Middle-ear Mechanics in Normal and Pathological Ears

我们的工作目标是了解声音在正常、病变和再造中耳中的传播。 从而为中耳疾病患者开发更好的诊断测试和手术程序。中位 耳部疾病，如慢性中耳炎(COM)，在美国影响着1000多万人，是 严重传导性听力损失的常见原因，其严重程度高达60分贝。听力损失 30-60分贝对患者的生活和沟通能力有明显的不良影响。它是 耳科医生承认鼓室成形术后的听力结果 网站往往不能令人满意。导致手术失败的因素包括缺乏明确的 对再造耳结构-功能关系的理解和当前诊断的失败 测试(耳镜、测听、鼓室导纳)以确定这种关系。 在过去的五年里，我们利用独特而强大的方法组合来研究 中耳力学，包括使用激光多普勒测振仪的在体测量 身体人类颞骨的测量，以及基于物理的定量建模。我们的工作已经完成 A)导致采用激光测振法进行新的测试，以改进术前鉴别诊断 鼓膜完整的患者中的听骨病变，以及b)提供特定的外科手术 优化某些类型中耳外科手术的术后听力效果的建议 (例如：III型鼓室成形术、腓骨切除术)。 在接下来的五年里，我们的目标是进一步开发和利用这些方法在a)正常耳朵，b) 鼓膜穿孔和上鼓管裂开的病耳，以及c)有 对COM行听骨膜或鼓膜重建术。我们还将在体外进行 一种新的手持式探头用于客观、术中诊断听小骨固定的评价。 我们预计，我们的工作将有助于更好地理解正常结构与功能之间的关系 和病理中耳，改进了传导性听力损失的鉴别诊断，更好地进行了术前检查 患者咨询和手术计划，减少手术失败的数量和优化手术 手术技巧和听力结果。

The goal of our work is to understand sound transmission in normal, diseased and reconstructed middle ears so as to develop better diagnostic tests and surgical procedures for patients with middle-ear disease. Middle ear diseases, such as chronic otitis media (COM), which affect over 10 million people in the U.S., are common causes of significant conductive hearing loss that range in severity up to 60 dB. Hearing losses of 30-60 dB have significant adverse effects on patients' lives and their ability to communicate. It is acknowledged by otologic surgeons that postoperative hearing results after tympanoplasty procedures for COM are often unsatisfactory. Factors contributingto failures after surgical procedures include lack of clear understanding of structure-function relationshipsin the reconstructed ear and failure of current diagnostic tests (otoscopy,audiometry, tympanometry) to identify such relationships. Over the past five years, we have utilized a unique and powerful combination of methods to study middle-ear mechanics including in-vlvo measurements using laser Doppler vibrometry, In-vltro measurements in cadaveric human temporal bones, and physics-based, quantitativemodeling. Our work has a) resulted in new tests employing laser vibrometry for improved preoperative differential diagnosis of ossicular lesions in patients with an intact tympanic membrane, and b) provided specific surgical recommendations to optimize postoperative hearing results in certain types of middle-ear surgical procedures (examples: type III tympanoplasty, stapedectomy). Over the next five years, we aim to develop and exploit these methods further in a) normal ears, b) diseased ears with tympanic membrane perforations and superior canal dehiscence, and c) ears that have undergone ossicular or tympanic membrane reconstructions for COM. We will also perform in-vitro evaluation of a novel, hand-held probe for objective, intra-operativediagnosis of ossicular fixation. We anticipate that our work will lead to better understandingof structure-function relationships in normal and pathological middle ears, improved differential diagnosis of conductive hearing loss, better preoperative patient counseling and surgical planning, reduction in the number of failed surgeries and optimization of surgical techniques and hearing results.