On the hearing effects of a cholesteatoma growing: A biomechanical study

2021 ◽  
pp. 095441192110466
Author(s):  
Leonor Mendonça ◽  
Carla F Santos ◽  
Fernanda Gentil ◽  
Marco Parente ◽  
Bruno Areias ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Sound Pressure ◽  
Chronic Otitis Media ◽  
Biomechanical Study ◽  
The Finite Element Method ◽  
High Frequencies ◽  
Initial Stage ◽  
Hearing Function ◽  
Stapes Footplate

Chronic otitis media enables the appearance of a benign middle ear tumor, known as a cholesteatoma, that may compromise hearing. To evaluate the influence of a cholesteatoma growth on the hearing function, a computational middle ear model based on the finite element method was used and three different size of cholesteatoma were modeled. The cholesteatoma solidification and the consequent degradation of the ossicles were also simulated as two condition that commonly occurs during cholesteatoma evolution. A sound pressure level of 80 dB SPL was applied in the tympanic membrane and a steady state analysis was performed for frequencies from 100 Hz to 10 kHz. The displacements of both the tympanic membrane and the stapes footplate were measured. The results were compared with a healthy case and it was shown that the cholesteatoma development leads to a decrease in the umbo and stapes displacements. The ossicles degradation simulation showed the higher difference comparing with the cholesteatoma in an initial stage, with lower displacements in the stapes footplate mainly for high frequencies. The observed displacement differences are directly connected to hearing loss, being possible to conclude that cholesteatoma evolution in the middle ear will lead to hearing problems, mainly in an advanced stage.

Eustachian Tube Ventilatory Function in Children

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 171-177 ◽  
Author(s):  
Erdem I. Cantekin ◽  
Charles D. Bluestone ◽  
Leon P. Parkin
Keyword(s):  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Response Characteristic ◽  
Ventilatory Function ◽  
Stimulus Response ◽  
Tympanostomy Tubes ◽  
History Of ◽  
Middle Ear Disease

In order to establish a simple stimulus-response characteristic of Eustachian tube physiology in children, the tubal ventilatory function was studied. The parameters of active and passive opening of the tube were measured for three groups of patients with non-intact tympanic membranes. The group with traumatic perforations of the tympanic membrane without any history of middle ear disease had better active equilibration function than the group with chronic otitis media and perforations of the tympanic membrane and the group with tympanostomy tubes in the tympanic membrane. Quantitatively, this could be expressed in terms of residual positive pressures. In the study of repeated inflation of the middle ear, all groups had lower second opening pressures which are attributed to the effect of surface forces.

Unusual middle-ear mischief: trans-tympanic trauma from a hair grip resulting in ossicular, facial nerve and oval window disruption

2006 ◽  
Vol 120 (9) ◽  
pp. 793-795 ◽  
Author(s):  
J D Snelling ◽  
A Bennett ◽  
P Wilson ◽  
M Wickstead
Keyword(s):  
Facial Nerve ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Oval Window ◽  
Delayed Presentation ◽  
Stapes Footplate ◽  
Horizontal Portion

A case of piercing of the tympanic membrane, resulting in unusual consequences, is described. This is the first reported case of the long process of a dislocated incus resulting in trauma to the horizontal portion of a dehiscent facial nerve. Simultaneous depression of the stapes footplate resulted in a perilymph leak, but with delayed presentation.

Tympanic membrane/middle ear pathologic correlates in chronic otitis media

1999 ◽  
Vol 109 (5) ◽  
pp. 712-716 ◽  
Author(s):  
Vikram J. Jaisinghani ◽  
Michael M. Paparella ◽  
Patricia A. Schachern ◽  
Chap T. Le
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media

Atypical incus necrosis: a case report and literature review

2007 ◽  
Vol 122 (10) ◽  
pp. 1124-1126 ◽  
Author(s):  
N Choudhury ◽  
G Kumar ◽  
M Krishnan ◽  
D J Gatland
Keyword(s):  
Case Report ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Conductive Deafness ◽  
Ossicular Replacement ◽  
Stapes Footplate ◽  
History Of ◽  
Serous Otitis Media ◽  
Replacement Prosthesis

AbstractObjective:We report an atypical case of ossicular necrosis affecting the incus, in the absence of any history of chronic serous otitis media. We also discuss the current theories of incus necrosis.Case report:A male patient presented with a history of right unilateral hearing loss and tinnitus. Audiometry confirmed right conductive deafness; tympanometry was normal bilaterally. He underwent a right exploratory tympanotomy, which revealed atypical erosion of the proximal long process of the incus. Middle-ear examination was otherwise normal, with a mobile stapes footplate. The redundant long process of the incus was excised and a partial ossicular replacement prosthesis was inserted, resulting in improved hearing.Conclusion:Ossicular pathologies most commonly affect the incus. The commonest defect is an absent lenticular and distal long process of the incus, which is most commonly associated with chronic otitis media. This is the first reported case of ossicular necrosis, particularly of the proximal long process of the incus, in the absence of chronic middle-ear pathology.

scholarly journals A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Operative Findings

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 

2D Modeling of the Human Ear Using the Equivalent Mechanical Impedance

2020 ◽  
Author(s):  
Chahbi Aziz ◽  
Assif Safaa ◽  
Faiz Adil ◽  
Hajjaji Abdelowahed.
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Sound Pressure ◽  
Mechanical Impedance ◽  
Ossicular Chain ◽  
Body Parts ◽  
Frequency Range ◽  
Ear Canal ◽  
Finite Elements Analysis ◽  
Human Tympanic Membrane

Several mass–spring–damper models have been developed to study the response of the human body parts. In such models, the lumped elements represent the mass of different body parts, and stiffness and damping properties of various tissues. The aim of this research is to develop a 2D axisymmetric model to simulate the motion of the human tympanic membrane. In this contribution we develop our model using a Comsol Multiphysics software to construct a 2D axisymmetric objects, the acoustic structure interaction between the ear canal (field of propagation of the acoustic wave) and the structure of ear (skin, cartilage, bone, tympanic membrane) was solved using finite elements analysis (FEA). A number of studies have investigated the motion of the human tympanic membrane attached to the ossicular chain and the middle ear cavity. While, in our model the tympanic annular is assumed to be fixed and the loading of what comes behind the tympanic membrane as the ossicular chain, middle ear cavity and cochlea were replaced by the equivalent mechanical impedance of a spring mass damper system. The obtained results demonstrate that the maximum displacements of the umbo are obtained at the frequency range of [0.9 - 2.6] kHz, the sound pressure gain had the shape of peak with a maximum at [2 – 3] kHz frequency range. The umbo displacement depends on the damping coefficient d, and the sound pressure at the tympanic membrane was enhanced compared to that at the ear canal entrance.

Efficacy of Acoustic Reflectometry in Detecting Middle Ear Effusion

1986 ◽  
Vol 95 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Christine A. Avery ◽  
George A. Gates ◽  
Thomas J. Prihoda
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Lower Sensitivity ◽  
Middle Ear Effusion ◽  
Receiver Operator Characteristics ◽  
Ear Effusion

The acoustic otoscope measures the amount of sound reflected from the tympanic membrane. Since the amount of reflected sound is increased by fluid in the middle ear, it seemed likely that the acoustic otoscope could be used for detection of otitis media. We compared acoustic reflectometry with over 4,000 tympanometric and otoscopic examinations in 451 children who were examined at regular intervals following surgery for chronic otitis media with effusion. The data indicate a lower sensitivity and specificity of acoustic reflectometry than had been reported previously. The receiver-operator characteristics of this device are discussed.

scholarly journals Anterior epitympanic attic antrum space obstruction and symptom onset associated with myringosclerosis in benign chronic suppurative otitis media

2020 ◽  
Vol 8 (6) ◽  
pp. 2013
Author(s):  
Zulfikar Naftali ◽  
Suprihati . ◽  
Dharmana E. ◽  
Setyawan H.
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Symptom Onset ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Control Group ◽  
Chi Square ◽  
Suppurative Otitis Media ◽  
Control Approach

Background: The AAA (Anterior epitympanic, Attic, and Antrum) space is the space between the mastoid and middle ear which functions to balance the pressure in both organs (buffer). Pathological tissue in the AAA cavity due to chronic infection would disrupt the buffer function and could change the morphology of the mucosa in the tympanic membrane and middle ear. Obstruction in the AAA space measured subjectively by observing the smoothness of the flow using saline solution has been shown to be associated with a plaque in the tympanic membrane (myringosclerosis) in Chronic Otitis Media (COM) patients. This study aims to determine the relationship between AAA space obstructions with myringosclerosis using CT-Scan for an objective result.Methods: Retrospective study with case-control approach used in this study. Case criterias are Chronic Suppurative Otitis Media (CSOM) patients with myringosclerosis, both men and women and age 15-50 years, while the control group are benign CSOM patients without myringosclerosis. Data were analyzed with the chi-square test to prove the association between the AAA space status and length of symptom onset with myringosclerosis.Results: During January 2017-December 2019 there were 33 respondents, 19 cases and 14 controls, 21 men and 12 women with an average age of 35 years (cases) and 23.5 years (control). The length of symptom onset more than 5 years (p <0.05, OR 6.94 with CI 0.5-1.5) and AAA space obstruction (p <0.05 OR 34.25 with CI 0.8-1.8) has been shown to be associated with myringosclerosis in people with benign CSOM.Conclusions: AAA space obstruction and symptom onset more than 5 years significantly associated with myringosclerosis. 

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