Improving Restoration of Middle-Ear Function Following Blast Related Injuries

改善爆炸相关损伤后中耳功能的恢复

• 批准号: 10222612
• 负责人: Wei Dong
• 金额: --
• 依托单位: VA LOMA LINDA HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10222612
• 关键词: 3-Dimensional; Acoustics; Anatomic Models; Animal Model; Auricular prosthesis; Cadaver; Characteristics; Clinical; Clinical Treatment; Cochlea; Complex; Conductive hearing loss; Congenital Abnormality; Data; Development; Devices; Diagnosis; Dislocations; Ear; Ear Injury; Ear ossicles; Environment; Evaluation; Excision; Exhibits; Experimental Models; Failure; Frequencies; Gerbils; Glues; Goals; Hearing; Human; Incus; Individual; Injury; Intraoperative Monitoring; Investigation; Knowledge; Labyrinth; Lasers; Measurement; Measures; Methods; Military Personnel; Modeling; Monitor; Morphology; Motion; Movement; Noise; Operative Surgical Procedures; Outcome; Pathologic; Pathology; Patients; Pattern; Perforation; Preparation; Procedures; Process; Production; Prosthesis; Reconstructive Surgical Procedures; Research; Residual state; Role; Rupture; Services; Soldier; Stapes; Structure; Surgical Disarticulation; System; Temporal bone structure; Testing; Time; Tympanic Membrane Perforation; Tympanic membrane; Veterans; Work; base; bone; clinical Diagnosis; design; experience; flexibility; healing; hearing impairment; hearing restoration; improved; manubrium; middle ear; normal hearing; operation; otoacoustic emission; physical property; pressure; pressure sensor; reconstruction; repaired; restoration; sample fixation; sensor; sound; success; tool; transmission process; tumor; vibration

Project Summary/Abstract Conductive hearing loss in military personnel is commonly caused by blast-related middle ear injuries, which can include tympanic membrane rupture and dislocation of the middle-ear ossicles. The current proposal seeks to evaluate methods and devices for restoring hearing not only for active-duty military personnel and Veterans who suffer from a blast-induced conductive hearing loss, but also for others who experience conductive hearing loss for various reasons (e.g., ruptured eardrum, birth defects, stiffening of middle ear bones). While these injuries are clinically treatable, the effects of middle-ear pathology on hearing are not well quantified, and clinical outcomes often fail to completely restore normal hearing for those suffering from a conductive hearing loss. The current proposal seeks to precisely measure the complex vibrational patterns along the ossicular chain and related pressures at the ends of the middle ear system; the umbo attached to the tympanic membrane and stapes attached to the cochlea, under both normal and particularly under various pathological conditions (damaged/repaired/reconstructed using prosthesis). These studies will use Laser Doppler Vibrometry, unique micro-pressure sensors and direct measures of otoacoustic emissions (OAEs). Aim 1 will evaluate the effects of systematically varied tympanic membrane perforations on middle ear sound transmission in an animal model. The role of the tympanic membrane in sound transmission will be explored and its influence on the motion of the ossicles will be characterized under varied perforation and naturally healed conditions. Measurement of distortion product otoacoustic emissions (DPOAEs) following stimulation with paired tones will be used to quantify the effect of varying degrees of damage to the tympanic membrane. In Aim 2 we will measure sound transmission in an animal model with simulated ossicular chain pathologies. In addition, the effect of an abnormal ossicular chain on the production and acoustic characteristics of DPOAEs will be systematically explored in order to develop quantitative tools for diagnosing hearing loss and for use in the design and implementation of improved methods of treatment. Aim 3 evaluates middle ear sound transmission in human cadaver temporal bone models of clinically repaired human ears. Using direct pressure and velocity measurements, the functional differences between normal middle ear structures and two currently employed methods of repairing disarticulation of the middle ear ossicular chain, incus/stapes fixation or partial/total ossicular chain replacement using prostheses, will be quantified in detail. The proposed research will provide important information that will serve to improve our ability to specifically diagnose the causes of conductive hearing loss, direct the development of improved methods of treatment, and assist in the rational design of advanced prosthetics that more effectively restore hearing.

项目摘要/摘要 军事人员的导电听力损失通常是由爆炸相关的中耳受伤引起的 可以包括鼓膜膜破裂和中骨的脱位。当前的提议寻求 评估方法和设备，不仅为现役军人和退伍军人恢复听证会 他们患有爆炸引起的导电性听力损失，也遭受经历导电的其他人 听力损失是由于各种原因（例如，耳膜破裂，出生缺陷，中耳骨骼的僵硬）。尽管 这些伤害在临床上是可治疗的，中等病理学对听力的影响尚未得到很好的量化，并且 临床结果通常无法完全恢复患有导电听力的人的正常听力 损失。当前的提案旨在精确测量沿骨的复杂振动模式 中耳系统末端的链和相关压力； umbo附着在鼓膜上 膜和连接到耳蜗的肌肉，在正常情况下，尤其是在各种病理下 条件（使用假体损坏/修复/重建）。这些研究将使用激光多普勒 振动法，独特的微压传感器和耳声发射的直接测量（OAE）。目标1意志 评估系统多样化的鼓膜膜穿孔对中耳声音的影响 动物模型中的传播。鼓膜膜在声音传输中的作用将探讨 它对骨运动的影响将在各种穿孔下进行表征，并且自然而然 治愈条件。刺激后的失真产物耳声排放（DPOAE）的测量 使用配对的音调将用于量化对鼓膜膜的不同程度损害的影响。 在AIM 2中，我们将测量具有模拟骨链病理学的动物模型中的声音传播。在 此外，异常骨链对DPOAE的产生和声学特征的影响 将进行系统探索，以开发用于诊断听力损失和使用的定量工具 改进的治疗方法的设计和实施。 AIM 3评估中耳声音 临床修复的人耳的人尸体颞骨模型的传播。使用直接压力 和速度测量，正常中耳结构与当前两个的功能差异 使用中耳骨链，uncus/stapes固定或 使用假体的部分/总骨链替换将进行详细量化。拟议的研究 将提供重要信息，以提高我们专门诊断原因的能力 导电性听力损失，指导改进的治疗方法的发展，并协助合理 高级假肢的设计，可以更有效地恢复听力。