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Mattingly JK, Hartl RMB, Jenkins HA, Tollin DJ, Cass SP, Greene NT. A Comparison of Intracochlear Pressures During Ipsilateral and Contralateral Stimulation With a Bone Conduction Implant. Ear Hear 2021; 41:312-322. [PMID: 31389846 PMCID: PMC8043255 DOI: 10.1097/aud.0000000000000758] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To compare contralateral to ipsilateral stimulation with percutaneous and transcutaneous bone conduction implants. BACKGROUND Bone conduction implants (BCIs) effectively treat conductive and mixed hearing losses. In some cases, such as in single-sided deafness, the BCI is implanted contralateral to the remaining healthy ear in an attempt to restore some of the benefits provided by binaural hearing. While the benefit of contralateral stimulation has been shown in at least some patients, it is not clear what cues or mechanisms contribute to this function. Previous studies have investigated the motion of the ossicular chain, skull, and round window in response to bone vibration. Here, we extend those reports by reporting simultaneous measurements of cochlear promontory velocity and intracochlear pressures during bone conduction stimulation with two common BCI attachments, and directly compare ipsilateral to contralateral stimulation. METHODS Fresh-frozen whole human heads were prepared bilaterally with mastoidectomies. Intracochlear pressure (PIC) in the scala vestibuli (PSV) and tympani (PST) was measured with fiber optic pressure probes concurrently with cochlear promontory velocity (VProm) via laser Doppler vibrometry during stimulation provided with a closed-field loudspeaker or a BCI. Stimuli were pure tones between 120 and 10,240 Hz, and response magnitudes and phases for PIC and VProm were measured for air and bone conducted sound presentation. RESULTS Contralateral stimulation produced lower response magnitudes and longer delays than ipsilateral in all measures, particularly for high-frequency stimulation. Contralateral response magnitudes were lower than ipsilateral response magnitudes by up to 10 to 15 dB above ~2 kHz for a skin-penetrating abutment, which increased to 25 to 30 dB and extended to lower frequencies when applied with a transcutaneous (skin drive) attachment. CONCLUSIONS Transcranial attenuation and delay suggest that ipsilateral stimulation will be dominant for frequencies over ~1 kHz, and that complex phase interactions will occur during bilateral or bimodal stimulation. These effects indicate a mechanism by which bilateral users could gain some bilateral advantage.
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Affiliation(s)
- Jameson K. Mattingly
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
| | | | - Herman A. Jenkins
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
| | - Daniel J. Tollin
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
- Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO
| | - Stephen P. Cass
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
| | - Nathaniel T. Greene
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO
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Vogt K, Wasmann JW, Van Opstal AJ, Snik AFM, Agterberg MJH. Contribution of spectral pinna cues for sound localization in children with congenital unilateral conductive hearing loss after hearing rehabilitation. Hear Res 2019; 385:107847. [PMID: 31786443 DOI: 10.1016/j.heares.2019.107847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 11/01/2019] [Accepted: 11/12/2019] [Indexed: 12/27/2022]
Abstract
Congenital unilateral conductive hearing loss (UCHL) jeopardizes directional hearing and speech perception in noisy conditions. Potentially, children with congenital UCHL can benefit from fitting a hearing device, such as a bone-conduction device (BCD). However, the literature reports limited benefit from fitting a BCD, and often, surprisingly, relatively good sound localization in the unaided condition is reported. In this study, we hypothesized that the limited benefit with a BCD is related to (i) insufficient access to binaural cues and (ii) relying on monaural spectral pinna cues for sound localization in the horizontal plane. Directional hearing was tested in seventeen children with congenital UCHL (age 6-19) using a percutaneous BCD. Additionally, a mold was placed in the pinna of the normal-hearing ear to diminish direction-dependent spectral pinna cues. Relatively good localization in azimuth was found in the unaided hearing condition in the majority of the children. Sound localization improved when listening with a BCD, and no correlation between age of implantation and aided localization performance was found. When the mold was inserted, the unaided and aided localization abilities of most children deteriorated. Interestingly, in the children with poor localization performance in the unaided condition, sound localization improved significantly with the BCD, and was hardly affected by molding the pinna of the normal-hearing ear. These observations indicate that the majority of these children rely on spectral pinna cues to localize sounds, independent of listening with or without their device. In conclusion, an important reason for the limited benefit of BCD fitting in children with congenital UCHL might be ascribed to an effective coping strategy (use of spectral pinna cues) that still plays a dominant role after BCD fitting.
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Affiliation(s)
- Katharina Vogt
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
| | - Jan-Willem Wasmann
- Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre Nijmegen, the Netherlands
| | - A John Van Opstal
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
| | - Ad F M Snik
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands
| | - Martijn J H Agterberg
- Department of Biophysics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, the Netherlands; Department of Otorhinolaryngology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre Nijmegen, the Netherlands.
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Trevino M, Lobarinas E, Maulden AC, Heinz MG. The chinchilla animal model for hearing science and noise-induced hearing loss. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3710. [PMID: 31795699 PMCID: PMC6881193 DOI: 10.1121/1.5132950] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 05/07/2023]
Abstract
The chinchilla animal model for noise-induced hearing loss has an extensive history spanning more than 50 years. Many behavioral, anatomical, and physiological characteristics of the chinchilla make it a valuable animal model for hearing science. These include similarities with human hearing frequency and intensity sensitivity, the ability to be trained behaviorally with acoustic stimuli relevant to human hearing, a docile nature that allows many physiological measures to be made in an awake state, physiological robustness that allows for data to be collected from all levels of the auditory system, and the ability to model various types of conductive and sensorineural hearing losses that mimic pathologies observed in humans. Given these attributes, chinchillas have been used repeatedly to study anatomical, physiological, and behavioral effects of continuous and impulse noise exposures that produce either temporary or permanent threshold shifts. Based on the mechanistic insights from noise-exposure studies, chinchillas have also been used in pre-clinical drug studies for the prevention and rescue of noise-induced hearing loss. This review paper highlights the role of the chinchilla model in hearing science, its important contributions, and its advantages and limitations.
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Affiliation(s)
- Monica Trevino
- School of Behavioral and Brain Sciences, Callier Center, The University of Texas at Dallas, 1966 Inwood Road, Dallas, Texas 75235, USA
| | - Edward Lobarinas
- School of Behavioral and Brain Sciences, Callier Center, The University of Texas at Dallas, 1966 Inwood Road, Dallas, Texas 75235, USA
| | - Amanda C Maulden
- Department of Speech, Language, and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, Indiana 47907, USA
| | - Michael G Heinz
- Weldon School of Biomedical Engineering, Purdue University, 715 Clinic Drive, West Lafayette, Indiana 47907, USA
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Banakis Hartl RM, Greene NT, Benichoux V, Dondzillo A, Brown AD, Tollin DJ. Establishing an Animal Model of Single-Sided Deafness in Chinchilla lanigera. Otolaryngol Head Neck Surg 2019; 161:1004-1011. [PMID: 31570054 DOI: 10.1177/0194599819877649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES (1) To characterize changes in brainstem neural activity following unilateral deafening in an animal model. (2) To compare brainstem neural activity from unilaterally deafened animals with that of normal-hearing controls. STUDY DESIGN Prospective controlled animal study. SETTING Vivarium and animal research facilities. SUBJECTS AND METHODS The effect of single-sided deafness on brainstem activity was studied in Chinchilla lanigera. Animals were unilaterally deafened via gentamycin injection into the middle ear, which was verified by loss of auditory brainstem responses (ABRs). Animals underwent measurement of ABR and local field potential in the inferior colliculus. RESULTS Four animals underwent chemical deafening, with 2 normal-hearing animals as controls. ABRs confirmed unilateral loss of auditory function. Deafened animals demonstrated symmetric local field potential responses that were distinctly different than the contralaterally dominated responses of the inferior colliculus seen in normal-hearing animals. CONCLUSION We successfully developed a model for unilateral deafness to investigate effects of single-sided deafness on brainstem plasticity. This preliminary investigation serves as a foundation for more comprehensive studies that will include cochlear implantation and manipulation of binaural cues, as well as functional behavioral tests.
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Affiliation(s)
- Renee M Banakis Hartl
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Nathaniel T Greene
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - Anna Dondzillo
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Andrew D Brown
- Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Daniel J Tollin
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA.,Department of Physiology and Biophysics, School of Medicine, University of Colorado, Aurora, Colorado, USA
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Yang J, Wang Z, Huang M, Chai Y, Jia H, Wu Y, Dai Y, Li Y, Wu H. BoneBridge implantation in patients with single-sided deafness resulting from vestibular schwannoma resection: objective and subjective benefit evaluations. Acta Otolaryngol 2018; 138:877-885. [PMID: 30676881 DOI: 10.1080/00016489.2018.1469789] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The BoneBridge could rehabilitate hearing for patients with single-sided deafness (SSD). OBJECTIVES To evaluate the objective and subjective benefits of BoneBridge implantation in patients after vestibular Schwannoma resection and to explore the factors affecting the benefits. MATERIAL AND METHODS We prospectively enrolled all 15 patients implanted with BoneBridge after VS resection from January to June 2017. The primary outcome was the ability to hear in noisy conditions. The secondary outcomes were the soft-band BoneBridge try-on rate, the frequency of BB use, the sound source localization test result, and questionnaire measures of quality of life (QoL). RESULTS Patients showed better speech recognition ability in the presence of noise with the BoneBridge. The BoneBridge provided no help in sound localization, although most patients reported subjective sound localization benefits. The results of QoL questionnaires showed significant satisfaction with BoneBridge implantation. The unilateral hearing deprivation duration and high education levels had significant impacts on the subjective benefits of patients. CONCLUSIONS The BoneBridge could improve speech recognition performance in complex auditory backgrounds, as well as QoL, especially in patients with short unilateral hearing deprivation durations and high education levels. SIGNIFICANCE The BoneBridge is an effective hearing aid for single-sided deafness patients after VS removal.
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Affiliation(s)
- Jie Yang
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Zhaoyan Wang
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Meiping Huang
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yongchuan Chai
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Huan Jia
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yingwei Wu
- Department of Radiology, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yongming Dai
- United Imaging Healthcare, MR Collaboration, Shanghai, China
| | - Yun Li
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Hao Wu
- Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Otolaryngology Head and Neck Surgery, Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
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A Preliminary Investigation of the Air-Bone Gap: Changes in Intracochlear Sound Pressure With Air- and Bone-conducted Stimuli After Cochlear Implantation. Otol Neurotol 2017; 37:1291-9. [PMID: 27579835 DOI: 10.1097/mao.0000000000001184] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion. BACKGROUND Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative ABG remains unexplained and could result in part from altered cochlear mechanics. Here, we sought to investigate changes to these mechanics via intracochlear pressure measurements before and after electrode implantation to quantify the contribution to postoperative ABG. METHODS Human cadaveric heads were implanted with titanium fixtures for bone conduction transducers. Velocities of stapes capitulum and cochlear promontory between the two windows were measured using single-axis laser Doppler vibrometry and fiber-optic sensors measured intracochlear pressures in scala vestibuli and tympani for air- and bone-conducted stimuli before and after cochlear implant electrode insertion through the round window. RESULTS Intracochlear pressures revealed only slightly reduced responses to air-conducted stimuli consistent with previous literature. No significant changes were noted to bone-conducted stimuli after implantation. Velocities of the stapes capitulum and the cochlear promontory to both stimuli were stable after electrode placement. CONCLUSION Presence of a cochlear implant electrode causes alterations in intracochlear sound pressure levels to air, but not bone, conducted stimuli and helps to explain changes in residual hearing noted clinically. These results suggest the possibility of a cochlear conductive component to postoperative changes in hearing sensitivity.
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Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation. Otol Neurotol 2016; 36:1554-61. [PMID: 26333018 DOI: 10.1097/mao.0000000000000838] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS Cochlear implants (CIs) designed for hearing preservation will not alter mechanical properties of the middle and inner ears as measured by intracochlear pressure (P(IC)) and stapes velocity (Vstap). BACKGROUND CIs designed to provide combined electroacoustic stimulation are now available. To maintain functional acoustic hearing, it is important to know if a CI electrode can alter middle or inner ear mechanics because any alteration could contribute to elevated low-frequency thresholds in electroacoustic stimulation patients. METHODS Seven human cadaveric temporal bones were prepared, and pure-tone stimuli from 120 Hz to 10 kHz were presented at a range of intensities up to 110 dB sound pressure level. P(IC) in the scala vestibuli (P(SV)) and tympani (PST) were measured with fiber-optic pressure sensors concurrently with VStap using laser Doppler vibrometry. Five CI electrodes from two different manufacturers with varying dimensions were inserted via a round window approach at six different depths (16-25 mm). RESULTS The responses of P(IC) and VStap to acoustic stimulation were assessed as a function of stimulus frequency, normalized to sound pressure level in the external auditory canal, at baseline and electrode-inserted conditions. Responses measured with electrodes inserted were generally within approximately 5 dB of baseline, indicating little effect of CI electrode insertion on P(IC) and VStap. Overall, mean differences across conditions were small for all responses, and no substantial differences were consistently visible across electrode types. CONCLUSION Results suggest that the influence of a CI electrode on middle and inner ear mechanics is minimal despite variation in electrode lengths and configurations.
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Effects of Skin Thickness on Cochlear Input Signal Using Transcutaneous Bone Conduction Implants. Otol Neurotol 2016; 36:1403-11. [PMID: 26164446 DOI: 10.1097/mao.0000000000000814] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HYPOTHESIS Intracochlear sound pressures (PIC) and velocity measurements of the stapes, round window, and promontory (VStap/RW/Prom) will show frequency-dependent attenuation using magnet-based transcutaneous bone conduction implants (TCBCIs) in comparison with direct-connect skin-penetrating implants (DCBCIs). BACKGROUND TCBCIs have recently been introduced as alternatives to DCBCIs. Clinical studies have demonstrated elevated high-frequency thresholds for TCBCIs as compared with DCBCIs; however, little data exist examining the direct effect of skin thickness on the cochlear input signal using TCBCIs. METHODS Using seven cadaveric heads, PIC was measured in the scala vestibuli and tympani with fiber-optic pressure sensors concurrently with VStap/RW/Prom via laser Doppler vibrometry. Ipsilateral titanium implant fixtures were placed and connected to either a DCBCI or a TCBCI. Soft tissue flaps with varying thicknesses (no flap and 3, 6, and 9 mm) were placed successively between the magnetic plate and sound processor magnet. A bone conduction transducer coupled to custom software provided pure-tone stimuli between 120 and 10,240 Hz. RESULTS Stimulation via the DCBCI produced the largest response magnitudes. The TCBCI showed similar PSV/ST and VStap/RW/Prom with no intervening flap and a frequency-dependent nonlinear reduction of magnitude with increasing flap thickness. Phase shows a comparable dependence on transmission delay as the acoustic baseline, and the slope steepens at higher frequencies as flap thickness increases, suggesting a longer group delay. CONCLUSION Proper soft tissue management is critical to optimize the cochlear input signal. The skin thickness-related effects on cochlear response magnitudes should be taken into account when selecting patients for a TCBCI.
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