Middle-ear Mechanics in Normal and Pathological Ears

描述（由申请人提供）：我们的工作目标是了解正常、病变和重建中耳的声音传输，以便为中耳疾病患者制定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，影响着美国超过3000万人，是导致严重传导性听力损失的常见原因，严重程度可达60分贝。30-60分贝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得到很好的理解。此外，某些类型的中耳手术后的听力结果(特别是对于

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.