Improving Restoration of Middle-Ear Function Following Blast Related Injuries

改善爆炸相关损伤后中耳功能的恢复

• 批准号: 10222612
• 负责人: Wei Dong
• 金额: --
• 依托单位: VA LOMA LINDA HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2023-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10222612
• 关键词: 3-Dimensional; Acoustics; Anatomic Models; Animal Model; Auricular prosthesis; Cadaver; Characteristics; Clinical; Clinical Treatment; Cochlea; Complex; Conductive hearing loss; Congenital Abnormality; Data; Development; Devices; Diagnosis; Dislocations; Ear; Ear Injury; Ear ossicles; Environment; Evaluation; Excision; Exhibits; Experimental Models; Failure; Frequencies; Gerbils; Glues; Goals; Hearing; Human; Incus; Individual; Injury; Intraoperative Monitoring; Investigation; Knowledge; Labyrinth; Lasers; Measurement; Measures; Methods; Military Personnel; Modeling; Monitor; Morphology; Motion; Movement; Noise; Operative Surgical Procedures; Outcome; Pathologic; Pathology; Patients; Pattern; Perforation; Preparation; Procedures; Process; Production; Prosthesis; Reconstructive Surgical Procedures; Research; Residual state; Role; Rupture; Services; Soldier; Stapes; Structure; Surgical Disarticulation; System; Temporal bone structure; Testing; Time; Tympanic Membrane Perforation; Tympanic membrane; Veterans; Work; base; bone; clinical Diagnosis; design; experience; flexibility; healing; hearing impairment; hearing restoration; improved; manubrium; middle ear; normal hearing; operation; otoacoustic emission; physical property; pressure; pressure sensor; reconstruction; repaired; restoration; sample fixation; sensor; sound; success; tool; transmission process; tumor; vibration

Project Summary/Abstract Conductive hearing loss in military personnel is commonly caused by blast-related middle ear injuries, which can include tympanic membrane rupture and dislocation of the middle-ear ossicles. The current proposal seeks to evaluate methods and devices for restoring hearing not only for active-duty military personnel and Veterans who suffer from a blast-induced conductive hearing loss, but also for others who experience conductive hearing loss for various reasons (e.g., ruptured eardrum, birth defects, stiffening of middle ear bones). While these injuries are clinically treatable, the effects of middle-ear pathology on hearing are not well quantified, and clinical outcomes often fail to completely restore normal hearing for those suffering from a conductive hearing loss. The current proposal seeks to precisely measure the complex vibrational patterns along the ossicular chain and related pressures at the ends of the middle ear system; the umbo attached to the tympanic membrane and stapes attached to the cochlea, under both normal and particularly under various pathological conditions (damaged/repaired/reconstructed using prosthesis). These studies will use Laser Doppler Vibrometry, unique micro-pressure sensors and direct measures of otoacoustic emissions (OAEs). Aim 1 will evaluate the effects of systematically varied tympanic membrane perforations on middle ear sound transmission in an animal model. The role of the tympanic membrane in sound transmission will be explored and its influence on the motion of the ossicles will be characterized under varied perforation and naturally healed conditions. Measurement of distortion product otoacoustic emissions (DPOAEs) following stimulation with paired tones will be used to quantify the effect of varying degrees of damage to the tympanic membrane. In Aim 2 we will measure sound transmission in an animal model with simulated ossicular chain pathologies. In addition, the effect of an abnormal ossicular chain on the production and acoustic characteristics of DPOAEs will be systematically explored in order to develop quantitative tools for diagnosing hearing loss and for use in the design and implementation of improved methods of treatment. Aim 3 evaluates middle ear sound transmission in human cadaver temporal bone models of clinically repaired human ears. Using direct pressure and velocity measurements, the functional differences between normal middle ear structures and two currently employed methods of repairing disarticulation of the middle ear ossicular chain, incus/stapes fixation or partial/total ossicular chain replacement using prostheses, will be quantified in detail. The proposed research will provide important information that will serve to improve our ability to specifically diagnose the causes of conductive hearing loss, direct the development of improved methods of treatment, and assist in the rational design of advanced prosthetics that more effectively restore hearing.

项目概要/摘要 军事人员的传导性听力损失通常是由爆炸相关的中耳损伤引起的， 可能包括鼓膜破裂和中耳小骨脱位。目前的提案寻求 评估恢复听力的方法和设备，不仅适用于现役军人和退伍军人 遭受爆炸引起的传导性听力损失的人，也适用于其他经历过传导性听力损失的人 各种原因导致的听力损失（例如鼓膜破裂、出生缺陷、中耳骨僵硬）。尽管 这些损伤在临床上是可以治疗的，中耳病理学对听力的影响尚未得到很好的量化，并且 对于传导性听力障碍患者来说，临床结果通常无法完全恢复正常听力 损失。当前的提议旨在精确测量沿听骨的复杂振动模式 中耳系统末端的链条和相关压力；附在鼓膜上的鼓膜 附着在耳蜗上的膜和镫骨，在正常情况下，特别是在各种病理情况下 条件（损坏/修复/使用假肢重建）。这些研究将使用激光多普勒 振动测量、独特的微压力传感器和耳声发射 (OAE) 的直接测量。目标1将 评估系统变化的鼓膜穿孔对中耳声音的影响 动物模型中的传播。将探讨鼓膜在声音传播中的作用 其对小骨运动的影响将在不同的穿孔和自然情况下表征 痊愈的情况。刺激后失真产物耳声发射 (DPOAE) 的测量 配对音调将用于量化不同程度的鼓膜损伤的影响。 在目标 2 中，我们将通过模拟听骨链病理学来测量动物模型中的声音传输。在 此外，异常听骨链对 DPOAE 的产生和声学特性的影响 将系统地探索，以开发诊断听力损失和用于听力损失的定量工具 设计和实施改进的治疗方法。目标 3 评估中耳声音 临床修复的人耳的人类尸体颞骨模型中的传播。使用直接压力 和速度测量，正常中耳结构与目前两种结构之间的功能差异 采用修复中耳听骨链离断、砧骨/镫骨固定或 使用假体进行的部分/全部听骨链置换将被详细量化。拟议的研究 将提供重要信息，有助于提高我们专门诊断原因的能力 传导性听力损失，指导改进治疗方法的开发，并协助合理治疗 设计先进的假肢，更有效地恢复听力。