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Sanders-Mello F, Jonkman RE, Atay J, Atay J, Rozema FR, Koolstra JH. Symmetry of the external acoustic meatus: A potential alternative reference plane for three-dimensional imaging in dentistry. Heliyon 2024; 10:e30460. [PMID: 38756604 PMCID: PMC11096971 DOI: 10.1016/j.heliyon.2024.e30460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024] Open
Abstract
Objective In this study, we thoroughly analyzed how balanced the left and right sides of the external acoustic meatus are. Despite previous research focusing on the consistency of various anatomical features and the shape of the external acoustic meatus, which are important for creating guidelines to assess changes in the skull, there hasn't been enough attention given to how symmetrical it is. Our aim was to fill this gap by providing a comprehensive examination of its bilateral symmetry, which is crucial for accurate evaluations in dentistry and medicine. Study design After importing 26 cone-beam computed tomography scans of patients into the ITK-SNAP 3D imaging software, a midsagittal plane was set up as the plane of symmetry for each patient. With this plane, we compared the positions of the most superior and inferior left and right points of the external acoustic meatus. We also compared the lengths and depths of the lines connecting the two points. Results There were no statistically significant differences in the position, length, or depth of the external acoustic meatus between the right and left halves of the skull. Conclusion Specific points on the skull, such as the highest (most superior MSP) and lowest (most inferior MIP) points, demonstrated a high degree of symmetry in the left and right halves. They demonstrated sufficient symmetry to establish a reliable reference plane. Along with the trajectory connecting them, these points can serve as viable alternatives to the Porion for three-dimensional imaging.
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Affiliation(s)
| | | | - Josef Atay
- Academic Center for Dentistry Amsterdam (ACTA), the Netherlands
| | - Jasmine Atay
- Academic Center for Dentistry Amsterdam (ACTA), the Netherlands
| | - Frederik R. Rozema
- Academic Center for Dentistry Amsterdam (ACTA), The Netherlands Department of Oral Medicine, University of Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, the Netherlands
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Shim JH, Sunwoo W, Choi BY, Kim KG, Kim YJ. Improving the Accuracy of Otitis Media with Effusion Diagnosis in Pediatric Patients Using Deep Learning. Bioengineering (Basel) 2023; 10:1337. [PMID: 38002461 PMCID: PMC10669592 DOI: 10.3390/bioengineering10111337] [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: 10/26/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Otitis media with effusion (OME), primarily seen in children aged 2 years and younger, is characterized by the presence of fluid in the middle ear, often resulting in hearing loss and aural fullness. While deep learning networks have been explored to aid OME diagnosis, prior work did not often specify if pediatric images were used for training, causing uncertainties about their clinical relevance, especially due to important distinctions between the tympanic membranes of small children and adults. We trained cross-validated ResNet50, DenseNet201, InceptionV3, and InceptionResNetV2 models on 1150 pediatric tympanic membrane images from otoendoscopes to classify OME. When assessed using a separate dataset of 100 pediatric tympanic membrane images, the models achieved mean accuracies of 92.9% (ResNet50), 97.2% (DenseNet201), 96.0% (InceptionV3), and 94.8% (InceptionResNetV2), compared to the seven otolaryngologists that achieved accuracies between 84.0% and 69.0%. The results showed that even the worst-performing model trained on fold 3 of InceptionResNetV2 with an accuracy of 88.0% exceeded the accuracy of the highest-performing otolaryngologist at 84.0%. Our findings suggest that these specifically trained deep learning models can potentially enhance the clinical diagnosis of OME using pediatric otoendoscopic tympanic membrane images.
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Affiliation(s)
- Jae-Hyuk Shim
- Department of Biomedical Engineering, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Woongsang Sunwoo
- Department of Otorhinolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Kwang Gi Kim
- Department of Biomedical Engineering, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Young Jae Kim
- Department of Biomedical Engineering, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Republic of Korea
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El-Anwar MW, Fouad YA, Elgohary AF, Saber S, Mobasher MA. External Auditory Canal: Computed Tomography Analysis and Classification. Int Arch Otorhinolaryngol 2023; 27:e565-e570. [PMID: 37876695 PMCID: PMC10593536 DOI: 10.1055/s-0042-1758213] [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: 05/31/2022] [Accepted: 06/30/2022] [Indexed: 10/26/2023] Open
Abstract
Introduction Computed tomography (CT) details of the external auditory canal (EAC) are not fully covered in the literature, so building up base for the CT evaluation and description is important. Preoperative details of the EAC are mandatory before any approach or procedure involving the canal. Objective To determine the different dimensions, measurements, and grading of the EAC by CT scan that were not previously published. Methods The CT scans of 100 temporal bones (200 sides) were included. Axial images were acquired with multiplanar reformates to obtain delicate details in coronal and sagittal planes for all subjects. Results At the EAC entry, the mean vertical length (height) was 7.75 ± 1 mm, and its mean horizontal length (width) was 6.1 ± 0.8. At the bony cartilaginous junction of the EAC, the mean vertical length was 7.88 ± 1 mm, and its mean horizontal length was 6.22 ± 0.9. At the EAC isthmus, the mean vertical length was 6.8 ± 0.97 mm, and its mean horizontal length was 5.2 ± 0.76. At the medial end of the EAC, the mean vertical length was 7.1 ± 0.9 mm, and its mean horizontal length was 5.4 ± 0.85. There were no reported significant differences between right and left sides in all dimensions. Males showed significantly longer vertical and horizontal dimensions of the EAC entry, vertical dimension of the isthmus, and vertical dimension of the medial end of the EAC than females. Conclusion This study improves otologists and radiologists' awareness of EAC variations in the ear field and can be of help to residents in training.
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Affiliation(s)
- Mohammad Waheed El-Anwar
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yasser Ahmed Fouad
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Fouad Elgohary
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sameh Saber
- Department of Radiodiagnosis, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Adel Mobasher
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Martinez JC, Hwee GZ, Yap L, De Chua KW, Kamath S, Chung CKR, Teo WYB, Tan CKL, Dritsas S, Simpson RE. Lexicon for classifying ear-canal shapes. Sci Rep 2023; 13:11866. [PMID: 37481591 PMCID: PMC10363131 DOI: 10.1038/s41598-023-38570-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023] Open
Abstract
The ear canal is usually described as an S-shaped funnel. In attempting to classify ear-canal shapes obtained from point clouds digitized from molds of 300 ears, the problem of designing criteria for distinguishing and organizing the canal shapes arose. In this work, we extracted features inspired by the S-shape characteristic (critical point, maximum, minimum, twist, writhe, translation, rotation) and, through them, introduced 14 types of ear-canal shapes. This classification allowed comparison of ears within a type and of ears between different types. It expanded our range of descriptors of canal shapes and unlocked perspectives for applications.
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Affiliation(s)
- J C Martinez
- Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore.
| | - Goh Zhi Hwee
- Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore
| | - Luis Yap
- University of Sydney, Sydney, NSW, 2006, Australia
| | - Kenneth Wei De Chua
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Savitha Kamath
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Conrad Kang Rui Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Wendy Yu Bing Teo
- Department of Otorhinolaryngology-Head and Neck Surgery, Changi General Hospital, Singapore, Singapore
| | - Charmaine Kai Ling Tan
- Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore
| | - Stylianos Dritsas
- Singapore University of Technology and Design (SUTD), 8 Somapah Road, Singapore, 487372, Singapore
| | - Robert E Simpson
- School of Engineering, University of Birmingham, Birmingham, B15 2TT, UK
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Singh P, Mittal MK, Mathur NN, Sinha M, Panesar S, Khatri G, Thukral BB. Morphometric Analysis of the External Auditory Canal by Computed Tomography in Indian Population. Indian J Otolaryngol Head Neck Surg 2019; 71:1115-1122. [PMID: 31750135 DOI: 10.1007/s12070-017-1200-8] [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] [Received: 12/14/2015] [Accepted: 09/04/2017] [Indexed: 10/18/2022] Open
Abstract
Various studies have shown variations in size and shape of different anthropometric measurements of external auditory canal. We conducted an anthropometric study of the three-dimensional anatomy of the osseous external auditory canal (OEAC) using high-resolution computed tomography the temporal bone to identify the variations in subset of Indian population from North India. A retrospective review of high-resolution computed tomography images of the temporal bones of 125 patients (250 external auditory canals) of different ages (mean 28.43 years) acquired from September 2014 to February of 2015 was performed. Using a method, as proposed by Mahboubio et al. (Otol Neurotol 33:715-720, 2012), six defined dimensions of the OEAC in the parasagittal planes were recorded at the level of annulus, midcanal and the outermost point of osseous external auditory canal at bony-cartilaginous junction. The length and shape of the OEAC were also studied and the frequency rate of each was recorded. The most prevalent shape of the OEAC was found to be conical (64%) and the mean osseous external auditory canal length was 9.61 mm. The length of the OEAC was significantly different between ages above and below 12 years while the 6 defined cross sectional dimensions were statistically significant between ages above and below 8 years. The history of chronic suppurative otitis media had a significant bearing on the inferior mid-anteroposterior dimension at the level of bony-cartilaginous junction. There was statistically significant difference in supero-inferior diameter in the posterior half at the level of mid-canal and outer bony-cartilaginous junction between males and females. The comprehensive set of standardized measurements collected in this study provides three-dimensional information on osseous external auditory canal geometry. These measurements and the methodology will contribute to the development of element models of the osseous canal for computational modeling purposes and also provide important measurements for design of in-the-canal hearing aids, specialized earplugs and for defining average sizes for canalplasty procedures, in pre- and postoperative surgical planning and assessment of canal atresia and stenosis in Indian population. No such previous study has been done in North Indian population.
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Affiliation(s)
- Pragya Singh
- 1Department of Radiodiagnosis and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Mahesh Kumar Mittal
- 1Department of Radiodiagnosis and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Neeraj Narayan Mathur
- 2Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Mukul Sinha
- 1Department of Radiodiagnosis and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Sanjeet Panesar
- 3Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Garvit Khatri
- 1Department of Radiodiagnosis and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
| | - Brij Bhushan Thukral
- 1Department of Radiodiagnosis and Imaging, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India
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Lee YF, Wei PY, Chu CH, Liao WH, Shiao AS, Wang MC. A Retrospective Study to Identify the Relationship Between the Dimension of Osseous External Auditory Canal and Chronic Otitis Media. EAR, NOSE & THROAT JOURNAL 2019; 99:532-536. [PMID: 31155942 DOI: 10.1177/0145561319840884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Whether the dimension of the osseous external auditory canal (OEAC) is related to chronic otitis media (COM) remains an important but unresolved issue. In the literature, routine canaloplasty has been suggested to help elucidate this problem. In this study, we intended to investigate the relationship between the diameter or shape of OEAC and COM. We retrospectively reviewed the high-resolution computed tomography (HRCT) images of the temporal bones of 62 patients with unilateral COM who underwent tympanoplasty from January 1, 2011, to December 31, 2013. For comparison, the HRCT images of another 62 patients with normal ears were collected to be the control group. The shape of OEAC was categorized into 5 groups according to Mahboubi's classification, and the dimension of each patient's OEAC was measured at 2 defined sections (annular section and isthmus/midcanal section). The most prevalent shape of OEAC for the lesion sides of the ears was cylindrical, followed by conical, and hourglass in both the COM and the control groups. As to the dimension of OEAC, there were no significant differences between lesion ears and normal ears among patients in the COM group as well as between lesion ears in the COM group and normal ears in the control group. We concluded that the bony dimension of the external ear canal was not related to COM. This suggested that chronic inflammation or infection of middle ear may not cause bony thickening of OEAC, despite the kind of OEAC shape involved.
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Affiliation(s)
- Yi-Fang Lee
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
| | - Pei-Yin Wei
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
| | - Chia-Huei Chu
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
| | - Wen-Huei Liao
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
| | - An-Suey Shiao
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
| | - Mao-Che Wang
- Department of Otolaryngology-Head and Neck Surgery, 46615Taipei Veterans General Hospital.,School of Medicine, National Yang-Ming University, Taipei
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Yin D, Li C, Chen K, Hong J, Li J, Yang L, Zhang T, Dai P. Morphological characteristics of external auditory canal in congenital aural stenosis patients. Am J Otolaryngol 2017; 38:422-427. [PMID: 28390808 DOI: 10.1016/j.amjoto.2017.03.015] [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] [Received: 01/06/2017] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
Abstract
Objective To investigate characteristics of congenital aural stenosis (CAS) patients' external auditory canal (EAC) (position, length, orientation, etc.) and compare them with normal EAC. METHODS CT images of normal people and CAS patient were utilized. We obtained coordinates of EAC landmarks. Then the Matlab program could calculate some anatomic parameters about EAC, including distances from central point of tympanic annulus (CA), central point of osseous EAC opening (CO), central point of cartilaginous EAC inside opening (CCi), central point of cartilaginous EAC outside opening (CCo) to the Frankfurt horizontal plane (Pfrkt), the median sagittal plane (Psag), the coronal plane (Pcor); orientations of EAC bendings; straight and arc lengths of EAC. RESULTS Distances from CA, CO, CCi and CCo to Pfrkt were all shorter in CAS group than control group (p<0.05). The straight and arc lengths of cartilaginous EAC in CAS group were shorter than control group (p<0.05). Straight and arc lengths of EAC in CAS group were shorter than those in control group (p<0.05). The proportion of one bending in cartilaginous EAC in control group was significantly lower than CAS group (p<0.05). Orientations of EAC bendings in CAS group differed from those in control group (p<0.05). CONCLUSION In addition to smaller diameters, compared with normal EAC, the position of CAS patients' osseous EAC was higher compared with the normal. The majority of CAS patients have a bending and downward slanting cartilaginous EAC. Orientations of EAC bending in CAS patients were different from normal. Besides, the length of CAS patients' cartilaginous EAC was shorter. However, there were no significant differences between CAS patients and normal people in length of osseous EAC. These differences in anatomic parameters could provide the basis for optimizing the meatoplasty.
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Djalilian HR, Mahboubi H, Haidar YM, Paulick P, Merlo MW, Bachman M. Development of a novel completely-in-the-canal direct-drive hearing device. Laryngoscope 2016; 127:932-938. [PMID: 27546727 DOI: 10.1002/lary.26221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 07/05/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To develop a novel completely-in-the-canal device capable of directly driving the tympanic membrane (TM) and ossicular chain from the ear canal. STUDY DESIGN Development and feasibility study. METHODS A voice coil actuator design was developed to drive the TM. Bench testing of the device using laser Doppler vibrometry (LDV) and sound recording was performed. Temporal bone studies using LDV were performed using different designs of the contact tip-TM interface to find the most efficient method of sound transmission. Two short-term clinical performance studies were performed using the latest 3-mm-wide device. Comparison was made to natural sound and to the Vibrant SoundBridge floating mass transducer simulator. RESULTS On bench testing, the device was found to have a low (<0.5%) total harmonic distortion in all frequencies above 400 Hz. Temporal bone studies revealed the device was capable of producing vibrations equivalent to 104 to 120 dB sound across most frequencies. The most efficient method of stimulation was when the device was coupled to the malleus. Short-term clinical performance studies indicated that pure tones and complex sound can be presented with the device. The sound quality of the experimental device was rated as better than the SoundBridge simulator device. CONCLUSIONS The direct-drive hearing device is capable of producing a wide range of sound frequencies and amplitudes. The device can transmit complex sound with low power requirements. Further work on the development of the device is needed for long-term and wider clinical use. LEVEL OF EVIDENCE NA Laryngoscope, 127:932-938, 2017.
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Affiliation(s)
- Hamid R Djalilian
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.,Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A
| | - Hossein Mahboubi
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A
| | - Yarah M Haidar
- Division of Neurotology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A
| | - Peyton Paulick
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A
| | - Mark W Merlo
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A
| | - Mark Bachman
- Department of Computer Science and Electrical Engineering, University of California, Irvine, Irvine, California, U.S.A
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van Spronsen E, Geerse S, Mirck PGB, van der Baan S, Fokkens WJ, Ebbens FA. The shape of the osseous external auditory canal and its relationship to chronic external otitis. Otol Neurotol 2015; 35:1790-6. [PMID: 24853245 DOI: 10.1097/mao.0000000000000430] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In literature and based on clinical observations, the shape of the osseous external auditory canal (OEAC) has often been suggested to be an etiologic factor in chronic otitis externa (COE). However, to date, no evidence has been presented to confirm this correlation. The aim of this study was to see whether evidence of such a correlation exists, and if so, what shape of the OEAC is related to COE. METHODS Using CT scans of 2 groups of patients (with and without COE), a novel and easy to use method was introduced to measure 2 dimensions of the OEAC: the pretympanic recess (the depth (DPTR) and anterior curvature (ACPTR)). In addition, a descriptive classification of the entire OAEC was introduced. RESULTS The proposed method was demonstrated to be useful as excellent interobserver agreements were found (r = 0.89). No significant differences in the descriptive classifications of the OEAC were observed between COE and the non-COE patients. The DPTR was significantly deeper in COE patients. For the ACPTR, no significant differences were observed. CONCLUSION Based on a new method of determining the DPTR, we demonstrate that the DPTR is significantly deeper in COE patients and that the shape of the OEAC is thus of importance in the pathogenesis of COE.
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Affiliation(s)
- Erik van Spronsen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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Paulick PE, Merlo MW, Mahboubi H, Djalilian HR, Bachman M. A micro-drive hearing aid: a novel non-invasive hearing prosthesis actuator. Biomed Microdevices 2015; 16:915-25. [PMID: 25129112 DOI: 10.1007/s10544-014-9896-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The direct hearing device (DHD) is a new auditory prosthesis that combines conventional hearing aid and middle ear implant technologies into a single device. The DHD is located deep in the ear canal and recreates sounds with mechanical movements of the tympanic membrane. A critical component of the DHD is the microactuator, which must be capable of moving the tympanic membrane at frequencies and magnitudes appropriate for normal hearing, with little distortion. The DHD actuator reported here utilized a voice coil actuator design and was 3.7 mm in diameter. The device has a smoothly varying frequency response and produces a precisely controllable force. The total harmonic distortion between 425 Hz and 10 kHz is below 0.5 % and acoustic noise generation is minimal. The device was tested as a tympanic membrane driver on cadaveric temporal bones where the device was coupled to the umbo of the tympanic membrane. The DHD successfully recreated ossicular chain movements across the frequencies of human hearing while demonstrating controllable magnitude. Moreover, the micro-actuator was validated in a short-term human clinical performance study where sound matching and complex audio waveforms were evaluated by a healthy subject.
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Jacob R, Gupta S, Isaacson B, Kutz JW, Roland P, Xi Y, Booth TN. High-resolution CT findings in children with a normal pinna or grade I microtia and unilateral mild stenosis of the external auditory canal. AJNR Am J Neuroradiol 2014; 36:176-80. [PMID: 25125664 DOI: 10.3174/ajnr.a4067] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY A subset of patients presents with unilateral conductive hearing loss, a normal pinna or grade I microtia, and mild external auditory canal stenosis. The physical findings of microtia and a small external canal are commonly absent or subtle in this group of patients, who are being commonly referred for imaging to evaluate isolated conductive hearing loss. We present a case series of patients with unilateral conductive hearing loss and characteristic ossicular abnormalities, commonly anterior fixation of the malleus. All patients had a significantly increased distance from the cochlear promontory to the handle of the malleus and an abnormal incudostapedial angle, indicative of an abnormal ossicular position and/or morphology. Successful surgical reconstruction of the ossicular chain was attempted and accomplished in 3 patients.
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Affiliation(s)
- R Jacob
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
| | - S Gupta
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - B Isaacson
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - J W Kutz
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - P Roland
- Otolaryngology (S.G., B.I., J.W.K., P.R.), Children's Medical Center of Dallas, University of Texas, Southwestern Medical Center, Dallas, Texas
| | - Y Xi
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
| | - T N Booth
- From the Departments of Radiology (R.J., Y.X., T.N.B.)
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Abstract
Traditionally, otologists have aimed to produce a clean, dry, safe ear with the best possible hearing result. More recently, “less invasively” has been added to this list of goals. The development of small-diameter, high-quality rigid endoscopes and high-definition video systems has made totally endoscopic, transcanal surgery a reality in adult otology and a possibility in pediatric otology. This article reviews the anatomy of the pediatric middle ear and its surrounding airspaces and structures based on the work of dozens of researchers over the past 50 years. It will focus on the developmental changes in ear anatomy from birth through the first decade, when structure and function change most rapidly. Understanding the limits and possibilities afforded by new endoscopic technologies, the pediatric otologist can strive for results matching or exceeding those achieved by more invasive surgical approaches.
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Affiliation(s)
- Glenn Isaacson
- Departments of Otolaryngology–Head & Neck Surgery and Pediatrics, Temple University School of Medicine, Philadelphia, Pennsylvania, USA
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13
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Investigation of a novel completely-in-the-canal direct-drive hearing device: a temporal bone study. Otol Neurotol 2012. [PMID: 23202151 DOI: 10.1097/mao.0b013e318278522e] [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
HYPOTHESIS Whether a prototype direct-drive hearing device (DHD) is effective in driving the tympanic membrane (TM) in a temporal bone specimen to enable it to potentially treat moderate-to-severe hearing loss. BACKGROUND Patient satisfaction with air conduction hearing aids has been low because of sound distortion, occlusion effect, and feedback issues. Implantable hearing aids provide a higher quality sound but require surgery for placement. The DHD was designed to combine the ability of driving the ossicular chain with placement in the external auditory canal. METHODS DHD is a 3.5-mm wide device that could fit entirely into the bony ear canal and directly drive the TM rather than use a speaker. A cadaveric temporal bone was prepared. The device developed in our laboratory was coupled to the external surface of the TM and against the malleus. Frequency sweeps between 300 Hz to 12 kHz were performed in 2 different coupling methods at 104 and 120 dB, and the DHD was driven with various levels of current. Displacements of the posterior crus of the stapes were measured using a laser Doppler vibrometer. RESULTS The DHD showed a linear frequency response from 300 Hz to 12 kHz. Placement against the malleus showed higher amplitudes and lower power requirements than when the device was placed on the TM. CONCLUSION DHD is a small completely-in-the-canal device that mechanically drives the TM. This novel device has a frequency output wider than most air conduction devices. Findings of the current study demonstrated that the DHD had the potential of being incorporated into a hearing aid in the future.
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