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Müller C, Polk ML, Lorenz K, Bornitz M, Zahnert T, Neudert M. Real-time monitoring of middle ear prosthesis coupling. Hear Res 2023; 432:108737. [PMID: 37027992 DOI: 10.1016/j.heares.2023.108737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/25/2023] [Accepted: 03/04/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION In reconstructive middle ear surgery, acoustic quality has received a high level of attention in recent years. Careful intraoperative selection and positioning of passive middle ear prostheses during tympanoplasty with ossiculoplasty is essential to ensure satisfactory sound transmission and postoperative hearing outcome. The reconstruction quality of the ossicular chain (OC) can be evaluated intraoperatively using a surgical assistance system which is based on a real-time monitoring system (RTM system) that acquires the transmission (middle ear transfer function (METF)) with electromagnetic excitation of the OC. In this experimental study, the METF with electromagnetic excitation of the (reconstructed) OC was compared to usual acoustic excitation and the benefit of the RTM system was investigated for the implantation of partial (PORP) and total (TORP) prostheses. METHODS Laser Doppler vibrometry (LDV) was used to measure the middle ear transfer function (METF) in 18 human temporal bones (TB). The RTM system uses electromagnetic excitation of the OC with a magnet placed on the umbo. Comparatively, measurements with the usual acoustical excitation, using an earphone in the external auditory canal, were performed. The measurements began with the intact OC, followed by real-time monitoring guided OC reconstruction with PORP and TORP. In addition, during the simulation of an intraoperative setting, the influence of the influence of opening (tympanomeatal flap lifted and pushed anteriorly) and closing (tympanomeatal flap folded back) the tympanic membrane on the measurements with the RTM system was determined. RESULTS Electromagnetic and acoustic excitation of the intact and the reconstructed OC provided comparable METF. The application of the RTM system significantly improved the quality of the OC reconstruction. The METF increased by up to 10 dB over the entire frequency range during implantation of the PORP with positioning control by the RTM system. When using the TORP, the METF could be improved by up to 15 dB. The opening of the tympanomeatal flap did not affect the measurements with the RTM system at the reconstructed OC. CONCLUSION In this TB study, we demonstrated that the quality of OC reconstruction (improved METF as a benchmark for improved transmission) could be significantly increased by means of a RTM system. Intraoperative studies should now be conducted to investigate to which quantitative extent the intraoperative reconstruction quality can be improved and whether or not this improvement also manifests in an increased (long-term) hearing outcome. This will enable conclusions to be drawn about the contribution of the intraoperative reconstruction quality to the (long-term) hearing outcome in the context of the conglomerate of various factors influencing the postoperative hearing outcome.
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Affiliation(s)
- Christoph Müller
- University Hospital Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD).
| | - Marie-Luise Polk
- University Hospital Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD)
| | - Korinna Lorenz
- University Hospital Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD)
| | - Matthias Bornitz
- Medical Faculty of the Technische Universität Dresden, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD)
| | - Thomas Zahnert
- University Hospital Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD)
| | - Marcus Neudert
- University Hospital Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Ear Research Center Dresden (ERCD)
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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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Anand S, Stoppe T, Lucena M, Rademakers T, Neudert M, Danti S, Moroni L, Mota C. Mimicking the Human Tympanic Membrane: The Significance of Scaffold Geometry. Adv Healthc Mater 2021; 10:e2002082. [PMID: 33945239 DOI: 10.1002/adhm.202002082] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/27/2021] [Indexed: 12/25/2022]
Abstract
The human tympanic membrane (TM) captures sound waves from the environment and transforms them into mechanical motion. The successful transmission of these acoustic vibrations is attributed to the unique architecture of the TM. However, a limited knowledge is available on the contribution of its discrete anatomical features, which is important for fabricating functional TM replacements. This work synergizes theoretical and experimental approaches toward understanding the significance of geometry in tissue-engineered TM scaffolds. Three test designs along with a plain control are chosen to decouple some of the dominant structural elements, such as the radial and circumferential alignment of the collagen fibrils. In silico models suggest a geometrical dependency of their mechanical and acoustical responses, where the presence of radially aligned fibers is observed to have a more prominent effect compared to their circumferential counterparts. Following which, a hybrid fabrication strategy combining electrospinning and additive manufacturing has been optimized to manufacture biomimetic scaffolds within the dimensions of the native TM. The experimental characterizations conducted using macroindentation and laser Doppler vibrometry corroborate the computational findings. Finally, biological studies with human dermal fibroblasts and human mesenchymal stromal cells reveal a favorable influence of scaffold hierarchy on cellular alignment and subsequent collagen deposition.
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Affiliation(s)
- Shivesh Anand
- Department of Complex Tissue Regeneration MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Thomas Stoppe
- Ear Research Center Dresden Department of Otorhinolaryngology Head and Neck Surgery Carl Gustav Carus Faculty of Medicine Technische Universität Dresden Dresden 01307 Germany
| | - Mónica Lucena
- Department of Complex Tissue Regeneration MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Timo Rademakers
- Department of Complex Tissue Regeneration MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Marcus Neudert
- Ear Research Center Dresden Department of Otorhinolaryngology Head and Neck Surgery Carl Gustav Carus Faculty of Medicine Technische Universität Dresden Dresden 01307 Germany
| | - Serena Danti
- Department of Civil and Industrial Engineering University of Pisa Pisa 56122 Italy
| | - Lorenzo Moroni
- Department of Complex Tissue Regeneration MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
| | - Carlos Mota
- Department of Complex Tissue Regeneration MERLN Institute for Technology‐Inspired Regenerative Medicine Maastricht University Maastricht 6229 ER The Netherlands
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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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Abstract
OBJECTIVE After tympanoplasty, it is often challenging to differentiate between different causes of a remaining air bone gap (ABG). Optical coherence tomography (OCT) offers a new approach for combined morphologic and functional measurements of the tympanic membrane and adjacent parts of the middle ear. Thus, it provides valuable diagnostic information in patients with a reduced sound transfer after middle ear surgery. PATIENT AND INTERVENTION A patient with history of tympanoplasty and a persistent ABG was investigated with endoscopic OCT before revision surgery. MAIN OUTCOME MEASURES The oscillation behavior and the thickness of the reconstructed tympanic membrane was determined. The oscillation amplitudes of the inserted prosthesis were compared to a finite element model simulation and to the clinical findings and the audiometric data of the patient. RESULTS OCT measurements showed a reduced oscillation amplitude of the prosthesis while revealing an aerated middle ear and good coupling of the prosthesis. Transfer loss measured by OCT showed a similar progression as the ABG measured by pure-tone audiometry with a mean divergence of 4.45 dB. CONCLUSION Endoscopic OCT is a promising tool for the evaluation of tympanoplasty outcome. It supports established otologic diagnostics and can help differentiating between different causes of conductional hearing loss.
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Beleites T, Zahnert T, Polk ML, Kluge A, Neudert M, Kemper M. [From reconstruction to function : Hands-on training in tympanoplasty using real-time feedback]. HNO 2020; 69:556-561. [PMID: 32910259 PMCID: PMC8233266 DOI: 10.1007/s00106-020-00941-x] [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] [Accepted: 07/21/2020] [Indexed: 11/25/2022]
Abstract
Hintergrund In der Mittelohrchirurgie bedarf es ausgezeichneter feinmotorischer Fertigkeiten. Aufgrund des hohen Komplikationspotenzials im Mittelohr ist die Ausbildung dieser Fertigkeiten am Modell anzustreben. Fragestellung Wie gut ist die Ausbildungsmöglichkeit an geeigneten Modellen? Können die am Modell erlernten Fertigkeiten in die intraoperative Situation übertragen werden? Beeinflusst das Modell und die Ausbildung daran die zukünftige Ohrchirurgie? Material und Methode Vorliegende Publikationen und eigene Erfahrungen am Dresdener Tympanoplastikmodell (DTM) wurden analysiert und diskutiert. Ergebnisse Obwohl die Mittelohrchirurgie hohe Anforderungen an den Ausführenden stellt und am Sinnesorgan Ohr schwerwiegende Komplikationen drohen, gibt es bisher nur wenige Trainingsmöglichkeiten dafür. Das DTM ist ein validiertes Übungsmodell, das diese Lücke schließen kann. Durch eine Real-Time-Feedback-Variante des Modells kann auch das Verständnis für Rekonstruktionsqualität und intraoperative akustische Noxen verbessert werden. Die Übertragung des Real-Time-Feedback-Gedankens in die reale Mittelohrchirurgie kann die Rekonstruktionsqualität zukünftig verbessern. Schlussfolgerungen Das Training an geeigneten Modellen ist speziell beim Erlernen der Mittelohrchirurgie anzustreben. Mit dem Real-Time-Feedback kann beim Lernen und Operieren eine weitere Sinneswahrnehmung in die eigene und fremde Qualitätskontrolle der Tympanoplastik sehr wirksam einbezogen werden.
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Affiliation(s)
- T Beleites
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - T Zahnert
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M-L Polk
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Kluge
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Neudert
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - M Kemper
- Klinik und Poliklinik für HNO, TU Dresden, Universitätsklinikum, Fetscherstr. 74, 01307, Dresden, Deutschland
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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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Evaluation of Coupling Efficiency in Round Window Vibroplasty With a New Handheld Probe. Otol Neurotol 2020; 40:e40-e47. [PMID: 30531640 DOI: 10.1097/mao.0000000000002058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HYPOTHESIS A handheld measuring probe was developed that analyzes the vibration characteristics of the stapes footplate after backward stimulation of the cochlea in round window vibroplasty. In temporal bone experiments, the measuring accuracy of the probe was tested. BACKGROUND In round window vibroplasty, the effectiveness of the transmitted vibrations into the inner ear is provided with limited visual and tactile information. Currently, there is no objective measuring tool available. METHODS In five unfixed temporal bones, a floating mass transducer was coupled to the round window membrane. During the excitation with different voltage levels (0, 5, 25, 100, 300 mV root mean square) corresponding to 0, 80, 94, 106, and 116 dB equivalent ear canal sound pressure respectively, the deflections of the footplate were recorded in parallel by laser Doppler vibrometry and the measuring probe. RESULTS The probe allowed for differentiation of the coupling efficiency. The measured footplate vibrations from the excitation levels of 106 dB (and 116 dB) were statistically significant compared with the testing without excitation. The footplate deflections determined in parallel by laser Doppler vibrometry showed comparable results. CONCLUSION In principal, the newly developed measuring probe allows for measuring the quality of retrograde cochlear excitation in a round window vibroplasty by detecting footplate vibrations. Further developments are directed for its application in clinical, intraoperative procedures.
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Feasibility Study of a Mechanical Real-Time Feedback System for Optimizing the Sound Transfer in the Reconstructed Middle Ear. Otol Neurotol 2019; 39:e907-e920. [PMID: 30444839 DOI: 10.1097/mao.0000000000002029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate electromechanical excitation as an alternative excitation mode for middle ear transfer function (METF) measurements as well as real-time feedback in prosthetic ossicular reconstruction. METHOD In eight human cadaveric temporal bones, the ossicular chain was excited using acoustic and mechanical (floating mass transducer, FMT) stimulation to determine the METF. After disconnecting the ossicular chain and reconstruction with partial or total prosthesis the METFs were measured again. Continuous FMT stimulation was then applied to improve the prosthesis' position using real-time feedback of the METF. RESULTS Mechanical stimulation of ossicular vibration showed characteristic differences to acoustic excitation resulting from the force characteristics of the FMT. Furthermore, the interspecimen METF variability was greater with electromechanical than acoustic stimulation because of interspecimen variability in the FMT coupling conditions. When the METF with FMT excitation was used as a real-time feedback tool, a measurable improvement in the quality of ossicular reconstruction could be achieved. CONCLUSIONS Mechanical excitation is an effective and suitable alternative stimulation method in experimental METF measurements. The system provides real-time feedback for ossicular reconstruction in the experimental setting. Some influencing factors still need to be distinguished for reliable measurements. However, the method does not yet meet the requirements for clinical application as an intraoperative, real-time monitoring tool. However, the system could be an excellent model for high-end cadaveric temporal bone training in ossiculoplasty.
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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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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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Neudert M, Zahnert T. Tympanoplasty - news and new perspectives. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2017; 16:Doc07. [PMID: 29279725 PMCID: PMC5738936 DOI: 10.3205/cto000146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Techniques and biomaterials for reconstructive middle ear surgery are continuously and steadily developing. At the same time, clinical post-surgery results are evaluated to determine success or failure of the therapy. Routine quality assessment and assurance is of growing importance in the medical field, and therefore also in middle ear surgery. The exact definition and acquisition of outcome parameters is essential for both a comprehensive and detailed quality assurance. These parameters are not the audiological results alone, but also additional individual parameters, which influence the postoperative outcome after tympanoplasty. Selection of patients and the preoperative clinical situation, the extent of the ossicular chain destruction, the chosen reconstruction technique and material, the audiometric frequency selection and the observational interval are only some of them. If these parameters are not well documented, the value of comparative analyses between different studies is very limited. The present overview aims at describing, comparing, and evaluating some of the existing assessment and scoring systems for middle ear surgery. Additionally, new methods for an intraoperative quality assessment in ossiculoplasty and the postoperative evaluation of suboptimal hearing results with imaging techniques are available. In the area of implant development, functional elements were integrated in prostheses to enable not only good sound transmission but also compensation of occurring atmospheric pressure changes. In combination with other components for ossicular repair, they can be used in a modular manner, which so far show experimentally and clinically promising results.
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Affiliation(s)
- Marcus Neudert
- Technical University of Dresden, Germany
- Medical Faculty “Carl Gustav Carus”, Dresden, Germany
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Dresden, Germany
| | - Thomas Zahnert
- Technical University of Dresden, Germany
- Medical Faculty “Carl Gustav Carus”, Dresden, Germany
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Dresden, Germany
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Niemczyk K, Morawski K, Delgado R, Bruzgielewicz A, Lachowska M. Objective assessment of hearing during second stage of tympanoplasty-surgical technique and measurement methodology presented in ten patients. Clin Otolaryngol 2017; 43:347-352. [PMID: 28756648 DOI: 10.1111/coa.12948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 11/26/2022]
Affiliation(s)
- K Niemczyk
- Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
| | - K Morawski
- Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
| | - R Delgado
- Intelligent Hearing Systems Inc., Miami, FL, USA.,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - A Bruzgielewicz
- Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
| | - M Lachowska
- Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
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