Mechanisms of Conductive Presbycusis in Humans

人类传导性老年性耳聋的机制

• 批准号: 10595084
• 负责人: AARON KYLE REMENSCHNEIDER
• 金额: $ 19.01万
• 依托单位: MASSACHUSETTS EYE AND EAR INFIRMARY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10595084
• 关键词: Acceleration; Acoustics; Affect; Age; Aging; Air; Behavioral; Biological Assay; Bone Conduction; Cadaver; Clinical; Conductive hearing loss; Development; Diagnosis; Ensure; Etiology; Frequencies; Functional disorder; Goals; Hearing; Hearing Tests; Hearing problem; High-Frequency Hearing Loss; Human; Impairment; Individual; Investigation; Joints; Knowledge; Lasers; Lesion; Life; Light; Measurement; Mechanics; Methods; Operative Surgical Procedures; Otologic Surgical Procedures; Output; Pathology; Patients; Population; Postoperative Period; Presbycusis; Prevalence; Research; Risk; Role; Secondary to; Social isolation; Sound Localization; Source; Speech; Speech Sound; Stimulus; Temporal bone structure; Testing; Transducers; United States; Work; accurate diagnostics; age effect; age related; bone; clinically relevant; cost; experience; hearing impairment; ineffective therapies; interest; middle ear; novel; novel therapeutics; patient subsets; repaired; research clinical testing; simulation; sound; sound frequency; source localization; targeted treatment; transmission process; trend

Mechanisms of Conductive Presbycusis In Humans Age-related high frequency hearing loss (presbycusis) is a near universally experienced condition, affecting tens of millions of individuals in the United States alone and costing worldwide more than $750 billion per year. Presbycusis results in difficulty understanding speech, problems hearing environmental sounds and, if unaddressed, can lead to social isolation. Given current demographic trends, the societal burden of presbycusis is expected to accelerate. Despite the prevalence of presbycusis, much remains unknown about its etiologic mechanisms. Presbycusis has long been assumed to be secondary to sensorineural dysfunction, but emerging evidence suggests conductive pathology contributes to presbycusis. The principal method for clinical evaluation of hearing is behavioral pure tone (500-8kHz) audiometry. Extended high frequency air conduction testing (>8kHz) is now commonly performed given new knowledge on the role of high frequency sound for speech understanding and sound localization. Unfortunately, clinical bone conduction testing stops at 4kHz. Above 4kHz, limitations in standard stimulus transducers that are largely unchanged from the 1950s, and a lack of normative bone conduction standards limit study of high frequency conductive loss. Differentiation between sensorineural and conductive presbycusis is not routinely performed, but is of interest because: 1) prior work demonstrates discrete changes within the middle ear can lead to isolated high frequency conductive loss (ie: with normal low-frequency thresholds) and 2) our ability to surgically repair the middle ear. Further investigation into the prevalence and functional significance of age- related middle ear change is necessary to ensure emerging therapies for presbycusis are appropriately directed. Newly developed bone conduction transducers without high frequency limitations permit comprehensive bone conduction testing at frequencies up to 16kHz. Novel transducers will help to finally establish whether a clinically relevant conductive or mixed presbycusis exists, shedding light on the functional effects of the aging middle ear. Development of reliable testing for high frequency conductive hearing loss carries implications beyond presbycusis, including post-middle-ear-surgery hearing assessment. Our goal is to identify mechanisms of conductive presbycusis and to establish methods to reliably diagnose high frequency conductive hearing loss. We hypothesize that a subset of patients with presbycusis have increased ossicular compliance resulting in conductive or mixed high frequency hearing loss.

人类导电长期的机制 与年龄相关的高频听力损失（Persbycusis）是一种几乎普遍经验的状况，影响 仅在美国，就有数千万个人，每年耗资超过7500亿美元。 长期cusis会导致难以理解语音，听到环境声音的问题以及，如果 未解决，可能导致社会隔离。考虑到当前的人口趋势，社会负担 预期会加速。尽管长老会流行，但仍未清楚 它的病因机制。长期长期以来一直认为是继发于感觉神经功能障碍的继发性， 但是新出现的证据表明，导电病理学有助于长期。 听力临床评估的主要方法是行为纯音（500-8kHz）听力测定法。 现在，鉴于有关新知识 高频声音在语音理解和声音本地化方面的作用。不幸的是，临床骨 传导测试停在4KHz。高于4KHz，标准刺激传感器的限制在很大程度上是 与1950年代不变，缺乏规范性的骨传导标准限制了高频的研究 导电损失。不常规执行感觉神经性和导电性老套之间的区分， 但很感兴趣，因为：1）先前的工作表明中耳内的离散变化可能会导致 孤立的高频导电损失（即：正常的低频阈值）和2）我们的能力 手术修复中耳。进一步研究年龄的患病率和功能意义 相关的中耳变化对于确保长期的新兴疗法是必要的 指导。 新开发的没有高频限制的骨传感器允许全面骨头 高达16kHz的传导测试。新颖的传感器将有助于最终确定 存在临床上相关的导电或混合长期的，阐明了衰老的功能效应 中耳。开发高频导电听力损失的可靠测试带来了影响 除长老会外，包括中射后手术的听力评估。我们的目标是确定 导电长期的机制，并建立可靠诊断高频的方法 导电听力损失。我们假设一部分长老会增加了骨骼 合规性导致导电或混合高频听力损失。