Effects of model definitions and parameter values in finite element modeling of human middle ear mechanics.

BACKGROUND: Despite continuing advances in finite element software, the realistic simulation of middle ear response under acoustic stimulation continues to be challenging. One reason for this is the wide range of possible choices that can be made during the definition of a model. Therefore, an explorative study of the relative influences of some of these choices is potentially very helpful. METHOD: Three finite element models of the human middle ear were constructed, based on high-resolution micro-computed tomography scans from three different human temporal bones. Interesting variations in modeling definitions and parameter values were selected and their influences on middle ear transmission were evaluated. The models were compared against different experimental validation criteria, both from the literature and from our own measurements. Simulation conditions were restricted to the frequency range 0.1-10 kHz. RESULTS: Modeling the three geometries with the same modeling definitions and parameters produces stapes footplate response curves that exhibit similar shapes, but quantitative differences of 4 dB in the lower frequencies and up to 6 dB around the resonance peaks. The model properties with the largest influences on our model outcomes are the tympanic membrane (TM) damping and stiffness and the cochlear load. Model changes with a small to negligible influence include the isotropy or orthotropy of the TM, the geometry of the connection between the TM and the malleus, the microstructure of the incudostapedial joint, and the length of the tensor tympani tendon. CONCLUSION: The presented results provide insights into the importance of different features in middle ear finite element modeling. The application of three different individual middle ear geometries in a single study reduces the possibility that the conclusions are strongly affected by geometrical abnormalities. Some modeling variations that were hypothesized to be influential turned out to be of minor importance. Furthermore, it could be confirmed that different geometries, simulated using the same parameters and definitions, can produce significantly different responses.

Wideband Tympanometry Normative Data for Turkish Young Adult Population.

OBJECTIVE: The aim of this study was to obtain norm values for a young adult Turkish group and to investigate the differences between female and male subjects in terms of wideband tympanometry. MATERIALS AND METHODS: One hundred ten young adult volunteers (mean±SD: 21.1±1.9 years) participated in this study. The measurements of wideband tympanometry were performed at octave frequencies between 226 Hz and 8000 Hz using Titan version 3.1. The stimulus level was set at 100 dB peSPL. RESULTS: A cross-sectional study design was used. In total, 218 ears were tested. A significant relationship was found between gender and absorbance values for the frequency band from 3100 Hz to 6900 Hz. The difference between the middle ear resonance frequency and ear canal volume (ECV) of the male and female subjects was also found to be significant. The difference in ECV may result from the difference in body size between the male and female subjects because there was a significant relationship among ECV and the height and weight. CONCLUSION: According to these results, it can be concluded that using separate norms for males and females may increase test specificity and sensitivity for the diagnosis of disorders, such as ossicular discontinuity and tympanic membrane perforations, affecting the high-frequency region.

Perspective of functional magnetic resonance imaging in middle ear research.

Functional magnetic resonance imaging (MRI) studies have frequently been applied to study sensory system such as vision, language, and cognition, but have proceeded at a considerably slower speed in investigating middle ear and central auditory processing. This is due to several factors, including the intrinsic anatomy of the middle ear system and inherent acoustic noise during acquisition of MRI data. However, accumulating evidences have demonstrated that clarification of some fundamental neural underpinnings of audition associated with middle ear mechanics can be achieved using functional MRI methods. This mini review attempted to take a narrow snapshot of the currently available functional MRI procedures and gave examples of what may be learned about hearing from their application. It is hoped that with these technical advancements, many new high impact applications in audition would follow. In particular, because the fMRI can be used in humans and in animals, fMRI may represent a unique tool that should promote translational research by enabling parallel analyses of physiological and pathological processes in the human and animal auditory system. This article is part of a special issue entitled "MEMRO 2012".

Registration of a validated mechanical atlas of middle ear for surgical simulation.

This paper is centered on the development of a new training and rehearsal simulation system for middle ear surgery. First, we have developed and validated a mechanical atlas based on finite element method of the human middle ear. The atlas is based on a microMRI. Its mechanical behavior computed in real-time has been successfully validated. In addition, we propose a method for the registration of the mechanical atlas on patient imagery. The simulation can be used for a rehearsal surgery with the geometrical anatomy of a given patient and with mechanical data that are validated. Moreover, this process does not necessitate a complete re-built of the model.

Specialization for underwater hearing by the tympanic middle ear of the turtle, Trachemys scripta elegans.

Turtles, like other amphibious animals, face a trade-off between terrestrial and aquatic hearing. We used laser vibrometry and auditory brainstem responses to measure their sensitivity to vibration stimuli and to airborne versus underwater sound. Turtles are most sensitive to sound underwater, and their sensitivity depends on the large middle ear, which has a compliant tympanic disc attached to the columella. Behind the disc, the middle ear is a large air-filled cavity with a volume of approximately 0.5 ml and a resonance frequency of approximately 500 Hz underwater. Laser vibrometry measurements underwater showed peak vibrations at 500-600 Hz with a maximum of 300 µm s(-1) Pa(-1), approximately 100 times more than the surrounding water. In air, the auditory brainstem response audiogram showed a best sensitivity to sound of 300-500 Hz. Audiograms before and after removing the skin covering reveal that the cartilaginous tympanic disc shows unchanged sensitivity, indicating that the tympanic disc, and not the overlying skin, is the key sound receiver. If air and water thresholds are compared in terms of sound intensity, thresholds in water are approximately 20-30 dB lower than in air. Therefore, this tympanic ear is specialized for underwater hearing, most probably because sound-induced pulsations of the air in the middle ear cavity drive the tympanic disc.

Transitional mammalian middle ear from a new Cretaceous Jehol eutriconodont.

The transference of post-dentary jaw elements to the cranium of mammals as auditory ossicles is one of the central topics in evolutionary biology of vertebrates. Homologies of these bones among jawed vertebrates have long been demonstrated by developmental studies; but fossils illuminating this critical transference are sparse and often ambiguous. Here we report the first unambiguous ectotympanic (angular), malleus (articular and prearticular) and incus (quadrate) of an Early Cretaceous eutriconodont mammal from the Jehol Biota, Liaoning, China. The ectotympanic and malleus have lost their direct contact with the dentary bone but still connect the ossified Meckel's cartilage (OMC); we hypothesize that the OMC serves as a stabilizing mechanism bridging the dentary and the detached ossicles during mammalian evolution. This transitional mammalian middle ear narrows the morphological gap between the mandibular middle ear in basal mammaliaforms and the definitive mammalian middle ear (DMME) of extant mammals; it reveals complex changes contributing to the detachment of ear ossicles during mammalian evolution.

Evaluation of implantable actuators by means of a middle ear simulation model.

The extension of indication of implantable hearing aids to cases of conductive hearing loss pushed the development of these devices. There is now a great variety of devices available with different actuator concepts and different attachment points to the middle ear or inner ear fluid. But there is little comparative data available about the devices to provide an insight into advantages and disadvantages of different types of actuators and attachment points at the ossicular chain. This paper investigates two principle (idealized) types of actuators in respect of attachments points at the ossicular chain and direction of excitation. Other parts of implantable hearing aids like microphone, amplifier and signal processing electronics were not incorporated into this study. Investigations were performed by means of a mathematical simulation model of the middle ear (finite element model). Actuator performance and theoretical gain were calculated by harmonic analysis in the frequency range of 100-6000 Hz and were compared for the different situations. The stapes head proofed to be an ideal attachment point for actuators of both types as this position is very insensitive to changes in the direction of excitation. The implantable actuators showed higher ratio of equivalent sound pressure to radiated sound pressure compared to an open hearing aid transducer and should therefore allow for more functional gain.

Effects of maturation on tympanometric wideband acoustic transfer functions in human infants.

Wideband acoustic transfer function (ATF) measurements of energy reflectance (ER) and admittance magnitude (|Y|) were obtained at varying static ear-canal pressures in 4-, 12-, and 27-week-old infants and young adults. Developmental changes in wideband ATF measurements varied as a function of frequency. For frequencies from 0.25 to 0.75 kHz there was as much as a 30% change in mean ER and mid |Y| with changes in static ear-canal pressure between 4 and 24 weeks of age. From 0.75 to 2 kHz, the effects of pressure produced a small number of significant differences in ER and mid |Y| with age, suggestive of a developmentally stable frequency range. Between 2 and 6 kHz, there were differential effects of pressure for the youngest infants; negative pressures caused increased ER and mid |Y| and positive pressures caused decreased ER and mid |Y|; the magnitude of this effect decreased with age. Findings from this study demonstrate developmental differences in wideband tympanometric ATF measurements in 4-, 12- and 24-week-old infants and provide additional insight on the effects of static ear-canal pressure in the young infant's ear. The maturational effects shown in the experimental data are discussed in light of known age-related anatomical changes in the developing outer and middle ear.

Sources of variability in reflectance measurements on normal cadaver ears.

OBJECTIVES: The development of acoustic reflectance measurements may lead to noninvasive tests that provide information currently unavailable from standard audiometric testing. One factor limiting the development of these tests is that normal-hearing human ears show substantial intersubject variations. This work examines intersubject variability that results from measurement location within the ear canal, estimates of ear-canal area, and variations in middle-ear cavity volume. DESIGN: Energy reflectance (ER) measurements were made on nine human-cadaver ears to study three variables. (1) ER was measured at multiple ear-canal locations. (2) The ear-canal area at each measurement location was measured and the ER was calculated with the measured area, a constant area, and an acoustically estimated area. (3) The ER was measured with the middle-ear cavity in three conditions: (1) normal, (2) the mastoid widely opened (large air space), and (3) the mastoid closed off at the aditus ad antrum (small air space). RESULTS: Measurement-location effects are generally largest at frequencies below about 2000 Hz, where in some ears reflectance magnitudes tend to decrease systematically as the measurement location moves away from the tympanic membrane but in other ears the effects seem minimal. Intrasubject variations in reflectance due to changes in either measurement location within the ear canal or differences in the estimate of the ear-canal area are smaller than variations produced by large variations in middle-ear cavity air volume or intersubject differences. At frequencies below 2000 Hz, large increases in cavity volume systematically reduce the ER, with more variable changes above 2000 Hz. CONCLUSIONS: ER measurements depend on all variables studied: measurement location, ear-canal cross-sectional area, and middle-ear cavity volume. Variations within an individual ear in either measurement location or ear-canal cross-sectional area result in relatively small effects on the ER, supporting the notion that diagnostic tests (1) need not control for measurement location and (2) can assume a constant ear-canal area across most subjects. Variations in cavity volume produce much larger effects in ER than measurement location or ear-canal area, possibly explaining some of the intersubject variation in ER reported among normal ears.

A new implantable middle ear hearing device for mixed hearing loss: A feasibility study in human temporal bones.

HYPOTHESIS: To assess the feasibility of a new, active middle ear device in temporal bones (TB). BACKGROUND: This device is designed for patients with mixed hearing loss subsequent to chronic middle ear infection, surgery, or trauma. This Bell-Vibroplasty is built from a VIBRANT MED-EL Vibrant Soundbridge and a Kurz Bell titanium partial ossicular replacement prosthesis. METHODS: In three fresh TBs, healthy and reconstructed middle ears were analyzed by means of laser Doppler interferometry. The sound transmission properties of a partial ossicular replacement prosthesis and a passive and an active Bell-Vibroplasty were compared with healthy middle ear function. RESULTS: The measurements provided reliable results with small standard deviations and good signal-to-noise ratios. The performance levels of the partial ossicular replacement prosthesis and of the passive Bell-Vibroplasty were comparable with that of healthy middle ear function. The activated Bell-Vibroplasty provided linear function and a flat frequency response within the measured frequency range (500 Hz-8 kHz), with peak deviations of less than 10 dB. The maximum output of the Bell-Vibroplasty was equivalent to 125-dB sound pressure level. CONCLUSION: Bell-Vibroplasty is feasible in TBs. Bell-Vibroplasty performance in TBs is sufficient to allow for a clinical trial as a next step.

Structures that contribute to middle-ear admittance in chinchilla.

We describe measurements of middle-ear input admittance in chinchillas (Chinchilla lanigera) before and after various manipulations that define the contributions of different middle-ear components to function. The chinchilla's middle-ear air spaces have a large effect on the low-frequency compliance of the middle ear, and removing the influences of these spaces reveals a highly admittant tympanic membrane and ossicular chain. Measurements of the admittance of the air spaces reveal that the high-degree of segmentation of these spaces has only a small effect on the admittance. Draining the cochlea further increases the middle-ear admittance at low frequencies and removes a low-frequency (less than 300 Hz) level dependence in the admittance. Spontaneous or sound-driven contractions of the middle-ear muscles in deeply anesthetized animals were associated with significant changes in middle-ear admittance.

Acoustic communication and burrow acoustics are reflected in the ear morphology of the coruro (Spalacopus cyanus, Octodontidae), a social fossorial rodent.

We studied the middle and inner ears of seven adult coruros (Spalacopus cyanus), subterranean and social rodents from central Chile, using free-hand dissection and routine staining techniques. Middle ear parameters that were focused on here (enlarged bullae and eardrums, ossicles of the "freely mobile type") are believed to enhance hearing sensitivity at lower frequencies. The organ of Corti was of a common mammalian type and revealed three peaks of higher inner hair cell densities. Based on a position frequency map, frequencies were assigned to the respective peaks along the basilar membrane. The first peak at around 300-400 Hz is discussed with respect to the burrow acoustics, while the peak around 10-20 kHz is probably a plesiomorphic feature. The most pronounced peak at around 2 kHz reflects the frequency at which the main energy of vocal communication occurs. The morphology of the ear of the coruro corresponds to the typical pattern seen in subterranean rodents (low frequency and low-sensitivity hearers), yet, at the same time, it also deviates from it in several functionally relevant features.

Mechanical leverage in the middle ear of the American bullfrog, Rana catesbeiana.

Textbooks lump the middle ears of 'submammalian Tetrapoda' as being 'one-ossicle ears'. Conventionally the anuran middle ear is depicted with a shaft-like skeletal unit connecting the tympanic membrane to the inner ear. This shaft comprises mediad a long bony columella and laterad a short cartilaginous extracolumella. But dissection of Rana catesbeiana ears showed: the extracolumella, as long as the columella, is proximally expanded in the vertical plane, forming dorsal and ventral heads. The medio-dorsal head is movably jointed to the columella, between these two there is an obtuse angle ventrad; the extracolumellar medio-ventral head is anchored by a ligament to the middle-ear cavity ceiling. When the tympanic membrane moves outwards, pulling the extracolumella, the medio-dorsal head of the extracolumella must be forced inwards, rotating on the ventral anchorage, pushing the columella towards the inner ear. The ossicular chain thus includes a mechanical lever, possessing the magnitude of the ratio length:width of the extracolumella; this is additional to the lever known from the columellar footplate, which rotates on its firm ventral attachment. These levers are confirmed physiologically, by the difference between the inner-ear sensitivity (shown by isopotential audiograms of microphonic potentials) when stimulated by a vibrator first at the tympanic membrane, then at the proximal stump of the amputated columella. Perusal of the primary literature showed that this morphology is widespread among anuran ears.

Effects of age and size in the ears of gekkonomorph lizards: middle-ear sensitivity.

Previous studies of electrophysiological audiograms in gekkonomorph lizards revealed greater sensitivity in adults than in juveniles. We investigated whether this difference, as far as it is affected by the middle ear, is due to animal age or size. The velocity transfer function of the tympanic membrane (TM) was examined using laser interferometry in nine samples: adults of three large gekkonomorph species, adults of three small species (each related to one of the former), and juveniles of the large species, their sizes matching those of the small-species adults. Each transfer function exhibited an inverted 'V' or 'U' shape, with the velocity of TM motion peaking in the mid-frequency range and becoming poorer at lower and higher frequencies. Among samples, maximum TM velocity correlated with animal length, perhaps because of a damping change in the larger TM. The frequency at maximum velocity negatively correlated with measurements of TM area. Presumably, with a larger TM area, the best frequency shifted downward because of increased middle-ear mass or decreased stiffness. The bandwidth of the transfer function negatively correlated with animal length, being broader in smaller animals and sharper in larger animals. This effect can be attributed to increased mass, decreased damping, or both. Among the middle-ear morphological measurements, the one most closely correlated with body length was the length of the extracolumellar anchorage at the TM. Among the physiological variables investigated, maximum velocity was negatively correlated with the frequency at which it occurred. The dependence of these transfer function variables on animal and ear size was similar, regardless of whether the comparison was among adults of species of different sizes, or among age classes within a species, so that age differences appear to be largely the result of size differences.

What middle ear parameters tell about impedance matching and high frequency hearing.

Acoustic energy enters the mammalian cochlea aided by an anatomical impedance matching performed by the middle ear. The purpose of this paper is to analyse the functional consequences of changes in scale of the middle ear when going from the smallest mammals to the largest. Our anatomical measurements in mammals of different sizes ranging from bats to elephants indicate that middle ear proportions are largely isometric. Thus the calculated transformer ratio is basically independent of animal size, a typical value lying between 30 and 80. Similarly, the calculated specific acoustic input impedance of the inner ear is independent of animal size, the average value being about 140 kPa s/m. We show that if the high frequency hearing limit of isometric ears is limited by ossicle inertia, it should be inversely proportional to the cubic root of the ossicular mass. This prediction is in reasonable agreement with published audiogram data. We then present a three-parameter model of the middle ear where some obvious deviations from perfect isometry are taken into account. The high frequency hearing limits of different species generally agree well with the predictions of this simple model. However, the hearing limits of small rodents clearly deviate from the model calculation. We interpret this observation as indicating that the hearing limit towards very high frequencies may be set by cochlear transduction mechanisms. Further we discuss the exceptional high frequency hearing of the cat and the amphibious hearing of seals.

Quantifying ear-canal geometry with multiple computer-assisted tomographic scans.

Several audiological tests require knowledge of the sound-pressure spectrum at the eardrum. However, microphone readings are typically made at another, more-accessible position in the auditory canal. Recordings are then "adjusted" to the plane of the eardrum via mathematical models of the ear canal and eardrum. As bandwidths of audiological instruments have increased, ear-canal models have, by necessity, become more precise geometrically. Reported herein is a noninvasive procedure for acquiring geometry of the ear canal in fine detail. The method employs a computer-assisted tomographic (CAT) scanner in two steps to make radiographic images of parasagittal cross sections at uniform intervals along the lateral length of the canal. Accuracy was evaluated by comparing areas of cross sections appearing in radiographic images of a cadaver ear canal to cross sectional areas of corresponding michrotome slices of an injection mold of the same canal. Percent differences between these two areas had a mean value of 9.65% for 26 different cross sections of the one ear canal studied. Ear canal volume estimated from the CAT images was 6.12% different from the estimated volume of the injection mold: an improvement over the reported 39% maximum error of conventional acoustic volume measurements.

Auditory behaviour and brainstem histochemistry in adult rats with characterized ear damage after neonatal ossicle ablation or cochlear disruption.

Binaural and monaural ossicle ablation in neonate rats before the time of onset of auditory input resulted in hearing deficits as detected by behavioural responses to sound stimuli in these rats as young adults. Cochlear disruption at the same neonatal age similarly resulted in the absence of startle reflexes in many of the rats. When the middle and inner ears of the rats were analysed postmortem in serial sections, it was observed that most ears after neonatal ossicle ablation contained only small remnants of the malleus-incus unit, separated from the stapes; in other ears an apparent continuity of ossicles had been restored. The rats with blind-ending ear canals and ossicle atrophy were those that had shown little response to sound stimuli. In the cochlear-disrupted rats, those with modiolar damage and loss of most spiral ganglion cells had shown substantial impairment of sound perception, even in some rats with only monaural modiolar loss. The chronic conduction deficit caused by neonatal ossicle removal did not result in detectable differences in relative cytochrome oxidase activity in the dorsal cochlear nuclei and central nucleus of the inferior colliculus. For monaurally ossicle-ablated rats, quantitation of the average intensity of enzyme reaction product in sections of dorsal or ventral cochlear nuclei, or central nucleus, did not reveal a difference between operated and non-operated sides. However, in binaurally ossicle-ablated rats, the relative enzyme activity in the anteroventral cochlear nuclei was reduced in comparison to this nucleus in control rats. The volume of the anteroventral cochlear nucleus in rats that had had neonatal binaural cochlear disruption was reduced relative to the volume in control rats or in rats that had had binaural ossicle ablation (P < 0.001); the latter procedure did not result in a statistically significant difference from controls in AVCN volume. In cochlear-operated rats with monaural modiolar damage, the AVCN contralateral to the damaged cochlea had a lower mean level of cytochrome oxidase activity in its neurons measured individually than that for neurons in the ipsilateral AVCN. These results suggested the importance during development of input from contralateral cochlear neurons.

[Aluminum oxide ceramic PORP and TORP prostheses]. / Keramische PORP en TORP prothesen van aluminiumoxyde.

The tolerance of bio-inert aluminium oxide ceramic as a PORP or TORP design has been studied histologically and clinically. Thirty-five patients had an aluminium oxide prosthesis implanted into the middle ear. There was a hearing gain of 21 dB in the speech frequencies. Patients were monitored for an average period of 20 months (3/4-2 1/4 years); the shortest period was 9 months, the longest 27. The functional results were satisfactory. The acoustic efficiency between 0-20 dB air-bone gap was not greater than with human ossicles or cartilage, although there was no fixation or resorption and a better structural stability.

The application of acoustic impedance measurements to pediatric clinical practice.

This article provides background information on acoustic impedance testing and illustrates utilization of test results in pediatric clinical practice. Acoustic impedance measurement devices are presently being used successfully by hearing screening programs and by otorhinolaryngologists in clinical and hospital settings. As a diagnostic tool, the acoustic impedance bridge can have particular applicability in dealing withe young children and other difficult-to-test populations. Impedance measurements can provide physicians with objective information about the condition of the middle ear, oftentimes more accurately than either otoscopic examination or standard audiometry. The technique described can assist physicians in diagnosing middle-ear diseases and in monitoring the effects of otological treatment.