Middle-ear Mechanics in Normal and Pathological Ears

描述(申请人提供)：我们的工作目标是了解正常中耳、病变中耳和再造中耳的声音传播，以便为中耳疾病患者开发更好的诊断测试和手术方法。中耳疾病，如慢性中耳炎和耳硬化症，在美国影响着3000多万人，是严重的传导性听力损失的常见原因，严重程度高达60分贝。听力损失30-60分贝会严重影响患者的生活和沟通能力。中耳声音传递的许多方面还没有被很好地理解。此外，某些类型的中耳外科手术后的听力结果(特别是 慢性中耳炎)往往不能令人满意，因为对良好听力效果很重要的结构性因素并不是那么清楚。在过去的10年里，我们使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测振仪的体内测量，人体身体颞骨的体外测量，以及基于物理的定量建模。我们的工作提供了对各种影响中耳和内耳的病理导致的传导性听力损失的机制的洞察，b)导致了新的诊断概念，以及c)提供了具体的手术建议，以优化某些类型的中耳外科手术的术后听力结果。在接下来的五年里，我们的目标是开发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成像，以：a)研究正常和病理耳的耳道反射和Umbo速度之间的相关性，b)确定决定听骨重建后充气耳听力的关键结构特征，以及c)研究使用一种新型植入物来改善非充气耳手术后的听力结果。我们预计，我们的工作将有助于更好地了解正常中耳和病理性中耳的结构-功能关系，改进传导性听力损失的鉴别诊断，并优化手术技术和听力结果。

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.