Effects of ossicular prosthesis mass and section of the stapes tendon on middle far transmission
Effects of ossicular prosthesis mass and section of the stapes tendon on middle far transmission
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DOI：
10.2310/7070.2007.0008
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发表时间：
2007-04-01
期刊：
影响因子：
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通讯作者：
Van Wijhe, Rene
中科院分区：
文献类型：
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作者：
Bance, Manohar;Morris, David P.;Van Wijhe, Rene
背景：改变假体质量对中耳传播的影响尚未有系统的研究。两者都没有镫骨肌腱切开的效果。这些都是可以通过手术改变的重要参数。假设：由于中耳以低频顺应性为主，假体质量会影响中耳高频的传输。方法：取8块新鲜颞骨，去除砧骨，从鼓膜向镫骨头植入假体。采用激光多普勒振动仪测量镫骨底板振动。在耳道内以90db SPL测量250至8 kHz的啁啾响应的振动。卸下的假体质量约为16 mg。将质量约为2、12和30毫克的载荷放在阀杆上。切断镫骨肌腱后重复记录。结果：质量载荷仅影响较高频率，仅在4 kHz以上有显著影响。低频效应很小。镫骨肌腱切片在低频上有所改善，但无统计学意义。结论：假体质量主要影响高频。使用较低质量的假体不会降低较低频率，因此较轻质量的假体可能是首选。镫骨肌腱切断术对听骨成形术后的中耳传播无不利影响。
Background: The effects of changing prosthesis mass on middle ear transmission have not been previously systematically studied. Neither has the effect of stapes tendon sectioning. These are important parameters that can be surgically varied.Hypothesis: Because the middle ear is compliance dominated at low frequencies, prosthesis mass will affect transmission of higher frequencies in the middle ear.Methods: Eight fresh cadaveric temporal bones, with the incus removed, were loaded with a replacement prosthesis from the tympanic membrane to the stapes head. Laser Doppler vibrometry was used to measure stapes footplate vibrations. Vibrations were measured in response to chirps from 250 to 8 kHz at 90 dB SPL in the ear canal. The unloaded prosthesis mass was approximately 16 mg. Loadings with masses of approximately 2,12, and 30 mg were placed on the stem. Recordings were repeated after cutting the stapes tendon.Results: Mass loading affected the higher frequencies only, with significant effects only above 4 kHz. There was little low-frequency effect. Stapes tendon section showed an improvement in the lower frequencies but did not reach statistical significance.Conclusions: Mass of prostheses affects mainly higher frequencies. There is no drop in lower frequencies from using lower masses, so lighter-mass prostheses may be preferred. Stapes tendon section does not have a detrimental effect on middle ear transmission after ossiculoplasty.