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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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Ugarteburu M, Withnell RH, Cardoso L, Carriero A, Richter CP. Mammalian middle ear mechanics: A review. Front Bioeng Biotechnol 2022; 10:983510. [PMID: 36299283 PMCID: PMC9589510 DOI: 10.3389/fbioe.2022.983510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
The middle ear is part of the ear in all terrestrial vertebrates. It provides an interface between two media, air and fluid. How does it work? In mammals, the middle ear is traditionally described as increasing gain due to Helmholtz’s hydraulic analogy and the lever action of the malleus-incus complex: in effect, an impedance transformer. The conical shape of the eardrum and a frequency-dependent synovial joint function for the ossicles suggest a greater complexity of function than the traditional view. Here we review acoustico-mechanical measurements of middle ear function and the development of middle ear models based on these measurements. We observe that an impedance-matching mechanism (reducing reflection) rather than an impedance transformer (providing gain) best explains experimental findings. We conclude by considering some outstanding questions about middle ear function, recognizing that we are still learning how the middle ear works.
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Affiliation(s)
- Maialen Ugarteburu
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Robert H. Withnell
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, United States
| | - Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Alessandra Carriero
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
- *Correspondence: Alessandra Carriero, ; Claus-Peter Richter,
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Biomedical Engineering, Northwestern University, Chicago, IL, United States
- Department of Communication Sciences and Disorders, Northwestern University, Chicago, IL, United States
- The Hugh Knowles Center, Northwestern University, Chicago, IL, United States
- *Correspondence: Alessandra Carriero, ; Claus-Peter Richter,
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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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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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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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Santa Maria PL, Gottlieb P, Santa Maria C, Kim S, Puria S, Yang YP. Functional Outcomes of Heparin-Binding Epidermal Growth Factor-Like Growth Factor for Regeneration of Chronic Tympanic Membrane Perforations in Mice. Tissue Eng Part A 2017; 23:436-444. [PMID: 28142401 PMCID: PMC5444491 DOI: 10.1089/ten.tea.2016.0395] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/27/2017] [Indexed: 02/02/2023] Open
Abstract
We aim to demonstrate that regeneration of chronic tympanic perforations with heparin-binding epidermal growth factor-like growth factor (HB-EGF) delivered by an injectable hydrogel restored hearing to levels similar to that of nonperforated tympanic membranes. Chronic tympanic membrane perforation is currently managed as an outpatient surgery with tympanoplasty. Due to the costs of this procedure in the developed world and a lack of accessibility and resources in developing countries, there is a great need for a new treatment that does not require surgery. In this study, we show in a mouse model through measurement of auditory brainstem response and distortion product otoacoustic emissions that tympanic perforations lead to hearing loss and this can be predominantly recovered with HB-EGF treatment (5 μg/mL). Our animal model suggests a return to function between 2 and 6 months after treatment. Auditory brainstem response thresholds had returned to the control levels at 2 months, but the distortion product otoacoustic emissions returned between 2 and 6 months. We also show how the vibration characteristics of the regenerated tympanic membrane, as measured by laser Doppler vibrometry, can be similar to that of an unperforated tympanic membrane. Using the best available methods for preclinical evaluation in animal models, it is likely that HB-EGF-like growth factor treatment leads to regeneration of chronic tympanic membrane perforations and restoration of the tympanic membrane to normal function, suggesting a potential route for nonsurgical treatment.
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Affiliation(s)
- Peter Luke Santa Maria
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia, Subiaco, Australia
| | - Peter Gottlieb
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Chloe Santa Maria
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia, Subiaco, Australia
| | - Sungwoo Kim
- Department of Orthopedic Surgery, Stanford University, Stanford, California
| | - Sunil Puria
- Department of Otolaryngology, Head and Neck Surgery, Stanford University, Stanford, California
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Yunzhi Peter Yang
- Department of Orthopedic Surgery, Stanford University, Stanford, California
- Department of Materials Science and Engineering, Stanford University, Stanford, California
- Department of Bioengineering, Stanford University, Stanford, California
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