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The findings presented in this paper will be of practical use in the development and optimizing of a new type of chamber stapes or whole middle ear prosthesis

Acoustic Fields and Waves in Solids

(1990)

被引用435|浏览11
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摘要

A stapedotomy surgery using a piston stapes prosthesis significantly modifies the perilymph fluid stimulation level and always leads to alteration of conditions in sound transmission through the cochlea. This paper shows the results of non-contact measurements of the stapes head velocity, a Teflon piston stapes prosthesis velocity and rou...更多

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简介
  • Stapedotomy surgery, introduced by SHEA [1], [2], is generally considered to be a safe method for treating ossicular chain pathological conditions in which a stapes ankylosis occurs, especially in the case of stapedial otosclerosis [3]–[8].
  • The auditory outcomes are expected to be better after stapedotomy with bigger piston diameters, for frequencies up to and including 2 kHz in particular [9].
  • Some authors claim that within the low and medium frequencies better outcomes are achieved after large fenestra stapedotomy or stapedectomy surgery [3], [4], [6].
  • Stapes Teflon piston prosthesis implantation was found to cause several times lower amplitude of round window membrane vibrations compared to physiological situation, for frequencies above 2 kHz in particular.
  • The change in the round window membrane motion testifies to the differences in the perilymph fluid stimulation level of the cochlea caused by the surgical procedure
重点内容
  • Stapedotomy surgery, introduced by SHEA [1], [2], is generally considered to be a safe method for treating ossicular chain pathological conditions in which a stapes ankylosis occurs, especially in the case of stapedial otosclerosis [3]–[8]
  • It was shown that the pre- and poststapedotomy values of round window membrane vibration parameters determining the intensity of sound transmission from the outer ear to the inner ear compartments are different [10], [11]
  • The change in the round window membrane motion testifies to the differences in the perilymph fluid stimulation level of the cochlea caused by the surgical procedure
  • Amplitude–frequency profiles of specimen 1 in the pre-stapedotomy state for 73 points on the surface of the stapes head are shown in figure 2
  • The measuring results for the stapes head, the Teflon piston stapes prosthesis and the round window membrane recorded in four human cadaver temporal bones showed the differences in the perilymph fluid stimulation level before and after stapedotomy surgery
  • The findings presented in this paper will be of practical use in the development and optimizing of a new type of chamber stapes or whole middle ear prosthesis
方法
  • In the procedure of preparing the physiological specimen, the following steps are taken: (1) shortening the external auditory canal and placing an ER3-14A polyurethane foam ear plug (Etymotic Research, Elk Grove Village, IL, USA), (2) attaching an ER3-04 speaker adapter (Etymotic Research, Elk Grove Village, IL, USA) to the plug, (3) opening a one-mm diameter in the anterior wall of the external auditory canal to insert the ER7-14C microphone tube (Etymotic Research, Elk Grove Village, IL, USA), (4) performing a maximally wide posterior tympanotomy to obtain a wide approach to the oval window (OW) niche, (5) performing a wide insight into the round window (RW) niche through the jugular fossa, (6) periodically dipping the specimen in a saline solution
结果
  • Amplitude–frequency profiles of specimen 1 in the pre-stapedotomy state for 73 points on the surface of the stapes head are shown in figure 2.
  • The typical resonant frequency of the middle ear conducting apparatus is observable at 0.8 kHz. The dispersion of the values of displacement amplitude exceeding 2 kHz is related to different vibration phases of individual stapes head vibration measuring points, which is demonstrated in the form of three-dimensional visualisation.
  • The typical resonant frequency of the middle ear conducting apparatus is again observable at 0.8 kHz. Dispersion of the values of displacement amplitude exceeding 2 kHz is related to different vibration phases of individual stapes prosthesis vibration measuring points, which is demonstrated in the form of three-dimensional visualisation
结论
  • The measuring results for the stapes head, the Teflon piston stapes prosthesis and the round window membrane recorded in four human cadaver temporal bones showed the differences in the perilymph fluid stimulation level before and after stapedotomy surgery.
  • The authors used a laser Doppler vibrometry technique to measure velocity and displacement amplitude of middle ear components
  • This technique is commonly used to assess real-time fast vibrations by non-contact method and especially useful for small objects.
  • This type of studies has been conducted for several years based on human cadaver temporal bones, among others, to understand mechanical properties of the ossicular system better [12], [18], [19], to understand the influence of some pathologies [20] or improve the prostheses used in otosurgery [21]–[23].
  • The findings presented in this paper will be of practical use in the development and optimizing of a new type of chamber stapes or whole middle ear prosthesis
基金
  • The authors would like to thank Professor Henryk Skarzyński, the IPPH Director, for granting permission to use facilities at the ICHS Head and Neck Clinical Anatomy Laboratory in Kajetany in order to conduct the research. This work was supported by the Polish Ministry of Science and Higher Education (Research Project No N N518 377637)
研究对象与分析
specimens: 4
This indicates that the Teflon piston stapes prosthesis leads to approximately 5-fold lower stimulation of perilymph vibration compared to physiological situation. The total results for four specimens in the form of average post-stapedotomy to pre-stapedotomy ratio of displacement amplitude A [dB] for both cochlear input and cochlear output vibration amplitude with individual results and standard deviation are presented in figure 5. Showing fluctuation, depending on frequency, the determined average ratio for the cochlear input stays at the same level close to 0 dB

subsequent specimens: 4
Amplitude–frequency characteristics of specimen 1 for points on the surface of the round window membrane while exposing the tympanic membrane to a sound of 90 dB SPL. Left: Round window membrane surface displacement amplitude of 34 points for pre-stapedotomy state. Right: Round window membrane surface displacement amplitude of 25 points for post-stapedotomy state. Post-stapedotomy to pre-stapedotomy ratio of displacement amplitude for the cochlear input (left) and the cochlear output (right) represented in SPL decibels according to the following formula: A [dB] = 20 log(A1/A0), where index 1 refers to the post-stapedotomy state, and index 0 refers to the pre-stapedotomy state. The figures present average values of vibration amplitude changes of the selected measuring points on the stapes head, stapes prosthesis and RW membrane for 4 subsequent specimens (black triangles) joined into curve lines (thin, grey, solid curved lines) and the values of average vibration amplitude of all the points for all specimens.

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