Development of a laser holography otoscope for diagnosis in the clinic

传导性听力损失，通常与中耳疾病有关，是耳科手术最常见的原因。传导性丧失的发病机制包括急性中耳感染、慢性中耳感染、听骨链疾病（例如耳硬化症）、头部或耳部创伤以及内耳的病理性第三窗。传导性听力损失的手术治疗范围从简单的（鼓膜切开术和鼓膜造口管插入）到复杂的（乳突切除术后中耳的完全重建）。虽然急性感染和中耳积液在耳科检查中相对容易诊断，但在完整的鼓膜（TM）和干燥的中耳中传导损失的原因不容易确定。此外，虽然鼓室成形术是慢性中耳疾病后的常见手术（我们机构每年进行500多例此类手术），但这些手术后的听力结果差异很大。我们的基本假设是：（a）完整TM的传导性听力障碍的术前诊断和（B）听骨和TM重建手术失败原因的评估可以通过测量TM的声音诱导运动来改善。这一假设是支持我们的分析全视场全息测量的声音引起的TM运动在动物和颞骨。这些测量结果是使用目前在MEEI用作研究工具的原型全息系统收集的。该建议将有助于将现有的全息平台转化为紧凑的全息设备，用于测量活体患者中可见TM的运动。新设备将被设计用于临床环境，并将通过伍斯特理工学院机械工程系的光学测量专家和马萨诸塞州眼耳医院的听觉科学家和临床医生之间的合作企业进行开发。

Conductive hearing loss, usually associated with middle-ear disorders, is the most common reason for otologic surgery. The pathogenesis of conductive loss includes, among others, acute middle-ear infection, chronic middle-ear infection, diseases of the ossicular chain (e.g. otosclerosis), trauma to the head or ear and pathologic third-windows of the inner ear. Surgical treatments for conductive hearing loss range from the simple (myringotomy and tympanostomy tube insertion) to the complex (total reconstruction of the middle ear after mastoidectomy). While acute infections and middle-ear effusion are relatively easily diagnosed on otologic examination, the cause of conductive loss with an intact tympanic membrane (TM) and dry middle ear is not easily determined. Furthermore, while tympanoplasty is a common procedure after chronic middle-ear disease (with over 500 such procedures performed in our institution each year), the hearing outcome after these procedures is highly variable. Our fundamental hypothesis is that both (a) the pre-surgical diagnosis of conductive-hearing disorders with intact TM and (b) the evaluation of causes of surgical failure in ossicular and TM reconstructions can be improved by measurements of the sound-induced motions of the TM. This hypothesis is supported by our analyses of full-field-of-view holographic measurements of sound-induced TM motions in animals and temporal bones. These measurements were gathered using a prototype holographic system that is currently used as a research tool at the MEEI. This proposal will aid in the translation of the available holographic platform into a compact holographic device for measurements of the motions of the visible TM in live patients. The new device will be designed for use in a clinical environment and it will be developed via a cooperative venture between the optical measurement experts within the Mechanical Engineering Department of the Worcester Polytechnic Institute and auditory scientists and clinicians at the Massachusetts Eye and Ear Infirmary.