Ossicle vibration measurements in conductive hearing loss

描述（由申请人提供）：该提案开发了一种手持式耳镜，该耳镜使用光学相干断层扫描（OCT）对完整鼓膜后的鼓膜和小骨进行成像。该系统基于频谱傅里叶域OCT，可以测量中耳听骨（锤骨、砧骨、镫骨）在nm到¿m振幅范围内的振动。在目标1中，我们构建并开发了一个耳镜原型，使用具有已知振动的幻影物体测试硬件和中耳分析软件的性能。在目的2中，我们使用原型耳镜研究人类颞骨标本，通过实验听骨固定和脱节来研究听骨链“紊乱”。Aim 3是一项试点临床应用，招募中耳功能正常或病理的人类受试者，通过传统方法进行评估。这种新型耳镜将大大提高传导性听力损失的无创诊断。目前的做法依赖于通过测量鼓膜对声音或压力的顺应性来间接评估听小骨的运动，或者在手术切开鼓膜以进入听小骨后直接检查。OCT耳镜可以无创地直接成像和测量振动，而无需切割鼓膜。该项目将产生一种创新的、非侵入性的诊断仪器，能够定位完整鼓膜后传导性听力损失的位置。OCT耳镜将有助于更好地了解正常、病变和重建中耳的声音传导，使临床医生能够做出更精确的术前诊断，分析更有信息的术后结果，并最终为传导性听力损失患者制定更有效的治疗方法。

DESCRIPTION (provided by applicant): The proposal develops a hand-held otoscope that uses optical coherence tomography (OCT) to image the tympanic membrane and ossicles behind an intact tympanic membrane. The system is based on spectral Fourier-domain OCT and can measure vibrations of the ossicles (malleus, incus, stapes) of the middle ear on the scale of nm to ¿m amplitude. In Aim 1 we construct and develop a protype of the otoscope testing the performance of the hardware and middle ear analysis software using phantom objects with known vibration. In Aim 2 we use the prototype otoscope to study human temporal bone specimens to investigate ossicular chain 'disorders' by experimental ossicle fixations and disarticulations. Aim 3 is a pilot clinical use in recruited human subjects with normal or pathological middle ear function as assessed by conventional methods. This new otoscope will greatly improve the non-invasive diagnosis of conductive hearing loss. Current practice relies on either indirect assessment of ossicle movement by measuring compliance of the tympanic membrane to sound or pressure, or direct examination after surgically cutting the tympanic membrane to gain access to the ossicles. The OCT otoscope can directly image and measure vibrations noninvasively, without cutting the tympanic membrane. The project will yield an innovative, non-invasive diagnostic instrument capable of localizing the site of conductive hearing loss behind an intact tympanic membrane. The OCT otoscope will facilitate a better understanding of sound conduction in normal, diseased and reconstructed middle ears, allowing clinicians to make more precise pre-surgical diagnosis, to analyze more informatively post-surgical results, and ultimately to develop more effective treatments for patients with conductive hearing loss.