Study for the interaction between the medium in the middle ear and vibro-acoustic transmission

2021 ◽  
Vol 263 (1) ◽  
pp. 5538-5540
Author(s):  
Jeon Jonghoon ◽  
Jonghoon Jeon ◽  
Kyunglae Gu ◽  
Junhong Park
Keyword(s):  
Middle Ear ◽  
Geometric Model ◽  
Signal Transmission ◽  
Bone Conduction ◽  
Human Perception ◽  
Transmission Mechanism ◽  
Evaluation Indexes ◽  
Individual Evaluation ◽  
Priority Factor ◽  
Air Conduction

This study presented a quantitative evaluation index related to sound response for diagnosis of middle ear condition. The signal transmission paths for human perception of sound are divided into bone conduction and air conduction, respectively, depending on the path through which vibration and sound are transmitted. The components of auditory system that can affect the sound signal variability include temporal bone, ear canal, eardrum, and middle ear cavity. The specific acoustic impedances were obtained through simple geometric model of the auditory components, and the sound transmission mechanism was implemented through the outer-middle ear circuit model. The frequency range corresponding to the resonance characteristics of each components were calculated. The response difference for the medium of middle ear was confirmed by deriving frequency response function between the input sound and the output sound in the frequency domain through the transfer function method. The reliability of the algorithm was confirmed through the ROC curve, and individual evaluation indexes were derived according to the priority factor between classification accuracy and error rate.

scholarly journals Cartilage Conduction Hearing and Its Clinical Application

2021 ◽  
Vol 11 (2) ◽  
pp. 254-262
Author(s):  
Tadashi Nishimura ◽  
Hiroshi Hosoi ◽  
Ryota Shimokura ◽  
Chihiro Morimoto ◽  
Tadashi Kitahara
Keyword(s):  
Hearing Aids ◽  
Sound Pressure ◽  
Signal Transmission ◽  
Bone Conduction ◽  
Transmission Mechanism ◽  
Ear Canal ◽  
Stable Fixation ◽  
Loud Sound ◽  
Aural Atresia ◽  
Air Conduction

Cartilage conduction (CC) is a form of conduction that allows a relatively loud sound to be audible when a transducer is placed on the aural cartilage. The CC transmission mechanism has gradually been elucidated, allowing for the development of CC hearing aids (CC-HAs), which are clinically available in Japan. However, CC is still not fully understood. This review summarizes previous CC reports to facilitate its understanding. Concerning the transmission mechanism, the sound pressure level in the ear canal was found to increase when the transducer was attached to the aural cartilage, compared to an unattached condition. Further, inserting an earplug and injecting water into the ear canal shifted the CC threshold, indicating the considerable influence of cartilage–air conduction on the transmission. In CC, the aural cartilage resembles the movable plate of a vibration speaker. This unique transduction mechanism is responsible for the CC characteristics. In terms of clinical applications, CC-HAs are a good option for patients with aural atresia, despite inferior signal transmission compared to bone conduction in bony atretic ears. The advantages of CC, namely comfort, stable fixation, esthetics, and non-invasiveness, facilitate its clinical use.

Role of ossiculoplasty in canal wall down tympanoplasty for middle-ear cholesteatoma: hearing results

2006 ◽  
Vol 121 (4) ◽  
pp. 324-328 ◽  
Author(s):  
E De Corso ◽  
M R Marchese ◽  
B Sergi ◽  
M Rigante ◽  
G Paludetti
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Consecutive Series ◽  
Canal Wall ◽  
Hearing Results ◽  
Middle Ear Cholesteatoma ◽  
Canal Wall Down ◽  
The Mean ◽  
Air Conduction ◽  
Cholesteatoma Surgery

The aim of this study was to evaluate the hearing results of ossiculoplasty in canal wall down tympanoplasty in one stage middle-ear cholesteatoma surgery.We carried out a retrospective review of a consecutive series of 142 cases which had undergone type two or three canal wall down tympanoplasty with ossicular reconstruction, between January 1995 and December 2002, due to chronic otitis media with cholesteatoma.Pre-operative audiometric testing revealed a mean air conduction pure tone average (PTA) of 50.97 dB and a mean bone conduction PTA of 22.14 dB. The mean post-operative result for air conduction PTA was 37.62 and for bone conduction PTA was 23.37 dB. The mean pre- and post-operative air–bone gaps (ABGs) were 28.83 and 13.94 dB, respectively, with a gain of 14.89 dB. Almost 62.67 per cent of patients closed their ABGs to within 20 dB.Our functional results are comparable with those of other authors. In the present study, we show that hearing improvement is possible following cholesteatoma surgery with canal wall down tympanoplasty and ossicular chain reconstruction.

Insertion of middle-ear Silastic sheeting during tympanoplasty: hearing outcomes

2010 ◽  
Vol 125 (5) ◽  
pp. 445-448 ◽  
Author(s):  
S M Elmorsy ◽  
H E Amer
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Chronic Inflammation ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
One Year ◽  
Operative Findings ◽  
Hearing Outcomes ◽  
Air Conduction

AbstractObjective:To study the effect of Silastic®sheeting placed in the middle ear during tympanoplasty, including the effect on hearing.Design:Retrospective study.Background:Chronic inflammation of the middle ear is common. Surgical treatment sometimes results in middle-ear adhesions and hearing deterioration.Materials and methods:We selected 106 patients with chronic otitis media, middle-ear adhesions and intact ossicles, based on intra-operative findings. These patients underwent single-stage tympanoplasty either with or without insertion of Silastic sheeting. Audiometry was undertaken pre-operatively and one and 12 months post-operatively.Results:Patients who had undergone Silastic sheet insertion showed significantly better air conduction, bone conduction and air–bone gap averages one year post-operatively, compared with those who had not.

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

Fluctuating hearing loss in presbyacusis

1988 ◽  
Vol 102 (1) ◽  
pp. 25-26
Author(s):  
F. W. Martin ◽  
R. W. Ruckley
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Bone Conduction ◽  
Simple Explanation ◽  
Subjective Improvement ◽  
Middle Ear Pressure ◽  
Before And After ◽  
Valsalva's Manoeuvre ◽  
Fluctuating Hearing Loss ◽  
Air Conduction

AbstractThirty-six patients with bilateral symmetrical presbyacusis who reported a temporary improvement in the hearing of one ear following a Valsalva's manoeuvre were further investigated. Bone conduction and air conduction thresholds, middle ear pressure and middle ear compliance were measured before and after Valsalva's manoeuvre in the ears which had a subjective improvement in hearing following auto-inflation. Bone conduction thresholds remained unaltered in 66 per cent of ears while average air conduction thresholds varied by less than 5 decibels. Middle ear pressure was unchanged in over half the ears tested and in 81 per cent of the ears there was no change in middle ear compliance. There appears to be no simple explanation for the temporary subjective fluctuation in hearing reported by patients with presbyacusis.

scholarly journals Bone-conduction threshold and air-bone gap may predict frequency-specific air-conduction threshold after tympanoplasty

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248421
Author(s):  
Ethan I. Huang ◽  
Yu-Chieh Wu ◽  
Hsiu-Mei Chuang ◽  
Tzu-Chi Huang
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Disease Process ◽  
Hearing Improvement ◽  
Exclusion Criteria ◽  
Bone Conduction Threshold ◽  
Estimate Frequency ◽  
Quantitative Statistics ◽  
Preoperative Predictors ◽  
Air Conduction

Postoperative hearing improvement is one of the main expectations for patients receiving tympanoplasty. The capacity to predict postoperative hearing may help to counsel a patient properly and avoid untoward expectations. It is difficult to predict postoperative hearing without knowing the disease process in the middle ear, which can only be assessed intraoperatively. However, the duration and extent of the underlying pathologies may represent in bone-conduction threshold and air-bone gap. Here in patients undergoing tympanoplasty without ossiculoplasty, we sorted and separated the surgery dates into the first group to build the predicting models and the second group to test the predictions. There were 87 and 30 ears, respectively. No specific enrollment or exclusion criteria were based on underlying pathologies such as the perforation size of the tympanic membrane or the middle ear conditions. The results show that bone-conduction threshold and air-bone gap together predicted air-conduction threshold after the surgery, including each frequency of 0.5k, 1k, 2k, and 4k Hz. The discrepancies between the predictions and recordings did not differ among these four frequencies. Of the variance in mean postoperative air-conduction threshold, 56.7% was linearly accounted for by these two preoperative predictors in this sample. The results suggest a trend that, the higher the frequency, the larger the part was accounted for by these two preoperative predictors. These together may help a surgeon to estimate frequency-specific hearing outcome after the surgery, answer patients’ questions with quantitative statistics, and counsel patients with proper expectations.

Air Conduction, Bone Conduction, and Soft Tissue Conduction Audiograms in Normal Hearing and Simulated Hearing Losses

2015 ◽  
Vol 26 (01) ◽  
pp. 101-108 ◽  
Author(s):  
Cahtia Adelman ◽  
Adi Cohen ◽  
Adi Regev-Cohen ◽  
Shai Chordekar ◽  
Rachel Fraenkel ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Soft Tissue ◽  
Middle Ear ◽  
Bone Conduction ◽  
Auditory Stimulation ◽  
Threshold Shift ◽  
N Application ◽  
Similar Threshold ◽  
Air Conduction

Background: In order to differentiate between a conductive hearing loss (CHL) and a sensorineural hearing loss (SNHL) in the hearing-impaired individual, we compared thresholds to air conduction (AC) and bone conduction (BC) auditory stimulation. The presence of a gap between these thresholds (an air-bone gap) is taken as a sign of a CHL, whereas similar threshold elevations reflect an SNHL. This is based on the assumption that BC stimulation directly excites the inner ear, bypassing the middle ear. However, several of the classic mechanisms of BC stimulation such as ossicular chain inertia and the occlusion effect involve middle ear structures. An additional mode of auditory stimulation, called soft tissue conduction (STC; also called nonosseous BC) has been demonstrated, in which the clinical bone vibrator elicits hearing when it is applied to soft tissue sites on the head, neck, and thorax. Purpose: The purpose of this study was to assess the relative contributions of threshold determinations to stimulation by STC, in addition to AC and osseous BC, to the differential diagnosis between a CHL and an SNHL. Research Design: Baseline auditory thresholds were determined in normal participants to AC (supra-aural earphones), BC (B71 bone vibrator at the mastoid, with 5 N application force), and STC (B71 bone vibrator) to the submental area and to the submandibular triangle with 5 N application force) stimulation in response to 0.5, 1.0, 2.0, and 4.0 kHz tones. A CHL was then simulated in the participants by means of an ear plug. Separately, an SNHL was simulated in these participants with 30 dB effective masking. Study sample: Study sample consisted of 10 normal-hearing participants (4 males; 6 females, aged 20–30 yr). Data Collection and Analysis: AC, BC, and STC thresholds were determined in the initial normal state and in the presence of each of the simulations. Results: The earplug-induced CHL simulation led to a mean AC threshold elevation of 21–37 dB (depending on frequency), but not of BC and STC thresholds. The masking-induced SNHL led to a mean elevation of AC, BC, and STC thresholds (23–36 dB, depending on frequency). In each type of simulation, the BC threshold shift was similar to that of the STC threshold shift. Conclusions: These results, which show a similar threshold shift for STC and for BC as a result of these simulations, together with additional clinical and laboratory findings, provide evidence that BC thresholds likely represent the threshold of the nonosseous BC (STC) component of multicomponent BC at the BC stimulation site, and thereby succeed in clinical practice to contribute to the differential diagnosis. This also provides evidence that STC (nonosseous BC) stimulation at low intensities probably does not involve components of the middle ear, represents true cochlear function, and therefore can also contribute to a differential diagnosis (e.g., in situations where the clinical bone vibrator cannot be applied to the mastoid or forehead with a 5 N force, such as in severe skull fracture).

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

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