Hyperacusis Caused by Mechanical Abnormalities in the Ear

项目总结： 与神经感觉性听觉过敏相比，更多的患者患有传导性听力障碍。 由于耳朵的机械异常而导致的听觉过敏 声音/振动通过他们的身体传播。传导性症状 听力亢进的特征是自我感觉增加，甚至扭曲。 产生的或某些外部声音，包括自己的声音(自鸣音)，脉动的 血流、脚步、关节运动、眼睛运动和机械振动 从车辆上。这些症状在患有病理性疾病的患者中很常见。 第三窗病变，如上椎管裂开，其中开口发生在 包裹内耳的骨头。传导性听力亢进，由于脑干听觉功能异常 被动机械系统，可能是可以治疗的。最新的外科治疗 改变内耳周围结构力学的听觉过敏症显示 结果好坏参半，一些患者术后症状更严重。虽然 这些在患者身上进行的“实验性”手术治疗正在增加，其机制是 传导性听力亢进还不是很清楚，针对这一点的科学研究 问题是缺乏。 拟议的研究计划的目标是了解机械如何在 新鲜的身体耳朵，具有与活耳相似的机械结构，可以增加耳蜗量 推动(对听力的估计)，如听觉过敏症。我们的新式耳内压 当我们操纵机械装置时，测量技术将监测耳蜗驱动 在中耳和内耳。我们的目标是：1)测量上根管裂开的影响 和在骨传导刺激时耳蜗肌的接近裂开；2)确定 中耳听小骨在听觉过敏症中的作用；3)阐明听觉过敏症的机制。 使用有限元模型的传导性听觉过敏症。这项研究将增加我们的 对机械性病理引起的听力亢进的理解。这样的知识 将为开发有效的治疗方法提供必要的科学基础 为一种正在使数百万人虚弱的疾病制定计划。

Project Summary: Compared to neurosensory hyperacusis, many more patients suffer from conductive hyperacusis due to mechanical abnormalities of the ear that result in hypersensitivity to sound/vibration transmitted through their bodies. The symptoms of conductive hyperacusis are characterized by an increased and even distorted sensation of self- generated or certain external sounds, including one's own voice (autophony), pulsatile blood flow, footsteps, joint movements, eye movements, and machinery vibrations as from vehicles. These symptoms are common among patients who suffer pathological third-window lesions such as superior canal dehiscence, where an opening occurs in the bone encapsulating the inner ear. Conductive hyperacusis, due to abnormalities in the passive mechanical system, may be treatable. Recent surgical treatments for hyperacusis that change the mechanics of structures surrounding the inner ear show mixed results with some patients experiencing worse symptoms after surgery. Although these “experimental” surgical treatments in patients are increasing, the mechanisms of conductive hyperacusis are not well understood, and scientific research targeting this problem is lacking. The goal of the proposed research plan is to understand how mechanical changes in fresh cadaveric ears, with similar mechanics to the living ear, can increase the cochlear drive (an estimate of hearing) as in hyperacusis. Our novel intracochlear pressure measurement technique will monitor the cochlear drive as we manipulate the mechanics in the middle and inner ear. We aim to: 1) measure effects of superior canal dehiscence and near-dehiscence on cochlear drive during bone conduction stimulation; 2) determine the contribution of middle-ear ossicles to hyperacusis; and 3) elucidate mechanisms of conductive hyperacusis using a finite-element model. This study will increase our understanding of hyperacusis resulting from mechanical pathologies. Such knowledge will provide the scientific foundation necessary for the development of effective treatment plans for a disease that is debilitating for millions of people.