Eardrum function in live and cadaveric ears: Research and clinical relevance

摘要： 中耳疾病引起的慢性传导性听力损失可导致耳蜗神经病变。而我们的 中耳疾病的诊断和治疗不完善，部分原因是对中耳疾病的认识不全面 耳膜具有声音传输功能。关于鼓膜功能的多种自相矛盾的理论 在过去的150年里提出的。这些理论是建立在对 现有的鼓膜特征。几乎所有以前测量的鼓膜对声音的反应都是 使用稳定的音调刺激，而环境声音，如音乐、噪音和语音，是短暂的 在自然界中。人们对现实世界中的鼓膜瞬变反应知之甚少。不完整的知识 鼓膜也限制了我们对如何修复患病耳朵的看法。我们在这项研究中的第一个目标是 区分这些不同的鼓膜功能理论的证据。我们的第二个目标是提高 我们对耳膜对瞬变声音的反应的知识。我们的第三个目标是探索其临床应用。 鼓膜瞬变反应测定在中耳疾病鉴别诊断中的应用至 为了实现这些目标，我们在本研究中提出了三个目标。AIM 1采用了最先进的高速 我们实验室研制的全息干涉测量系统(HSHIS)用于定量测量鼓膜瞬变 对声音和机械瞬变刺激的响应，在非常高的空间(&gt；100,000点)和时间上 (&gt；每秒100k帧)分辨率。“实验模态分析”将被应用于提取三个重要的 然而，鼓膜的特征很难量化：(1)自然频率；(2)大小和空间 振型响应模式；(3)减振。目标1的结果将使我们能够理解和描述鼓膜 以前所未有的复杂程度发挥作用，并解决鼓膜相互矛盾的理论 功能。目标2将量化模拟中耳的身体耳的鼓膜瞬变反应 疾病。Aim 2的结果将评估病理性耳朵的鼓膜功能，并评估我们的 技术作为中耳疾病鉴别诊断的客观工具。目标3将研究鼓膜 在正常和疾病的中耳条件下，如渗出性中耳炎，活体龙猫耳朵的功能。 在文献中几乎没有关于活体鼓膜表面运动的详细报道，在Aim 3中的结果将填充 在那个空隙里。安乐死后立即重复测量，以直接量化任何死亡后的变化 在鼓膜功能方面。这一目标也是一项初步研究，以评估我们的系统在过去的临床应用 在病人身上进行临床试验。

ABSTRACT: Chronic conductive hearing loss due to middle-ear diseases can lead to cochlear neuropathy. While our diagnosis and management of middle-ear diseases are not perfect, in part due to incomplete knowledge of the eardrum function for sound transmission. Multiple contradictory theories of eardrum function have been proposed in the past 150 years. These theories are based on incomplete descriptions and misinterpretation of existing eardrum characterizations. Almost all previous measurements of the eardrum response to sound have used steady-state tonal stimuli, while environmental sounds, such as music, noises and speech, are transient in nature. Little is known about the eardrum transient response in the real world. Incomplete knowledge of the eardrum also limits our views on how to repair the diseased ear. Our first goal in this study is to provide evidence to distinguish between these different theories of the eardrum function. Our second goal is to improve our knowledge of the eardrum response to transient sound. Our third goal is to explore clinical application of the measurement of the eardrum transient response for differential diagnosis of middle-ear diseases. To achieve these goals, we propose three aims in this study. Aim 1 employs a state-of-the-art High Speed Holographic Interferometry System (HSHIS) developed in our laboratory to quantify the eardrum transient responses to acoustic and mechanical transient stimuli, at a very high spatial (>100,000 points) and temporal (>100k frames per second) resolution. ‘Experimental modal analysis’ will be applied to extract three important yet poorly quantified characteristics of the eardrum: (1) natural frequencies; (2) the magnitude and spatial pattern of modal responses; (3) damping. Results in aim 1 will enable us to understand and describe eardrum function with a level of sophistication that has not been available, and resolve contradictory theories of eardrum function. Aim 2 will quantify the eardrum transient response in cadaveric human ears with simulated middle-ear diseases. Results in aim 2 will evaluate eardrum function in pathological ears, and assess the use of our techniques as an objective tool for differential diagnosis of middle-ear diseases. Aim 3 will study the eardrum function in live chinchilla ears in normal and diseased middle ear conditions, such as Otitis Media with Effusion. Very little detailed surface motion of the live eardrum has been reported in the literature, results in aim 3 will fill in that gap. Measurements will be repeated just after euthanasia to directly quantify any post-mortem changes in eardrum function. This aim also serves as a pilot study to evaluate the clinical utility of our system before clinical trials in patients.