Ossicle vibration measurements in conductive hearing loss

描述(由申请人提供)：该方案开发了一种手持耳镜，它使用光学相干断层扫描(OCT)来成像完整鼓膜后面的鼓膜和听骨。该系统基于频谱傅里叶域OCT，可以测量中耳听小骨(锤骨、砧骨、砧骨)在纳米到？m幅度范围内的振动。在目标1中，我们构建并开发了一个耳镜样机，利用已知振动的体模对象来测试硬件和中耳分析软件的性能。在目标2中，我们使用原型耳镜研究人的颞骨标本，通过实验性的听小骨固定和脱节来研究听骨链‘紊乱’。AIM 3在招募的中耳功能正常或病理的受试者中进行了试点临床使用，按常规方法进行评估。这种新型耳镜将极大地提高传导性听力损失的无创性诊断。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骨的运动，或者在外科手术切断鼓膜以接触听小骨后进行直接检查。OCT耳镜可以无创地直接成像和测量振动，而不需要切断鼓膜。该项目将产生一种创新的非侵入性诊断仪器，能够定位完整鼓膜后面的传导性听力损失部位。OCT耳镜将有助于更好地了解正常、疾病和再造中耳的声传导，使临床医生能够做出更准确的术前诊断，更多地分析手术后的结果，最终为传导性听力损失患者开发更有效的治疗方法。

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.