Improving Restoration of Middle-Ear Function Following Blast Related Injuries

项目摘要/摘要 军事人员传导性听力损失通常是由爆炸相关的中耳损伤引起的， 可包括鼓膜破裂和中耳听小骨脱位。目前的提案旨在 评估不仅适用于现役军人和退伍军人的听力恢复方法和装置 患有爆炸性传导性听力损失的人，但也有其他经历传导性听力损失的人 由于各种原因造成的听力损失(例如，鼓膜破裂、出生缺陷、中耳骨僵硬)。而当 这些损伤在临床上是可以治疗的，中耳病理对听力的影响没有很好的量化，以及 对于患有传导性听力的患者，临床结果往往无法完全恢复正常听力 损失。目前的方案寻求精确测量沿听骨线的复杂振动模式。 中耳系统末端的链条和相关压力；Umbo附着在鼓膜上 附着膜和距骨，在正常情况下，尤其是在各种病理情况下 状况(损坏/修复/使用假肢重建)。这些研究将使用激光多普勒 振动测量、独特的微压传感器和耳声发射(OAES)的直接测量。目标1将 系统性不同鼓膜穿孔对中耳声的影响 动物模型中的传播。我们将探讨鼓膜在声音传播中的作用。 而它对听小骨运动的影响将表现为不同的穿孔和自然的 痊愈的情况。刺激后失真产物耳声发射(DPOAE)的测量 配对的音调将被用来量化不同程度的鼓膜损伤的影响。 在目标2中，我们将在一个模拟听骨链病理的动物模型中测量声音传输。在……里面 另外，听骨链异常对DPOAEs的产生和声学特性的影响 将进行系统的探索，以开发诊断听力损失的量化工具，并用于 改进治疗方法的设计和实施。Aim 3评估中耳声音 临床修复的人耳在身体颞骨模型中的传播。使用直接加压 和速度测量，正常中耳结构和目前两种结构之间的功能差异 采用的方法修复中耳听骨链脱位、砧骨固定或 使用假体的部分/全部听骨链置换术将被详细量化。拟议的研究 将提供重要信息，有助于提高我们具体诊断疾病原因的能力 传导性听力损失，指导改进治疗方法的发展，并协助合理 设计先进的假体，更有效地恢复听力。

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.