ACOUSTICAL ASPECTS OF MIDDLE EAR RECONSTRUCTIVE SURGERY

描述：慢性中耳炎（COM）是一种常见的慢性炎症， 影响中耳和乳突的疾病，可能导致 传导性听力损失高达60 dB。 COM的主要治疗方法是 外科手术，包括鼓室成形术和乳突切除术， 每年在美国进行超过70，000例手术。 手术后的听力结果往往是 不满意，尤其是当听骨链患病或当 中耳腔仍然通气不良。 这项研究的长期目标是发展声学 原则，可用于耳科医生，以改善和优化 鼓室成形术和乳突切除术后的听力结果。 的PI 提出将身体功能的联合收割机测量（例如，声压， 听骨运动、声阻抗）在经骨修饰的人体中的变化 颞骨制备及结构-功能测量 重建耳朵的关系，然后可以由耳科医生使用， 合理修改现有的重建技术或设计新的 技术. 这种方法对于PI在表征类型方面工作得很好 IV鼓室成形术，并导致了几个简单但具体的手术 优化术后听力效果的建议。 所提出的实验旨在研究以下问题 具体问题：（1）确定中耳空气大小的影响 鼓室成形术后听力效果的影响;（2） 用于改善鼓室成形术后听力的新型中耳植入物 导致不通气耳;（3）确定临界结构 听骨假体的特征决定了听力结果， 鼓室成形术;（4）评价共鸣在鼓室成形术中的作用 在耳道壁下乳突切除术腔中测定听力 结果

DESCRIPTION: Chronic otitis media (COM) is a common, chronic inflammatory condition affecting the middle ear and mastoid that can result in a conductive hearing loss of up to 60 dB. The main treatment for COM is surgical, consisting of tympanoplasty and mastoidectomy operations, with over 70,000 operations performed annually in the United States. Post-operative hearing results after such procedures are often unsatisfactory, especially when the ossicular chain is diseased or when the middle ear space remains poorly aerated. The long-term goal of this research proposal is to develop acoustical principles that can be used by otologists to improve and optimize the hearing results after tympanoplasty and mastoidectomy procedures. The PI proposes to combine measurements of physical function (e.g., sound pressure, ossicular motion, acoustic impedance) in a surgically-modified human temporal bone preparation with anatomical measurements of structure-function relationships of a reconstructed ear which can then be used by otologists to rationally modify current reconstructive techniques or to devise new techniques. This approach has worked well for the PI in characterizing type IV tympanoplasty, and has resulted in several simple but specific surgical recommendations to optimize post-operative hearing results. The proposed experiments have been designed to investigate the following specific issues: (1) To determine the effects of size of middle-ear air space on hearing results after tympanoplasty reconstruction; (2) To develop new types of middle-ear implants for improving post-tympanoplasty hearing results in non-aerated ears; (3) To define the critical structural characteristics of ossicular prostheses that determine hearing results after tympanoplasty reconstruction; and (4) To evaluate the role of resonance within canal-wall down mastoidectomy cavities in determining hearing results.