Middle-ear Mechanics in Normal and Pathological Ears

描述（由申请人提供）：我们工作的目标是了解正常、患病和重建中耳中的声音传输，以便为中耳疾病患者开发更好的诊断测试和手术程序。中耳疾病，如慢性中耳炎和耳硬化症，在美国影响超过3000万人，是严重传导性听力损失的常见原因，严重程度高达60 dB。30-60 dB的听力损失对患者的生活和沟通能力有显著的不利影响。中耳声音传输的许多方面还没有很好地理解。此外，某些类型的中耳手术后的听力结果（特别是对于 慢性中耳炎）通常是不令人满意的，因为对于良好的听力结果很重要的结构因素并不那么清楚。在过去的10年里，我们利用了一种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振动测量法进行体内测量，在尸体人颞骨中进行体外测量，以及基于物理学的定量建模。我们的工作a）深入了解了由影响中耳和内耳的各种病理引起的传导性听力损失的机制，B）产生了新的诊断概念，以及c）提供了具体的手术建议，以优化某些类型的术后听力结果中耳手术程序。在接下来的五年里，我们的目标是利用这些方法，并使用新的工具，如外耳声反射和鼓膜运动的激光全息照相，以便：a）研究正常耳和病理耳中耳道反射率和脐速度之间的相关性，B）定义决定听骨重建后充气耳的术后听力结果的关键结构特征，和c）研究使用新型植入物来改善非充气耳朵的术后听力结果。我们预计，我们的工作将导致更好地了解正常和病理中耳的结构-功能关系，提高传导性听力损失的鉴别诊断，优化手术技术和听力结果。 公共卫生相关性：中耳疾病，如慢性中耳炎和耳硬化症，在美国影响超过3000万人，通常导致显著的听力损失。 传导性听力损失，干扰沟通能力。我们研究的目的是了解正常和患病中耳的声音传输，并为中耳疾病患者开发更好的诊断测试和手术程序。

DESCRIPTION (provided by applicant): 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 and otosclerosis, which affect over 30 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. Many aspects of middle ear sound transmission are not well understood. Additionally, hearing results after certain types of middle-ear surgical procedures (especially for chronic otitis media) are often unsatisfactory, because the structural factors that are important for good hearing results are not all that clear. Over the past 10 years, we have utilized a unique and powerful combination of methods to study middle-ear mechanics including in-vivo measurements using laser Doppler vibrometry, in-vitro measurements in cadaveric human temporal bones, and physics-based, quantitative modeling. Our work has a) provided insight into mechanisms of conductive hearing loss caused by a variety of pathologies affecting the middle- and inner- ears, b) resulted in new diagnostic concepts, and c) provided specific surgical recommendations to optimize postoperative hearing results in certain types of middle-ear surgical procedures. Over the next five years, we aim to exploit these methods and use new tools such as external-ear acoustic reflectance and laser holography of motion of the tympanic membrane in order to: a) investigate correlations between ear canal reflectance and umbo velocity in normal and pathologic ears, b) define critical structural features that determine postoperative hearing results in aerated ears after ossicular reconstructions, and c) investigate use of a novel implant to improve post-surgical hearing results in non-aerated ears. We anticipate that our work will lead to better understanding of structure-function relationships in normal and pathological middle ears, improved differential diagnosis of conductive hearing loss, and optimization of surgical techniques and hearing results. PUBLIC HEALTH RELEVANCE: Middle ear diseases such as chronic otitis media and otosclerosis, which affect over 30 million people in the United States, often result in significant conductive hearing loss that interferes with the ability to communicate. The goal of our research is to understand sound transmission in normal and diseased middle ears, and to develop better diagnostic tests and surgical procedures for patients with middle-ear disease.