Facial Blood Flow Responses to Dynamic Exercise.

We reported previously that a static handgrip exercise evoked regional differences in the facial blood flow. The present study examined whether regional differences in facial blood flow are also evoked during dynamic exercise. Facial blood flow was measured by laser speckle flowgraphy during 15 min of cycling exercise at heart rates of 120 bpm, 140 bpm and 160 bpm in 12 subjects. The facial vascular conductance index was calculated from the blood flow and mean arterial pressure. The regional blood flow and conductance index values were determined in the forehead, eyelid, nose, cheek, ear and lip. One-way ANOVA and Tukey's post-hoc test were used to examine effects of exercise intensity and target regions. The blood flow and conductance index in skin areas increased significantly with the exercise intensity. The blood flow and conductance index in the lip increased significantly at 120 bpm and 140 bpm compared to the control, while the values in the lip at 160 bpm did not change from the control values. These results suggest that the blood flow in facial skin areas, not in the lip, responds similarly to dynamic exercise, in contrast to the responses to static exercise.

Ethyl Alcohol Versus Botulinum Toxin A: A Comparative Study of the Visual and Histopathological Outcomes in the Rabbit Anterior Auricular Muscle Model.

BACKGROUND: Botulinum toxin has long been known for its paralytic effects at the neuromuscular junction. Although it has been widely used for vascular and nervous tissues, there has been no study of the aesthetic effects of the application of ethanol to muscle tissues to date. OBJECTIVE: The authors aimed to demonstrate the effects of the application of ethanol to muscle tissues after an intramuscular injection and to compare the effects of botulinum toxin A (BTA) and ethanol. METHODS AND MATERIALS: A total of 28 rabbits were divided into 4 groups (n = 7 each). Botulinum toxin A (5 units) and different concentrations of ethanol (5 cc) were injected into the left and right anterior auricular muscles of all rabbits, respectively. Ear ptosis was assessed, and histopathological examination was performed after all rabbits were euthanized in the eighth week. RESULTS: Muscle function was affected earlier in ethanol-treated ears than in botulinum-treated ears; however, the ptotic effect lasted for a significantly shorter duration in ethanol-injected ears than in BTA-applied ears. CONCLUSION: Ethanol can block muscle function reversibly and can serve as an alternative to BTA, particularly when rapid results are desirable.

Genetic correlations between cartilage regeneration and degeneration reveal an inverse relationship.

OBJECTIVE: The etiology of osteoarthritis (OA) is unknown, however, there appears to be a significant contribution from genetics. We have identified recombinant inbred strains of mice derived from LG/J (large) and SM/J (small) strains that vary significantly in their ability to repair articular cartilage and susceptibility to post-traumatic OA due to their genetic composition. Here, we report cartilage repair phenotypes in the same strains of mice in which OA susceptibility was analyzed previously, and determine the genetic correlations between phenotypes. DESIGN: We used 12 recombinant inbred strains, including the parental strains, to test three phenotypes: ear-wound healing (n = 263), knee articular cartilage repair (n = 131), and post-traumatic OA (n = 53) induced by the surgical destabilization of the medial meniscus (DMM). Genetic correlations between various traits were calculated as Pearson's correlation coefficients of strain means. RESULTS: We found a significant positive correlation between ear-wound healing and articular cartilage regeneration (r = 0.71; P = 0.005). We observed a strong inverse correlation between articular cartilage regeneration and susceptibility to OA based on maximum (r = -0.54; P = 0.036) and summed Osteoarthritis Research Society International (OARSI) scores (r = -0.56; P = 0.028). Synovitis was not significantly correlated with articular cartilage regeneration but was significantly positively correlated with maximum (r = 0.63; P = 0.014) and summed (r = 0.70; P = 0.005) OARSI scores. Ectopic calcification was significantly positively correlated with articular cartilage regeneration (r = 0.59; P = 0.021). CONCLUSIONS: Using recombinant inbred strains, our study allows, for the first time, the measurement of genetic correlations of regeneration phenotypes with degeneration phenotypes, characteristic of OA (cartilage degeneration, synovitis). We demonstrate that OA is positively correlated with synovitis and inversely correlated with the ability to repair cartilage. These results suggest an addition to the risk paradigm for OA from a focus on degeneration to regeneration.

Longitudinal changes in dynamic characteristics of neonatal external and middle ears.

OBJECTIVES: Neonates have smaller and less mature ears than adults. Developmental changes in structure and function continually occur after birth and may affect the diagnostic results obtained by audiometric assessment instrumentation, such as tympanometry and otoacoustic emission. In the present study, we investigated longitudinal changes in external and middle ear dynamic characteristics by performing sweep frequency impedance (SFI) tests. METHODS: SFI tests were longitudinally performed on healthy Japanese neonates (1 female and 1 male) from birth to 3 and 5 months, respectively. A sound of sweeping sinusoidal frequency, ranging from 0.1 kHz to 2 kHz, was presented to the ear canal at 50-daPa intervals of static pressure from +200 to -200 daPa. Test results were expressed a curve showing the sound pressure level (SPL) relative to probe tone frequency, called SPL curve. RESULTS: The first fluctuation in resonance frequency (RF1) and SPL (ΔSPL1), related to the external ear, showed significant developmental changes as chronological age increased; that is, RF1 and ΔSPL1 were respectively increased and decreased and thereafter became unmeasurable by 5 months of age. In contrast, the second fluctuation in resonance frequency (RF2) and SPL (ΔSPL2), related to the middle ear, did not show significant changes over the measurement period. CONCLUSIONS: The present results suggest that the dynamic characteristics of the external ear canal wall changed with increases in chronological age; the resonance of the wall at about 0.3 kHz at birth tended to increase to about 0.7 kHz and to be unmeasurable by 5 months of age, while those of the middle ear did not significantly changed. These results showing how neonatal-ear dynamics changes with chronological age may be an important key in further hearing research and the development of hearing devices and diagnostic tools suitable for neonates.

The effects of low-and high-frequency non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) on gastric slow waves evaluated using in vivo high-resolution mapping in porcine.

BACKGROUNDS: Gastric motility is regulated by an electrophysiological activity called slow-wave and neuronal innervations by the vagus nerve. Transcutaneous auricular vagal nerve stimulation (taVNS) has been demonstrated to have therapeutic potential for a wide range of medical conditions, including the management of gastric dysfunctions. The main objective of this study was to gain a better understanding of how non-invasive neuromodulation influences gastric slow wave under in vivo conditions. METHODS: TaVNS protocols were applied in conjunction with 192-channel gastric bioelectrical mapping in porcine subjects under general anesthesia. The spatiotemporal profiles of gastric slow wave were assessed under two different taVNS protocols at 10 and 80 Hz. KEY RESULTS: The taVNS protocols effectively altered the interval and amplitude of gastric slow waves, but not the velocity or the percentage of spatial dysrhythmias. In the subjects that responded to the protocols, the 10 Hz protocol was shown to normalize slow-wave propagation pattern in 90% of the subjects, whereas the 80 Hz protocol was shown to inhibit slow waves in 60% of the subjects. CONCLUSIONS AND INFERENCES: Chronic responses of gastric motility and slow waves in response to taVNS should be investigated using non-invasive means in conscious subjects in future.

TREAT AF (Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Atrial Fibrillation): A Randomized Clinical Trial.

OBJECTIVES: This study was a sham-controlled, double-blind, randomized clinical trial to examine the effect of chronic low level tragus stimulation (LLTS) in patients with paroxysmal AF. BACKGROUND: Low-level transcutaneous electrical stimulation of the auricular branch of the vagus nerve at the tragus (LLTS) acutely suppresses atrial fibrillation (AF) in humans, but the chronic effect remains unknown. METHODS: LLTS (20 Hz, 1 mA below the discomfort threshold) was delivered using an ear clip attached to the tragus (active arm) (n = 26) or the ear lobe (sham control arm) (n = 27) for 1 h daily over 6 months. AF burden over 2-week periods was assessed by noninvasive continuous electrocardiogram monitoring at baseline, 3 months, and 6 months. Five-minute electrocardiography and serum were obtained at each visit to measure heart rate variability and inflammatory cytokines, respectively. RESULTS: Baseline characteristics were balanced between the 2 groups. Adherence to the stimulation protocol (≤4 sessions lost per month) was 75% in the active arm and 83% in the control arm (p > 0.05). At 6 months, the median AF burden was 85% lower in the active arm compared with the control arm (ratio of medians: 0.15; 95% confidence interval: 0.03 to 0.65; p = 0.011). Tumor necrosis factor-alpha was significantly decreased by 23% in the active group relative to the control group (ratio of medians: 0.77; 95% confidence interval: 0.63 to 0.94; p = 0.0093). Frequency domain indices of heart rate variability were significantly altered with active versus control stimulation (p < 0.01). No device-related side effects were observed. CONCLUSIONS: Chronic, intermittent LLTS resulted in lower AF burden than did sham control stimulation, supporting its use to treat paroxysmal AF in selected patients. (Transcutaneous Electrical Vagus Nerve Stimulation to Suppress Atrial Fibrillation [TREAT-AF]; NCT02548754).

Outcome measures of facial nerve regeneration: A review of murine model systems.

Animal models of nerve function have been subject to extensive study in order to understand and investigate methods which may improve axon regeneration and promote functional outcomes following nerve injury and repair. As the facial nerve is a cranial nerve, there is mounting evidence that cranial nerve regeneration differs from peripheral, and outcome models specifically addressing the facial nerve are required. Murine models are the most commonly utilized, with a variety of methods employed to measure the actions of whisking, eye closure, or ear movement as indicators of facial nerve regeneration. Each method of measurement is reviewed in terms of validity, strengths, limitations, and the specific outcome data provided. The authors propose that prior to choosing an outcome model, the goals and objectives of a planned study should be well defined, as various outcome measures may be useful depending on the information which is desired. The aim of this paper, therefore, is to provide the reader with a concise review which may facilitate project design.

The Auditory Mechanics of the Outer Ear of the Bush Cricket: A Numerical Approach.

Bush crickets have tympanal ears located in the forelegs. Their ears are elaborate, as they have outer-, middle-, and inner-ear components. The outer ear comprises an air-filled tube derived from the respiratory trachea, the acoustic trachea (AT), which transfers sound from the mesothoracic acoustic spiracle to the internal side of the ear drums in the legs. A key feature of the AT is its capacity to reduce the velocity of sound propagation and alter the acoustic driving forces of the tympanum (the ear drum), producing differences in sound pressure and time between the left and right sides, therefore aiding the directional hearing of the animal. It has been demonstrated experimentally that the tracheal sound transmission generates a gain of ∼15 dB and a propagation velocity of 255 ms-1, an approximately 25% reduction from free-field propagation. However, the mechanism responsible for this change in sound pressure level and velocity remains elusive. In this study, we investigate the mechanical processes behind the sound pressure gain in the AT by numerically modeling the tracheal acoustic behavior using the finite-element method and real three-dimensional geometries of the tracheae of the bush cricket Copiphora gorgonensis. Taking into account the thermoviscous acoustic-shell interaction on the propagation of sound, we analyze the effects of the horn-shaped domain, material properties of the tracheal wall, and the thermal processes on the change in sound pressure level in the AT. Through the numerical results obtained, it is discerned that the tracheal geometry is the main factor contributing to the observed pressure gain.

Limitations of present models of blast-induced sound power conduction through the external and middle ear.

The use of models to predict the effect of blast-like impulses on hearing function is an ongoing topic of investigation relevant to hearing protection and hearing-loss prevention in the modern military. The first steps in the hearing process are the collection of sound power from the environment and its conduction through the external and middle ear into the inner ear. Present efforts to quantify the conduction of high-intensity sound power through the auditory periphery depend heavily on modeling. This paper reviews and elaborates on several existing models of the conduction of high-level sound from the environment into the inner ear and discusses the shortcomings of these models. A case is made that any attempt to more accurately define the workings of the middle ear during high-level sound stimulation needs to be based on additional data, some of which has been recently gathered.

Dynamic relationship between noseleaf and pinnae in echolocating hipposiderid bats.

Old World leaf-nosed bats (family Hipposideridae) can deform the shapes of their 'noseleaves' (i.e. ultrasonic emission baffles) and outer ears during echolocation behaviors. Prior work has shown that deformations on the emission as well as on the reception side can have an impact on the properties of the emitted/received sonar signals. The occurrence of the deformations on the emission and reception sides raises the question of whether the bats coordinate these two dynamic biosonar features to achieve synergistic effects. To address this question, simultaneous three-dimensional reconstructions of the trajectories of landmarks on the dynamic noseleaf and pinna geometries have been obtained in great roundleaf bats (Hipposideros pratti). These joint kinematics data on the noseleaf and pinnae have shown both qualitative and quantitative relationships between the noseleaf and pinna motions: large noseleaf deformations (opening or closing) tended to be associated with non-rigid pinna motions. Furthermore, closing deformations of the noseleaves tended to co-occur with closing motions of the pinna. Finally, a canonical correlation analysis of the motion trajectories has revealed a tight correlation between the motions of the landmarks on the noseleaf and both pinnae. These results demonstrate that the biosonar system of hipposiderid bats includes coordinated emission and reception dynamics.

Fast-moving bat ears create informative Doppler shifts.

Many animals have evolved adept sensory systems that enable dexterous mobility in complex environments. Echolocating bats hunting in dense vegetation represent an extreme case of this, where all necessary information about the environment must pass through a parsimonious channel of pulsed, 1D echo signals. We have investigated whether certain bats (rhinolophids and hipposiderids) actively create Doppler shifts with their pinnae to encode additional sensory information. Our results show that the bats' active pinna motions are a source of Doppler shifts that have all attributes required for a functional relevance: (i) the Doppler shifts produced were several times larger than the reported perception threshold; (ii) the motions of the fastest moving pinna portions were oriented to maximize the Doppler shifts for echoes returning from the emission direction, indicating a possible evolutionary optimization; (iii) pinna motions coincided with echo reception; (iv) Doppler-shifted signals from the fast-moving pinna portion entered the ear canal of a biomimetic pinna model; and (v) the time-frequency Doppler shift signatures were found to encode target direction in an orderly fashion. These results indicate that instead of avoiding or suppressing all self-produced Doppler shifts, rhinolophid and hipposiderid bats actively create Doppler shifts with their own pinnae. These bats could hence make use of a previously unknown nonlinear mechanism for the encoding of sensory information, based on Doppler signatures. Such a mechanism could be a source for the discovery of sensing principles not only in sensory physiology but also in the engineering of sensory systems.

Adaptations to a semiaquatic lifestyle in the external ear of southern pinnipeds (Otariidae and Phocidae, Carnivora): Morphological evidences.

Pinnipeds are semiaquatic carnivorans that spend most of their lives in water and use coastal terrestrial, or ice pack, environments to breed, molt and rest. Certain characteristics of the ear have been linked to ecological aspects. In our contribution we focus on the study of the macroscopic and microscopic morphology of the external ear (with the exception of the osseous outer ear canal) of six species of Southern pinnipeds. In order to recognize the different components of tissues, sections were stained following several routine protocols. In addition, double-staining and enzymatic clearing (Alcian blue-alizarin red) was performed to assess the arrangement of skeletal elements in the OEC. The basic structure of the pinna in the southern otariids studied match those previously analyzed for Northern Hemisphere species. The cartilage macro anatomy of the OEC of Mirounga leonina and Arctocephallus gazella is different from that of the Northern Hemisphere species, with only one plate of cartilage, but markedly different between them. The histology of the otariids OEC is homogeneous along the entire extension, but phocids has three different regions (distal, middle, and proximal). The cartilage histology of most phocids is also different from that of analyzed otariids, with an elastic cartilage that resembles a myxoid-like tissue, but is not present in M. leonina, were the tissue around the OEC is very rich in adipocytes. The southern elephant seal M. leonina OEC has a combination of features similar to both the rest of the phocids and to the otariids. An auditory organ that is functional both over and under water could be essential for social behavior in these species.

Development of the interscutularis model as an outcome measure for facial nerve surgery.

INTRODUCTION: Animal models for the study of facial paralysis have been well developed, but concern has arisen regarding the accuracy of eye closure and whisker movement as outcome measures due to new data regarding interconnectivity between facial nerve branches and autonomic innervation. The posterior auricular nerve (PAN) is an isolated branch of the facial nerve which has been confirmed as the sole motor innervat or of the interscutularis muscle. This study was designed to develop a model for facial nerve palsy utilizing the PAN and interscutularis muscle. METHODS: A custom-made automated video capture system was built into a poly methyl methacrylate cage using a high definition monochrome digital camera and image sensor to record the animal as it drank from a water feeder. A copper floor pad and copper collar around the water feeder were connected to an electrical circuit for automatic saving of the video recording 10 s prior to and 30 s following the drinking event. A pre-operative baseline recording of ear movement during drinking was captured. Female YFP-16 mice at 6 weeks were assigned to sham (Sh, n = 5), nerve excision (Ex, n = 10), or nerve crush (Cr, n = 10) groups with all interventions performed on the right PAN. Sh mice were irrigated with 10 ml normal saline as were the Ex and Cr mice following operative intervention. In Ex mice, a 3 mm section of the PAN was sharply excised and nerve gap was confirmed with fluorescent microscopy. In Cr mice, the PAN was crushed 3 mm from the origin of the facial nerve trunk with size 5 jeweler's forceps for two periods of 20 s. Post-operative video recordings were collected on post-operative days (POD) 1, 10, 20, and 30. To determine the change in ear movement, the right ear was graphically compared to the left control side. RESULTS: Sh animals exhibited a statistically significant reduction in ear movement at POD01 compared to other POD recordings (p < 0.05), but no significant change in right ear movement following POD05. Ex animals had a significant reduction in right ear movement at all PODs in comparison to the left ear (p < 0.05) with no significant change in right ear movement during the study period (p = 0.94). Cr animals showed a significant reduction in right ear movement compared to the left at POD01, POD10, and POD20 (p < 0.05). At POD30, there was no significant difference between ear movement on either side (p = 0.35). There was a significant change in right ear movement during the data collection period (p < 0.05). CONCLUSION: The results show that significant differences were demonstrated between the experimental groups and that significant changes within the crush group were identifiable making this an acceptable model to develop as an accurate outcome measure following rodent facial nerve surgery.

Dry-Contact Electrode Ear-EEG.

OBJECTIVE: Ear-EEG is a recording method in which EEG signals are acquired from electrodes placed on an earpiece inserted into the ear. Thereby, ear-EEG provides a noninvasive and discreet way of recording EEG, and has the potential to be used for long-term brain monitoring in real-life environments. Whereas previously reported ear-EEG recordings have been performed with wet electrodes, the objective of this study was to develop and evaluate dry-contact electrode ear-EEG. METHODS: To achieve a well-functioning dry-contact interface, a new ear-EEG platform was developed. The platform comprised actively shielded and nanostructured electrodes embedded in an individualized soft-earpiece. The platform was evaluated in a study of 12 subjects and four EEG paradigms: auditory steady-state response, steady-state visual evoked potential, mismatch negativity, and alpha-band modulation. RESULTS: Recordings from the prototyped dry-contact ear-EEG platform were compared to conventional scalp EEG recordings. When all electrodes were referenced to a common scalp electrode (Cz), the performance was on par with scalp EEG measured close to the ear. With both the measuring electrode and the reference electrode located within the ear, statistically significant (p < 0.05) responses were measured for all paradigms, although for mismatch negativity, it was necessary to use a reference located in the opposite ear, to obtain a statistically significant response. CONCLUSION: The study demonstrated that dry-contact electrode ear-EEG is a feasible technology for EEG recording. SIGNIFICANCE: The prototyped dry-contact ear-EEG platform represents an important technological advancement of the method in terms of user-friendliness, because it eliminates the need for gel in the electrode-skin interface.

A Novel Understanding of Phocidae Hearing Adaptations Through a Study of Northern Elephant Seal (Mirounga angustirostris) Ear Anatomy and Histology.

The most conspicuous aural adaptation in northern elephant seals (NES) is complete absence of an auricle and a tortuous collapsed external acoustic meatus. The NES epitympanic recess contains massive ossicles immersed in the middle ear cavernous sinuses. Engorgement of the cavernous sinuses would make ossicles fully buoyant during deep diving. NES have a comparatively larger cochlear nerve, which carries a significantly larger number of axons than in terrestrial mammals, which would give them auditory ability similar to the obligate marine mammals such as cetaceans. Our calculations show that the traditional "air-dependent" impedance matching mechanism in NES functions to just half of the capacity compared with the one described in terrestrial mammals. Impedance matching would be further hindered in NES while diving due to fully collapsed external acoustic meatus. Thanks to similarities of acoustic impedance between the sea water, soft tissues, and blood sinuses, very little sound energy would be reflected and lost. When sound is generated underwater, the large ossicles, buoyant in the cavernous sinus, would not move due to oscillation of tympanic membrane. Rather, they would be oscillating due to their inertia and process of acoustic streaming. Our mathematical simulation shows that an increase in sound frequency would cause increased displacement of the stapedial footplate and thus transmit the sound energy to the inner ear. We contend that during diving, impedance matching and sound signal amplification in the middle ear courses through the cavernous sinuses and oscillates the enlarged ossicles, thus enabling a high-frequency ultrasonic hearing range in Phocidae. Anat Rec, 302:1605-1614, 2019. © 2018 American Association for Anatomy.

A design for a dynamic biomimetic sonarhead inspired by horseshoe bats.

The noseleaf and pinnae of horseshoe bats (Rhinolophus ferrumequinum) have both been shown to actively deform during biosonar operation. Since these baffle structures directly affect the properties of the animals biosonar system, this work mimics horseshoe bat sonar system with the goal of developing a platform to study the dynamic sensing principles horseshoe bats employ. Consequently, two robotic devices were developed to mimic the dynamic emission and reception characteristics of horseshoe bats. The noseleaf and pinnae shapes were modeled as smooth blanks matched to digital representations of a horseshoe bat specimens noseleaf and pinnae. Local shape features mimicking structures on the pinnae and noseleaf were added digitally. Flexible baffles with local shape feature combinations were manufactured and paired with actuation mechanisms to mimic pinnae and noseleaf deformations in vivo. Two noseleaves with and without local shape features were considered. Each noseleaf baffle was mounted to a platform called the dynamic emission head to actuate three surface elements of the baffle. Similarly, 12 pinna realizations composed of combinations of three local shape features were mounted to a platform called the dynamic reception head to deform the left and right pinnae independently. Motion of the noseleaf and pinnae were synchronized to the incoming and outgoing sonar waveform, and the joint time-frequency properties of the noseleaf and pinnae local feature combinations and pairs of pinnae and noseleaf thereof were characterized across spatial direction. Amplitude modulations to the outgoing and incoming sonar pulse information across spatial direction were observed for all pinnae and noseleaf local shape feature combinations. Peak modulation variance generated by motion of the pinnae and combinations of the noseleaf and pinnae approached a white Gaussian noise variance bound. It was found the dynamic emitter generated less modulation than either the combined or reception scenarios.

Ear-EEG detects ictal and interictal abnormalities in focal and generalized epilepsy - A comparison with scalp EEG monitoring.

OBJECTIVE: Ear-EEG is recording of electroencephalography from a small device in the ear. This is the first study to compare ictal and interictal abnormalities recorded with ear-EEG and simultaneous scalp-EEG in an epilepsy monitoring unit. METHODS: We recorded and compared simultaneous ear-EEG and scalp-EEG from 15 patients with suspected temporal lobe epilepsy. EEGs were compared visually by independent neurophysiologists. Correlation and time-frequency analysis was used to quantify the similarity between ear and scalp electrodes. Spike-averages were used to assess similarity of interictal spikes. RESULTS: There were no differences in sensitivity or specificity for seizure detection. Mean correlation coefficient between ear-EEG and nearest scalp electrode was above 0.6 with a statistically significant decreasing trend with increasing distance away from the ear. Ictal morphology and frequency dynamics can be observed from visual inspection and time-frequency analysis. Spike averages derived from ear-EEG electrodes yield a recognizable spike appearance. CONCLUSIONS: Our results suggest that ear-EEG can reliably detect electroencephalographic patterns associated with focal temporal lobe seizures. Interictal spike morphology from sufficiently large temporal spike sources can be sampled using ear-EEG. SIGNIFICANCE: Ear-EEG is likely to become an important tool in clinical epilepsy monitoring and diagnosis.

Sweep frequency impedance measures in young infants: developmental characteristics from birth to 6 months.

OBJECTIVE: International Journal of Audiology To study the developmental characteristics of sweep frequency impedance (SFI) measures in healthy infants from birth to 6 months. DESIGN: All infants were assessed using high-frequency tympanometry (HFT), distortion product otoacoustic emission (DPOAE) and SFI tests. SFI measures consisted of measurement of resonance frequency (RF) and mobility (ΔSPL) of the outer and middle ear. A mixed model analysis of variance was applied to the SFI data to examine the effect of age on RF and ΔSPL. STUDY SAMPLE: Study included 117 ears from 83 infants of different age groups from birth to 6 months. RESULTS: The mean RF of the outer ear increased from 279 Hz at birth to 545 Hz at 4 months, whereas mean ΔSPL of the outer ear decreased from 7.9 dB at birth to 3.7 dB at 4 months of age. In contrast, the mean RF and ΔSPL of the middle ear did not change significantly with age up to 6 months. CONCLUSIONS: Developmental characteristics should be considered when evaluating the function of the outer and middle ear of young infants (≤6 months) using the SFI. The preliminary normative SFI data established in this study may be used to assist with the evaluation.

Estimation of Round-Trip Outer-Middle Ear Gain Using DPOAEs.

The reported research introduces a noninvasive approach to estimate round-trip outer-middle ear pressure gain using distortion product otoacoustic emissions (DPOAEs). Our ability to hear depends primarily on sound waves traveling through the outer and middle ear toward the inner ear. The role of the outer and middle ear in sound transmission is particularly important for otoacoustic emissions (OAEs), which are sound signals generated in a healthy cochlea and recorded by a sensitive microphone placed in the ear canal. OAEs are used to evaluate the health and function of the cochlea; however, they are also affected by outer and middle ear characteristics. To better assess cochlear health using OAEs, it is critical to quantify the effect of the outer and middle ear on sound transmission. DPOAEs were obtained in two conditions: (i) two-tone and (ii) three-tone. In the two-tone condition, DPOAEs were generated by presenting two primary tones in the ear canal. In the three-tone condition, DPOAEs at the same frequencies (as in the two-tone condition) were generated by the interaction of the lower frequency primary tone in the two-tone condition with a distortion product generated by the interaction of two other external tones. Considering how the primary tones and DPOAEs of the aforementioned conditions were affected by the forward and reverse outer-middle ear transmission, an estimate of the round-trip outer-middle ear pressure gain was obtained. The round-trip outer-middle ear gain estimates ranged from -39 to -17 dB between 1 and 3.3 kHz.