Using Stapes Velocity to Estimate the Efficacy of Mechanical Stimulation of the Round Window With an Active Middle Ear Implant.

OBJECTIVE: To test a method to measure the efficacy of active middle ear implants when coupled to the round window. METHODS: Data previously published in Koka et al. ( Hear Res 2010;263:128-137) were used in this study. Simultaneous measurements of cochlear microphonics (CM) and stapes velocity in response to both acoustic stimulation (forward direction) and round window (RW) stimulation (reverse direction) with an active middle ear implant (AMEI) were made in seven ears in five chinchillas. For each stimulus frequency, the amplitude of the CM was measured separately as a function of intensity (dB SPL or dB mV). Equivalent vibrational input to the cochlea was determined by equating the acoustic and AMEI-generated CM amplitudes for a given intensity. In the condition of equivalent CM amplitude between acoustic and RW stimulation-generated output, we assume that the same vibrational input to the cochlea was present regardless of the route of stimulation. RESULTS: The measured stapes velocities for equivalent CM output from the two types of input were not significantly different for low and medium frequencies (0.25-4 kHz); however, the velocities for AMEI-RW drive were significantly lower for higher frequencies (4-14 kHz). Thus, for RM stimulation with an AMEI, stapes velocities can underestimate the mechanical input to the cochlea by ~20 dB for frequencies greater than ~4 kHz. CONCLUSIONS: This study confirms that stapes velocity (with the assumption of equivalent stapes velocity for forward and reverse stimulation) cannot be used as a proxy for effective input to the cochlea when it is stimulated in the reverse direction. Future research on application of intraoperative electrophysiological measurements during surgery (CM, compound action potential, or auditory brainstem response) for estimating efficacy and optimizing device coupling and performance is warranted.

The Effects of Middle-ear Stiffness on the Auditory Brainstem Neural Encoding of Phase.

The middle-ear system relies on a balance of mass and stiffness characteristics for transmitting sound from the external environment to the cochlea and auditory neural pathway. Phase is one aspect of sound that, when transmitted and encoded by both ears, contributes to binaural cue sensitivity and spatial hearing. The study aims were (i) to investigate the effects of middle-ear stiffness on the auditory brainstem neural encoding of phase in human adults with normal pure-tone thresholds and (ii) to investigate the relationships between middle-ear stiffness-induced changes in wideband acoustic immittance and neural encoding of phase. The auditory brainstem neural encoding of phase was measured using the auditory steady-state response (ASSR) with and without middle-ear stiffness elicited via contralateral activation of the middle-ear muscle reflex (MEMR). Middle-ear stiffness was quantified using a wideband acoustic immittance assay of acoustic absorbance. Statistical analyses demonstrated decreased ASSR phase lag and decreased acoustic absorbance with contralateral activation of the MEMR, consistent with increased middle-ear stiffness changing the auditory brainstem neural encoding of phase. There were no statistically significant correlations between stiffness-induced changes in wideband acoustic absorbance and ASSR phase. The findings of this study may have important implications for understanding binaural cue sensitivity and horizontal plane sound localization in audiologic and otologic clinical populations that demonstrate changes in middle-ear stiffness, including cochlear implant recipients who use combined electric and binaural acoustic hearing and otosclerosis patients.

Effects of unilateral eye closure on middle ear muscle contractions.

Middle ear muscle contractions (MEMCs) are most commonly considered a response to high-level acoustic stimuli. However, MEMCs have also been observed in the absence of sound, either as a response to somatosensory stimulation or in concert with other motor activity. The relationship between MEMCs and non-acoustic sources is unclear. This study examined associations between measures of voluntary unilateral eye closure and impedance-based measures indicative of middle ear muscle activity while controlling for demographic and clinical factors in a large group of participants (N=190) with present clinical acoustic reflexes and no evidence of auditory dysfunction. Participants were instructed to voluntarily close the eye ipsilateral to the ear canal containing a detection probe at three levels of effort. Orbicularis oculi muscle activity was measured using surface electromyography. Middle ear muscle activity was inferred from changes in total energy reflected in the ear canal using a filtered (0.2 to 8 kHz) click train. Results revealed that middle ear muscle activity was positively associated with eye muscle activity. MEMC occurrence rates for eye closure observed in this study were generally higher than previously published rates for high-level brief acoustic stimuli in the same participant pool suggesting that motor activity may be a more reliable elicitor of MEMCs than acoustic stimuli. These results suggest motor activity can serve as a confounding factor for auditory exposure studies as well as complicate the interpretation of any impulsive noise damage risk criteria that assume MEMCs serve as a consistent, uniform protective factor. The mechanism linking eye and middle ear muscle activity is not understood and is an avenue for future research.

The effect of total compression time and rate (slope) of compression on the incidence of symptomatic Eustachian tube dysfunction and middle ear barotrauma: a Phase II prospective study.

Eustachian tube dysfunction (ETD) and middle ear barotrauma (MEB) are common reported complications during hyperbaric oxygen treatment. Our Phase I study data was the first to demonstrate a statistically significant decrease in the occurrence of symptomatic ETD and MEB. The Phase I Trial suggested the total time interval and rate (slope) of compression (ROC) may be a determining factor in ETD and MEB. This Phase II study investigates an optimal rate of compression to reduce ETD and MEB when considering each multiplace treatment (with multiple patients) as the unit of observation as a group, rather than for each individual patient. Data were collected prospectively on 1,244 group patient-treatment exposures, collectively including 5,072 individual patient-treatment/exposures. We randomly assigned patient-treatment group exposures to four different time interval and rate (slope) of compression. These compression rates and slopes were identical to those used in the Phase I trial. All patients experiencing symptoms of MEB requiring compression stops were evaluated post treatment for the presence of ETD and MEB using the O'Neill Grading System (OGS) for ETD. Data were analyzed using the IBM-SPSS statistical software program. A statistically significant decrease in the number of compression holds was observed in the 15-minute compression schedule, correlating to the results observed in the Phase I trial. The 15-minute linear compression profile continues to demonstrate the decreased need for patient symptomatic compression stops (as in the Phase I trial) using a USN TT9 during elective hyperbaric oxygen treatments in a Class A multiplace hyperbaric chamber. Trial Registration: ClinicalTrials.gov Identifier: NCT04776967.

Are suspensory ligaments important for middle ear reconstruction?

As the resolution of 3D printing techniques improves, the possibility of individualized, 3-ossicle constructions adds a new dimension to middle ear prostheses. In order to optimize these designs, it is essential to understand how the ossicles and ligaments work together to transmit sound, and thus how ligaments should be replicated in a middle ear reconstruction. The middle ear ligaments are thought to play a significant role in maintaining the position of the ossicles and constraining axis of rotation. Paradoxically, investigations of the role of ligaments to date have shown very little impact on middle ear sound transmission. We explored the role of the two attachments in the gerbil middle ear analogous to human ligaments, the posterior incudal ligament and the anterior mallear process, severing both attachments and measuring change in hearing sensitivity. The impact of severing the attachments on the position of the ossicular chain was visualized using synchrotron microtomography imaging of the middle ear. In contrast to previous studies, a threshold change on the order of 20 dB across a wide range of frequencies was found when both ligaments were severed. Concomitantly, a shift in position of the ossicles was observed from the x-ray imaging and 3D renderings of the ossicular chain. These findings contrast with previous studies, demonstrating that these ligaments play a significant role in the transmission of sound through the middle ear. It appears that both mallear and incudal ligaments must be severed in order to impair sound transmission. The results of this study have significance for middle ear reconstructive surgery and the design of 3D-printed three-ossicle biocompatible prostheses.

Forward and Reverse Middle Ear Transmission in Gerbil with a Normal or Spontaneously Healed Tympanic Membrane.

Tympanic membranes (TM) that have healed spontaneously after perforation present abnormalities in their structural and mechanical properties; i.e., they are thickened and abnormally dense. These changes result in a deterioration of middle ear (ME) sound transmission, which is clinically presented as a conductive hearing loss (CHL). To fully understand the ME sound transmission under TM pathological conditions, we created a gerbil model with a controlled 50% pars tensa perforation, which was left to heal spontaneously for up to 4 weeks (TM perforations had fully sealed after 2 weeks). After the recovery period, the ME sound transmission, both in the forward and reverse directions, was directly measured with two-tone stimulation. Measurements were performed at the input, the ossicular chain, and output of the ME system, i.e., at the TM, umbo, and scala vestibuli (SV) next to the stapes. We found that variations in ME transmission in forward and reverse directions were not symmetric. In the forward direction, the ME pressure gain decreased in a frequency-dependent manner, with smaller loss (within 10 dB) at low frequencies and more dramatic loss at high frequency regions. The loss pattern was mainly from the less efficient acoustical to mechanical coupling between the TM and umbo, with little changes along the ossicular chain. In the reverse direction, the variations in these ears are relatively smaller. Our results provide detailed functional observations that explain CHL seen in clinical patients with abnormal TM, e.g., caused by otitis media, that have healed spontaneously after perforation or post-tympanoplasty, especially at high frequencies. In addition, our data demonstrate that changes in distortion product otoacoustic emissions (DPOAEs) result from altered ME transmission in both the forward and reverse direction by a reduction of the effective stimulus levels and less efficient transfer of DPs from the ME into the ear canal. This confirms that DPOAEs can be used to assess both the health of the cochlea and the middle ear.

Establishing critical differences in ear-canal stimulus amplitude for detecting middle ear muscle reflex activation during olivocochlear efferent measurements.

Objective: Assessments of the medial olivocochlear reflex (MOCR) may have clinical utility. The MOCR is measured using contralateral inhibition of otoacoustic emissions but concurrent activation of the middle ear muscle reflex (MEMR) confounds test interpretation. MEMR activation can be detected using the change in ear-canal stimulus amplitude without versus with an MOCR elicitor. This study provides a description of how critical differences in ear-canal stimulus amplitude can be established.Design: Clicks were presented in right ears without and with a contralateral MOCR elicitor. Ear-canal stimulus amplitudes were measured. Two measurements without an elicitor were used to develop critical differences. MEMR activation was considered present if the difference in ear-canal stimulus amplitude without versus with an elicitor exceeded the critical difference.Study sample: Forty-six normal-hearing adults (mean age = 23.4 years, 35 females) participated, with data from 44 participants included in the final analysis.Results: Two participants exceeded the 95% critical difference. The 80, 90 and 99% critical differences are also reported for reference.Conclusions: Results suggest that the contralateral elicitor can evoke the MEMR in a small number of participants. The methods described in this paper can be used for developing equipment- and clinic-specific critical differences for detecting MEMR activation.

Generalizability of clinically measured acoustic reflexes to brief sounds.

Middle ear muscle contractions (MEMC) can be elicited in response to high-level sounds, and have been used clinically as acoustic reflexes (ARs) during evaluations of auditory system integrity. The results of clinical AR evaluations do not necessarily generalize to different signal types or durations. The purpose of this study was to evaluate the likelihood of observing MEMC in response to brief sound stimuli (tones, recorded gunshots, noise) in adult participants (N = 190) exhibiting clinical ARs and excellent hearing sensitivity. Results revealed that the presence of clinical ARs was not a sufficient indication that listeners will also exhibit MEMC for brief sounds. Detection rates varied across stimulus types between approximately 20% and 80%. Probabilities of observing MEMC also differed by clinical AR magnitude and latency, and declined over the period of minutes during the course of the MEMC measurement series. These results provide no support for the inclusion of MEMC as a protective factor in damage-risk criteria for impulsive noises, and the limited predictability of whether a given individual will exhibit MEMC in response to a brief sound indicates a need to measure and control for MEMC in studies evaluating pharmaceutical interventions for hearing loss.

Average middle ear frequency response curves with preservation of curve morphology characteristics.

For the validation of modelling results or the comparison of middle ear interventions, such as prostheses placement, average responses of middle ear vibrations are needed. One such response is the amplitude and phase of the vibration of the stapes footplate as a function of frequency. Average responses and their standard deviation are commonly obtained by calculating the mean of a number of measured responses at each frequency. A typical middle ear magnitude response curve shows a number of distinct peaks, and the location of these peaks varies between ears. By simply taking an average along the magnitude or phase response axis, the typical fine structure of the response curve is flattened out, delivering an average curve which no longer has the typical morphology of an individual response curve. This paper introduces methods to avoid this problem by first aligning the typical curve features along the frequency axis prior to calculating the average along the magnitude or phase axis, resulting in average magnitude and phase curves which maintain the typical morphology of the curve obtained for an individual ear. In the method, landmark points on the response magnitude curves are defined and the frequencies at which these points occur are averaged. Next, these average frequencies are used to align the landmark points between curves, prior to averaging values along the magnitude or phase axes. Methods for semi-automatic and manual assignment of landmark points and curve alignment are presented. After alignment, the correspondence between the original landmark frequencies and aligned frequencies is obtained together with the warping function which maps each original magnitude curve to its aligned version. The phase curves are aligned using the warping functions determined from the corresponding magnitude curves. Finally, a method is proposed to compare the data set of an individual measurement or model result to an aligned average curve in terms of magnitude and frequency by applying the alignment procedure to the individual curve.

Quasi-static and dynamic motions of the columellar footplate in ostrich (Struthio camelus) measured ex vivo.

The nature of the movement of the columellar footplate (CFP) in birds is still a matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.

The Middle Ear Muscle Reflex in Rat: Developing a Biomarker of Auditory Nerve Degeneration.

OBJECTIVES: The long-term goal of this research is to determine whether the middle ear muscle reflex can be used to predict the number of healthy auditory nerve fibers in hearing-impaired ears. In this study, we develop a high-impedance source and an animal model of the middle ear muscle reflex and explore the influence of signal frequency and level on parameters of the reflex to determine an optimal signal to examine auditory nerve fiber survival. DESIGN: A high-impedance source was developed using a hearing aid receiver attached to a 0.06 diameter 10.5-cm length tube. The impedance probe consisted of a microphone probe placed near the tip of a tube coupled to a sound source. The probe was calibrated by inserting it into a syringe of known volumes and impedances. The reflex in the anesthetized rat was measured with elicitor stimuli ranging from 3 to 16 kHz presented at levels ranging from 35 to 100 dB SPL to one ear while the reflex was measured in the opposite ear containing the probe and probe stimulus. RESULTS: The amplitude of the reflex increased with elicitor level and was largest at 3 kHz. The lowest threshold was approximately 54 dB SPL for the 3-kHz stimulus. The rate of decay of the reflex was greatest at 16 kHz followed by 10 and 3 kHz. The rate of decay did not change significantly with elicitor signal level for 3 and 16 kHz, but decreased as the level of the 10-kHz elicitor increased. A negative feedback model accounts for the reflex decay by having the strength of feedback dependent on auditory nerve input. The rise time of the reflex varied with frequency and changed with level for the 10- and 16-kHz signals but not significantly for the 3-kHz signal. The latency of the reflex increased with a decrease in elicitor level, and the change in latency with level was largest for the 10-kHz stimulus. CONCLUSIONS: Because the amplitude of the reflex in rat was largest with an elicitor signal at 3 kHz, had the lowest threshold, and yielded the least amount of decay, this may be the ideal frequency to estimate auditory nerve survival in hearing-impaired ears.

Minimally invasive laser vibrometry (MIVIB) with a floating mass transducer - A new method for objective evaluation of the middle ear demonstrated on stapes fixation.

Ossicular fixation through otosclerosis, chronic otitis media and other pathologies, especially tympanosclerosis, are treated by surgery if hearing aids fail as an alternative. However, the best hearing outcome is often based on knowledge of the degree and location of the fixation. Objective methods to quantify the degree and position of the fixation are largely lacking. Laser vibrometry is a known method to detect ossicular fixation but clinical applicability remains limited. A new method, minimally invasive laser vibrometry (MIVIB), is presented to quantify ossicle mobility using laser vibrometry measurement through the ear canal after elevating the tympanic membrane, thus making the method feasible in minimally invasive explorative surgery. A floating mass transducer provides a clinically relevant transducer to drive ossicular vibration. This device was attached to the manubrium and drove vibrations at the same angle as the longitudinal axis of the stapes and was therefore used to assess ossicular chain mobility in a fresh-frozen temporal bone model with and without stapes fixation. The ratio between the umbo and incus long process was shown to be useful in assessing stapes fixation. The incus-to-umbo velocity ratio decreased by 15 dB when comparing the unfixated situation to stapes fixation up to 2.5 kHz. Such quantification of ossicular fixation using the incus-to-umbo velocity ratio would allow quick and objective analysis of ossicular chain fixations which will assist the surgeon in surgical planning and optimize hearing outcomes.

Feasibility of Round Window Stimulation by a Novel Electromagnetic Microactuator.

INTRODUCTION: Most implantable hearing aids currently available were developed to compensate the sensorineural hearing loss by driving middle ear structures (e.g., the ossicles). These devices are successfully used in round window (RW) stimulation clinically, although this was initially not the intended use. Here, a novel microactuator, specifically designed for RW stimulation, was tested in human temporal bones to determine actuator performance and applicability. METHODS: Stapes footplate response to RW stimulation was determined experimentally in human temporal bones and the obtained sound pressure output level was estimated. RESULTS: The actuator had a flat displacement response between 0.125 and 4 kHz, a resonance between 4 and 7 kHz, and a roll-off above. At increasing contact force, the stapes footplate displacement decreased by 5-10 dB re µm for forces ≥ 2 mN. The equivalent sound pressure level between 0.125 and 4 kHz amounted to 87-97 eq dB SPL and increased to 117 eq dB SPL for frequencies of 4-7 kHz. The total harmonic distortion (THD) of the actuator ranged within 15-40% for static forces of 5 mN. CONCLUSION: The feasibility of an electromagnetic actuator that may be placed into the RW niche was demonstrated but requires further optimization in terms of THD and static force sensitivity.

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.

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.

Membrane fluidity does not explain how solvents act on the middle-ear reflex.

Some volatile aromatic solvents have similar or opposite effects to anesthetics in the central nervous system. Like for anesthetics, the mechanisms of action involved are currently the subject of debate. This paper presents an in vivo study to determine whether direct binding or effects on membrane fluidity best explain how solvents counterbalance anesthesia's depression of the middle-ear reflex (MER). Rats were anesthetized with a mixture of ketamine and xylazine while also exposed to solvent vapors (toluene, ethylbenzene, or one of the three xylene isomers) and the amplitude of their MER was monitored. The depth of anesthesia was standardized based on the magnitude of the contraction of the muscles involved in the MER, determined by measuring cubic distortion product oto-acoustic emissions (DPOAEs) while triggering the bilateral reflex with contralateral acoustic stimulation. The effects of the aromatic solvents were quantified based on variations in the amplitude of the DPOAEs. The amplitude of the alteration to the MER measured in anesthetized rats did not correlate with solvent lipophilocity (as indicated by logKow values). Results obtained with the three xylene isomers indicated that the positions of two methyl groups around the benzene ring played a determinant role in solvent/neuronal cell interaction. Additionally, Solid-state Nuclear Magnetic Resonance (NMR) spectra for brain microsomes confirmed that brain lipid fluidity was unaffected by solvent exposure, even after three days (6h/day) at an extremely high concentration (3000ppm). Therefore, aromatic solvents appear to act directly on the neuroreceptors involved in the acoustic reflex circuit, rather than on membrane fluidity. The affinity of this interaction is determined by stereospecific parameters rather than lipophilocity.

Wideband Acoustic Immittance: Normative Study and Test-Retest Reliability of Tympanometric Measurements in Adults.

PURPOSE: The purpose of this study was to present normative data of tympanometric measurements of wideband acoustic immittance and to characterize wideband tympanograms. METHOD: Data were collected in 84 young adults with strictly defined normal hearing and middle ear status. Energy absorbance (EA) was measured using clicks for 1/12-octave frequencies (0.236 to 8 kHz), with the ear canal air pressure systematically varied (+200 to -300 daPa). In 40 ears, 7 consecutive trials and a trial of clinical 226-Hz acoustic admittance (Ya) tympanometry followed. A cavity test was also conducted. RESULTS: From the wideband EA tympanogram, several EA spectrums and EA tympanograms were derived. Descriptive statistics were performed, and population parameters were estimated. The immediate test-retest reliability was excellent. Effects of ear canal air pressure on EA were examined comprehensively. Differences in EA between tympanometric and ambient-pressure measurements were significant. Single-frequency EA tympanograms exemplified for half-octave frequencies were contrasted. The bandpass EA tympanogram, 0.236- and 1-kHz EA and Ya tympanograms, and 226-Hz Ya tympanogram were compared in 9 variables. CONCLUSIONS: This study established a database of wideband tympanograms in healthy adults. The data analyses will promote our understanding of the middle ear transfer function. These data will serve as a reference for further studies in clinical populations.

Acoustic input impedance of the avian inner ear measured in ostrich (Struthio camelus).

In both mammals and birds, the mechanical behavior of the middle ear structures is affected by the mechanical impedance of the inner ear. In this study, the aim was to quantify the acoustic impedance of the avian inner ear in the ostrich, which allows us to determine the effect on columellar vibrations and middle ear power flow in future studies. To determine the inner ear impedance, vibrations of the columella were measured for both the quasi-static and acoustic stimulus frequencies. In the frequency range of 0.3-4 kHz, we used electromagnetic stimulation of the ossicle and a laser Doppler vibrometer to measure the vibration response. At low frequencies, harmonic displacements were imposed on the columella using piezo stimulation and the resulting force response was measured with a force sensor. From these measurement data, the acoustic impedance of the inner ear could be determined. A simple RLC model in series of the impedance measurements resulted in a stiffness reactance of KIE = 0.20·10(12) Pa/m³, an inertial impedance of MIE = 0.652·10(6) Pa s(2)/m³, and a resistance of RIE = 1.57·10(9) Pa s/m. We found that values of the inner ear impedance in the ostrich are one to two orders in magnitude smaller than what is found in mammal ears.

Relationship Between Distortion Product - Otoacoustic Emissions (DPOAEs) and High-Frequency Acoustic Immittance Measures.

BACKGROUND Pathologies that alter the impedance of the middle ear may consequently modify the DPOAE amplitude. The aim of this study was to correlate information from 2 different clinical procedures assessing middle ear status. Data from DPOAE responses (both DP-Gram and DP I/O functions) were correlated with data from multi-component tympanometry at 1000 Hz. MATERIAL AND METHODS The subjects were divided into a double-peak group (DPG) and a single-peak group (SPG) depending on 1000 Hz tympanogram pattern. Exclusion criteria (described in the Methods section) were applied to both groups and finally only 31 ears were assigned to each group. The subjects were also assessed with traditional tympanometry and behavioral audiometry. RESULTS Compared to the single-peak group, in terms of the 226 Hz tympanometry data, subjects in the DPG group presented: (i) higher values of ear canal volume; (ii) higher peak pressure, and (iii) significantly higher values of acoustic admittance. DPOAE amplitudes were lower in the DPG group only at 6006 Hz, but the difference in amplitude between the DPG and SPG groups decreased as the frequency increased. Statistical differences were observed only at 1001 Hz and a borderline difference at 1501 Hz. In terms of DPOAE I/O functions, significant differences were observed only in 4 of the 50 tested points. CONCLUSIONS The 1000-Hz tympanometric pattern significantly affects the structure of DPOAE responses only at 1001 Hz. In this context, changes in the properties of the middle ear (as detected by the 1000 Hz tympanometry) can be considered as prime candidates for the observed variability in the DP-grams and the DP I/O functions.

Design, fabrication, and in vitro testing of novel three-dimensionally printed tympanic membrane grafts.

The tympanic membrane (TM) is an exquisite structure that captures and transmits sound from the environment to the ossicular chain of the middle ear. The creation of TM grafts by multi-material three-dimensional (3D) printing may overcome limitations of current graft materials, e.g. temporalis muscle fascia, used for surgical reconstruction of the TM. TM graft scaffolds with either 8 or 16 circumferential and radial filament arrangements were fabricated by 3D printing of polydimethylsiloxane (PDMS), flex-polyactic acid (PLA) and polycaprolactone (PCL) materials followed by uniform infilling with a fibrin-collagen composite hydrogel. Digital opto-electronic holography (DOEH) and laser Doppler vibrometry (LDV) were used to measure acoustic properties including surface motions and velocity of TM grafts in response to sound. Mechanical properties were determined using dynamic mechanical analysis (DMA). Results were compared to fresh cadaveric human TMs and cadaveric temporalis fascia. Similar to the human TM, TM grafts exhibit simple surface motion patterns at lower frequencies (400 Hz), with a limited number of displacement maxima. At higher frequencies (>1000 Hz), their displacement patterns are highly organized with multiple areas of maximal displacement separated by regions of minimal displacement. By contrast, temporalis fascia exhibited asymmetric and less regular holographic patterns. Velocity across frequency sweeps (0.2-10 kHz) measured by LDV demonstrated consistent results for 3D printed grafts, while velocity for human fascia varied greatly between specimens. TM composite grafts of different scaffold print materials and varied filament count (8 or 16) displayed minimal, but measurable differences in DOEH and LDV at tested frequencies. TM graft mechanical load increased with higher filament count and is resilient over time, which differs from temporalis fascia, which loses over 70% of its load bearing properties during mechanical testing. This study demonstrates the design, fabrication and preliminary in vitro acoustic and mechanical evaluation of 3D printed TM grafts. Data illustrate the feasibility of creating TM grafts with acoustic properties that reflect sound induced motion patterns of the human TM; furthermore, 3D printed grafts have mechanical properties that demonstrate increased resistance to deformation compared to temporalis fascia.