrane and ossicles with sub-nm resolution.
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Affiliation(s)
- Jesung Park
- Physical Sciences Inc., Andover, MA 01810, USA
| | - Jeffrey T. Cheng
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
| | | | | | | | | | - Daniel J. Lee
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Peacock J, Dirckx J, von Unge M. Towards quantitative diagnosis of ossicular fixation: Measurement of stapes fixations using magnetically driven ossicles in human temporal bones. Acta Otolaryngol 2015; 135:880-5. [PMID: 25956182 DOI: 10.3109/00016489.2015.1015605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Information on the degree of stapes fixation can be found by measuring the ratio of stapes to umbo and stapes to incus velocity. OBJECTIVES To evaluate a method of quantifying ossicular fixation in an ear with elevated tympanic membrane. METHOD Measurements were made on four fresh-frozen human temporal bones. After elevating the tympanic membrane, a small magnet was attached to the manubrium and an electromagnetic excitation coil was used to vibrate the ossicles. The vibration response of the umbo, the tip of the incus long process, and the posterior crus of the stapes were measured before and after partially fixing the footplate with luting cement. RESULTS The velocities at the different measurement points were unequally affected by the fixation. The difference in the velocity ratio between different points provides an indication of the degree of footplate fixation.
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Affiliation(s)
- John Peacock
- Laboratory of Biomedical Physics, University of Antwerp , Antwerp , Belgium
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Merchant GR, Röösli C, Niesten MEF, Hamade MA, Lee DJ, McKinnon ML, Ulku CH, Rosowski JJ, Merchant SN, Nakajima HH. Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. Otol Neurotol 2015; 36:172-7. [PMID: 25076227 DOI: 10.1097/mao.0000000000000294] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS Power reflectance (PR) measurements in ears with superior canal dehiscence (SCD) have a characteristic pattern, the detection of which can assist in diagnosis. BACKGROUND The aim of this study was to determine whether PR coupled with a novel detection algorithm can perform well as a fast, noninvasive, and easy screening test for SCD. The screening test aimed to determine whether patients with various vestibular and/or auditory symptom(s) should be further considered for more expensive and invasive tests that better define the diagnosis of SCD (and other third-window lesions). METHODS Power reflectance was measured in patients diagnosed with SCD by high-resolution computed tomography. The study included 40 ears from 32 patients with varying symptoms (e.g., with and without conductive hearing loss, vestibular symptoms, and abnormal auditory sensations). RESULTS Power reflectance results were compared to previously published norms and showed that SCD is commonly associated with a PR notch near 1 kHz. An analysis algorithm was designed to detect such notches and to quantify their incidence in affected and normal ears. Various notch detection thresholds yielded sensitivities of 80% to 93%, specificities of 69% to 72%, negative predictive values of 84% to 93%, and a positive predictive value of 67%. CONCLUSION This study shows evidence that PR measurements together with the proposed notch-detecting algorithm can be used to quickly and effectively screen patients for third-window lesions such as SCD in the early stages of a diagnostic workup.
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Affiliation(s)
- Gabrielle R Merchant
- *Eaton-Peabody Laboratory, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.; ‡Speech and Hearing Bioscience and Technology Program, Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, U.S.A.; §Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.; ∥Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland; ¶Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center, Utrecht, the Netherlands; and #Department of Otorhinolaryngology - Head and Neck Surgery, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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High-speed video analysis of acoustically oscillated guinea pig stapes. The Journal of Laryngology & Otology 2015; 129 Suppl 2:S33-7. [DOI: 10.1017/s0022215114002357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:We investigated the ossicular movement in the near-intact middle ear in response to acoustic stimulation using a high-speed video camera and video analysis software program.Design:We have designed a good visual access to the middle ear of the guinea pig by opening the ventral wall of the otic capsule, without injuring the sound-conducting structures, from the external auditory canal to the oval window. The high-speed video camera could record analysable ossicular motion up to 4000 frames per second.Results:The stapes showed reciprocal movement in the same frequency as the stimulating tone, and with an amplitude proportional to the stimulating sound intensity. Injury to the tympanic membrane attenuated the stapedial motion, which was recovered to that of the control level by patch repair of the perforation.Conclusion:Our experimental set-up was capable of evaluating the conductive hearing, regardless of the status of the animal's sensorineural hearing or even life. Such a video analysis may provide a powerful tool to investigate the physiology of the middle ear.
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Zhang X, Guan X, Nakmali D, Palan V, Pineda M, Gan RZ. Experimental and modeling study of human tympanic membrane motion in the presence of middle ear liquid. J Assoc Res Otolaryngol 2014; 15:867-81. [PMID: 25106467 DOI: 10.1007/s10162-014-0482-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 07/18/2014] [Indexed: 10/24/2022] Open
Abstract
Vibration of the tympanic membrane (TM) has been measured at the umbo using laser Doppler vibrometry and analyzed with finite element (FE) models of the human ear. Recently, full-field TM surface motion has been reported using scanning laser Doppler vibrometry, holographic interferometry, and optical coherence tomography. Technologies for imaging human TM motion have the potential to lead to using a dedicated clinical diagnosis tool for identification of middle ear diseases. However, the effect of middle ear fluid (liquid) on TM surface motion is still not clear. In this study, a scanning laser Doppler vibrometer was used to measure the full-field surface motion of the TM from four human temporal bones. TM displacements were measured under normal and disease-mimicking conditions with different middle ear liquid levels over frequencies ranging from 0.2 to 8 kHz. An FE model of the human ear, including the ear canal, middle ear, and spiral cochlea was used to simulate the motion of the TM in normal and disease-mimicking conditions. The results from both experiments and FE model show that a simple deflection shape with one or two major displacement peak regions of the TM in normal ear was observed at low frequencies (1 kHz and below) while complicated ring-like pattern of the deflection shapes appeared at higher frequencies (4 kHz and above). The liquid in middle ear mainly affected TM deflection shapes at the frequencies higher than 1 kHz.
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Affiliation(s)
- Xiangming Zhang
- School of Aerospace and Mechanical Engineering and Bioengineering Center, University of Oklahoma, 865 Asp Avenue, Room 200, Norman, OK, 73019, USA,
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Normative data of incus and stapes displacement during middle ear surgery using laser Doppler vibrometry. Otol Neurotol 2014; 34:1719-24. [PMID: 23928515 DOI: 10.1097/mao.0b013e3182976528] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To report normative data for incus and stapes motion using laser Doppler vibrometry (LDV) during middle ear surgery and to discuss possible limitations of the procedure. STUDY DESIGN Institutional review board-approved, retrospective study of data from patients undergoing the Envoy Esteem implantable device at 3 institutions. SETTING Quaternary referral health system. PATIENTS ELIGIBILITY CRITERIA patients sucsessfully implanted with an Esteem device. METHODS Data from 70 patients undergoing the Envoy Esteem procedure were reviewed. Sound at 100 dB and 50 frequencies ranging from 125 to 8,000 Hz were used during the procedure. LDV was performed to measure the displacment of the body of the incus and the posterior crus of the stapes to assess whether there was sufficient ossicular mobility to allow for implantation. RESULTS The average displacement of the ossicles for all 70 patients was collected and analyzed. The trend was an average displacement around 100 nm from 125 to 500 Hz for both the incus and stapes with a linear decline starting at 1,000 Hz for the incus and 500 Hz for the stapes, with slightly greater displacement of the stapes at higher frequencies. CONCLUSION This is the first article to report in vivo measures of ossicular mobility. These data help to understand the micromechanics of ossicular motion as well as the use and limitations of LDV. This information may lead to a prescreening process for implanted middle ear devices that function by overdriving the stapes.
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Burkhardt A, Kirsten L, Bornitz M, Zahnert T, Koch E. Investigation of the human tympanic membrane oscillation ex vivo by Doppler optical coherence tomography. JOURNAL OF BIOPHOTONICS 2014; 7:434-41. [PMID: 23225692 DOI: 10.1002/jbio.201200186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/23/2012] [Accepted: 11/20/2012] [Indexed: 05/03/2023]
Abstract
Investigations of the tympanic membrane (TM) can have an important impact on understanding the sound conduction in the ear and can therefore support the diagnosis and treatment of diseases in the middle ear. High-speed Doppler optical coherence tomography (OCT) has the potential to describe the oscillatory behaviour of the TM surface in a phase-sensitive manner and additionally allows acquiring a three-dimensional image of the underlying structure. With repeated sound stimuli from 0.4 kHz to 6.4 kHz, the whole TM can be set in vibration and the spatially resolved frequency response functions (FRFs) of the tympanic membrane can be recorded. Typical points, such as the umbo or the manubrium of malleus, can be studied separately as well as the TM surface with all stationary and wave-like vibrations. Thus, the OCT methodology can be a promising technique to distinguish between normal and pathological TMs and support the differentiation between ossicular and membrane diseases.
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Affiliation(s)
- Anke Burkhardt
- Dresden University of Technology, Faculty of Medicine Carl Gustav Carus, Department Clinical Sensoring and Monitoring, Fetscherstraße 74, 01307 Dresden, Germany.
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Sequential Multipoint Motion of the Tympanic Membrane Measured by Laser Doppler Vibrometry. Otol Neurotol 2014; 35:719-24. [DOI: 10.1097/mao.0000000000000242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Peacock J, Dirckx J, von Unge M. Magnetically driven middle ear ossicles with laser vibrometry as a new diagnostic tool to quantify ossicular fixation. Acta Otolaryngol 2014; 134:352-7. [PMID: 24628334 DOI: 10.3109/00016489.2013.841990] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
CONCLUSION Information on the degree of incus fixation can be gathered by measuring the ratio of incus to umbo long process velocity through the ear canal. OBJECTIVES To test a new method of quantifying partial ossicular fixation in an ear with an elevated tympanic membrane. METHODS Measurements were made on four fresh-frozen human temporal bones. After elevating the tympanic membrane a small magnet was attached to the manubrium and an electromagnetic excitation coil was used to vibrate the ossicles. The vibration response of the tip of the incus long process and the umbo were measured before and after artificially fixating the incus to the lateral attic wall. RESULTS Partial incus fixation resulted in a decrease in both the incus and umbo velocities, with the incus velocity being more severely reduced. The decreased ratio of their vibrations is a clear indicator of the degree of incus fixation.
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Affiliation(s)
- John Peacock
- Laboratory of Biomedical Physics, University of Antwerp , Belgium
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