Effects of draining cochlear fluids on stapes displacement in human middle-ear models

Influence of inner ear impedance on middle ear sound transfer functions

Introduction

For experimental studies on sound transfer in the middle ear, it may be advantageous to perform the measurements without the inner ear. In this case, it is important to know the influence of inner ear impedance on the middle ear transfer function (METF). Previous studies provide contradictory results in this regard. With the current study, we investigate the influence of inner ear impedance in more detail and find possible reasons for deviations in the previous studies.

Methods

11 fresh frozen temporal bones were prepared in our study. The factors related to inner ear impedance, including round window membrane stiffness, cochleostomy, cochlea fluid and cochlea destruction were involved in the experimental design. After measuring in the intact specimen as a reference (step 1), the round window membrane was punctured (step 2), then completely removed (step 3). The cochleostomy was performed (step 4) before the cochlear fluid was carefully suctioned through scala tympani (step 5) and scala vestibuli (step 6). Finally, cochlea was destroyed by drilling (step 7). Translational and rotational movement of the stapes footplate were measured and calculated at each step. The results of the steps were compared to quantify the effect of inner ear impedance changing related to the process of cochlear drainage.

Results

As the inner ear impedance decreases from step 1 to 7, the amplitudes of the METF curves at each frequency gradually increase in general. From step 6 on, the measured METF are significantly different with respect to the intact group at high frequencies above 3 kHz. The differences are frequency dependent. However, the significant decrement of rotational motion appears at the frequencies above 4.5 kHz from the step 5.

Conclusion

This study confirms the influence of inner ear impedance on METF only at higher frequencies (≥3 kHz). The rotational motions are more sensitive to the drainage of fluid at the higher frequency. Study results that found no influence of cochlea impedance may be due to incomplete drainage of the cochlea.

Effect of Endolymphatic Hydrops on Sound Transmission in Live Guinea Pigs Measured with a Laser Doppler Vibrometer

Objective. This study aimed at describing the mechanism of hearing loss in low frequency and the different dynamic behavior of the umbo, the stapes head, and the round window membrane (RWM) between normal guinea pigs and those with endolymphatic hydrops (EH), using a laser Doppler vibrometer (LDV). Methods. Cochlear sections were stained with hematoxylin and eosin (HE) to evaluate the hydropic ratio (HR). Auditory brainstem responses (ABR) and whole-mount immunostaining were measured. Displacement of the umbo, stapes head, and RWM in response to ear-canal sound was evaluated using a LDV. Results. Mean HR values in EH model of all the turns are larger than the control group. The ABR threshold of the EH group was significantly higher than that of the control. Strong positive correlation was found between HR at apical turn and ABR threshold elevation at 1000 Hz and at subapical turn and ABR threshold elevation at 2000 Hz. FITC-phalloidin immunostaining of the cochlear basilar membrane in the apical, subapical, and suprabasal turns showed missing and derangement stereocilia of third-row outer hair cells. The umbo, stapes head, and RWM displacement in ears with EH was generally lower than that of normal ears. The EH-induced differences in stapes head and RWM motion were significant at 0.5 kHz. Conclusion. The LDV results suggested that the higher inner ear impedance in EH affected the dynamic behavior of the two opening windows of the cochlea and then reduced the vibration of the ossicular chain by increasing the afterload, resulting in acoustic dysfunction. The vibration reduction mainly occurred at low frequencies, which has related with the morphology changes of the apical and subapical turns in EH model.

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation

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.

A micropower miniature piezoelectric actuator for implantable middle ear hearing device

This paper describes the design and development of a small actuator using a miniature piezoelectric stack and a flextensional mechanical amplification structure for an implantable middle ear hearing device (IMEHD). A finite-element method was used in the actuator design. Actuator vibration displacement was measured using a laser vibrometer. Preliminary evaluation of the actuator for an IMEHD was conducted using a temporal bone model. Initial results from one temporal bone study indicated that the actuator was small enough to be implanted within the middle ear cavity, and sufficient stapes displacement can be generated for patients with mild to moderate hearing losses, especially at higher frequency range, by the actuator suspended onto the stapes. There was an insignificant mass-loading effect on normal sound transmission (<3 dB) when the actuator was attached to the stapes and switched off. Improved vibration performance is predicted by more firm attachment. The actuator power consumption and its generated equivalent sound pressure level are also discussed. In conclusion, the actuator has advantages of small size, lightweight, and micropower consumption for potential use as IMHEDs.

Effect of cochlear implant electrode insertion on middle-ear function as measured by intra-operative laser Doppler vibrometry

Hypothesis:

The aim of this study was to investigate the impact of cochlear implant electrode insertion on middle-ear low frequency function in humans.

Background:

Preservation of residual low frequency hearing with addition of electrical speech processing can improve the speech perception abilities and hearing in noise of cochlear implant users. Preservation of low frequency hearing requires an intact middle-ear conductive mechanism in addition to intact inner-ear mechanisms. Little is known about the effect of a cochlear implant electrode on middle-ear function.

Methods:

Stapes displacement was measured in seven patients undergoing cochlear implantation. Measurements were carried out intra-operatively before and after electrode insertion. Each patient acted as his or her own control. Sound was delivered into the external auditory canal via a speaker and calibrated via a probe microphone. The speaker and probe microphone were integrated into an individually custom-made ear mould. Ossicular displacement in response to a multisine stimulus at 80 dB SPL was measured at the incudostapedial joint via the posterior tympanotomy, using an operating microscope mounted laser Doppler vibrometry system.

Results:

Insertion of a cochlear implant electrode into the scala tympani had a variable effect on stapes displacement. In three patients, there was little change in stapes displacement following electrode insertion. In two patients, there was a significant increase, while in a further two there was a significant reduction in stapes displacement. This variability may reflect alteration of cochlear impedance, possibly due to differing loss of perilymph associated with the electrode insertion.

Conclusion:

Insertion of a cochlear implant electrode produces a change in stapes displacement at low frequencies, which may have an effect on residual low frequency hearing thresholds.

Human middle ear transfer function measured by double laser interferometry system

HYPOTHESIS

Simultaneous measurements of vibrations on the stapes footplate, incudostapedial (IS) joint, and tympanic membrane (TM) can be made in both normal and drained cochleae, and the stapes displacement transfer function (S-DTF) and TM displacement transfer function (TM-DTF) are derived.

BACKGROUND

A single laser Doppler interferometer previously has been used for measuring movement of the stapes or TM in temporal bones. However, there may be a limitation to optimally describing acoustic-mechanical transmission when the interferometer and temporal bone are moved frequently during experimental recordings. Simultaneous measurements of vibrations of the TM and stapes footplate, or TM and IS joint may reveal different acoustic-mechanical characteristics of the middle ear.

METHODS

Dual laser interferometers simultaneously measured vibrations of the TM, IS joint, and stapes in 10 temporal bones with both intact and drained cochleae. From these measurements, the middle ear transfer function was expressed as the S-DTF, TM-DTF, and displacement transmission ratio (DTR).

RESULTS

Simultaneous displacements of the TM, IS joint, and stapes footplate induced by sound pressure in the ear canal were recorded in both amplitude and phase. The middle ear transfer functions in terms of displacement ratio confirmed published single interferometer data but provided new information from drained cochlea.

CONCLUSION

Stapes and TM displacement transfer functions were determined using dual interferometry, provided accurate amplitude and phase relationships from stapes footplate, IS joint, and TM, with new data from drained and normal cochlea.

Three-dimensional stapes footplate motion in human temporal bones

The literature provides conflicting information on whether the motion of the stapes footplate is piston-like or some other type of motion, such as rotational or rocking. Examination of the three-dimensional (3D) motion of the stapes footplate appears to be an excellent way to understand this complicated motion. Five microsphere reflective targets were placed on the stapes footplate in ten fresh human cadaver temporal bone preparations, and their vibration measured through an extended facial recess approach using a laser Doppler vibrometer. The five target sites on the stapes footplate were center, anterior, posterior, superior and inferior. The stimulus was a sound input of 80-120 dB SPL at the tympanic membrane over a frequency range of 0.1 to 10 kHz. The 3D motion of the stapes footplate was calculated using the velocity amplitude and phase obtained for each target. For frequencies up to 1.0 kHz the vibration of the stapes footplate was primarily piston-like; this motion became complex at higher frequencies, with rotary motion along both the long and short axis of the footplate. When the cochlea was drained, stapes footplate motion became essentially piston-like for all frequencies.

Middle-ear transmission in humans: wide-band, not frequency-tuned?

Postmortem and in vivo vibration responses to sound of the stapes and the umbo of human ears are surveyed. The magnitudes of umbo velocity responses recorded postmortem decay between 1 and 5 or 10 kHz at rates between 0 and -3 dB/octave. In contrast, the magnitudes of in vivo umbo vibration are relatively invariant over a wide frequency range, amply exceeding the bandwidth of the audiogram according to one report. Similarly, most studies of postmortem stapes vibration report velocities tuned to about 1 kHz, with magnitudes that decay at a rate of about -6 dB/octave at higher frequencies. In contrast, in vivo stapes responses are apparently only mildly tuned. We conjecture that the bandwidth of stapes vibration velocity in humans will eventually be shown to exceed the bandwidth of the audiogram, in line with findings in other amniotic vertebrates.