Investigations of Human Auditory Mechanics

人类听觉机制的研究

• 批准号: 8181813
• 负责人: Hideko Heidi Nakajima
• 金额: $ 3.95万
• 依托单位: MASSACHUSETTS EYE AND EAR INFIRMARY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8181813
• 关键词: Address; Anterior semicircular canal (body structure); Auditory; Auricular prosthesis; Clinical; Clinical Treatment; Cochlea; Conductive hearing loss; Devices; Disease; Ear; Functional disorder; Grant; Hearing; Hearing Aids; Hearing problem; Human; Individual; Investigation; Knowledge; Labyrinth; Lesion; Life; Liquid substance; Mastoid process; Measurement; Measures; Mechanics; Mixed Conductive-Sensorineural Hearing Loss; Motion; Operative Surgical Procedures; Oval Window; Pathologic; Pathology; Patients; Preparation; Pressure Transducers; Scala Tympani; Semicircular canal structure; Sensory; Shunt Device; Side; Simulate; Specimen; Stapedectomies; Stapes; Stimulus; Surgical Plugs; Symptoms; Techniques; Temporal bone structure; Testing; Travel; alternative treatment; base; bone; clinical Diagnosis; flexibility; fluid flow; hearing impairment; inner ear diseases; middle ear; middle ear disorder; novel; pressure; public health relevance; research study; round window; sample fixation; simulation

DESCRIPTION (provided by applicant): This grant seeks to address important clinical and scientific questions regarding human hearing diseases and their treatment. To do so, we make simultaneous pressure measurements on each side of the cochlear partition in human cadaveric temporal bones. This new and powerful technique enables direct determination of the differential pressure across the cochlear partition, the stimulus that excites the cochlear partition and initiates the cochlear traveling wave. Thus, this intracochlear differential pressure measurement in cadaveric temporal bones allows for a representation of what a live human with normal sensory function would hear, enabling us to investigate human hearing under controlled circumstances and to answer questions which could not be previously addressed, as outlined in the following 3 aims: Aim 1) Determine if a useful level of hearing is possible when the oval window is blocked and the cochlea is stimulated via the round window (RW). The experiments under this aim will establish whether or not RW stimulation can effectively treat stapes fixation in patients where stapedectomy is contraindicated. Furthermore, they will test the degree to which the cochlea can be approximated as a rigid bone containing incompressible fluid with only two flexible windows (oval and round windows) responsible for the pressure difference across the cochlear partition. Aim 2) Understand how pathologic third-window lesions of the inner ear can result in hearing loss. Superior semicircular canal dehiscence (SCD) is a prototypical third window lesion, and it is unknown why some individuals with SCD have hearing loss while others do not. By studying the impact of controlled dehiscences on differential pressure and other measurements, we will test two hypotheses: 1. Pathologic third windows shunt fluid flow away from the cochlea, resulting in decreased pressure difference across the cochlear partition, leading to hearing loss; 2. The size of the dehiscence is a major factor in the determination of the hearing loss. This study will aid in understanding when and how third-window lesions produce hearing loss and determine whether size of the dehiscence is an important variable. The present treatment for SCD is highly invasive and is reserved for debilitating vestibular symptoms only. A novel alternative treatment for SCD-induced hearing loss is addressed as part of Aim 3. Aim 3) Investigate the application of RW stimulation to treat various diseases of the middle and inner ear, including: 1. semicircular canal dehiscence; 2. discontinuity of the ossicular chain; 3. non-aerated middle ear; and 4. stapes fixation (as in Aim 1). By measuring the trans-cochlear differential pressure evoked by RW stimulation in the controlled setting of cadaveric preparations, while simulating various diseased states, we will investigate whether RW stimulation is a feasible and efficacious treatment for various middle- and inner-ear disorders. It is anticipated that the results of the investigations under these three aims will answer fundamental questions regarding human hearing, and yield advances in the clinical diagnosis and treatment of hearing diseases. PUBLIC HEALTH RELEVANCE: This grant addresses mechanisms and treatments of middle- and inner-ear diseases that are common causes of hearing loss. A new measurement technique based on fiberoptic micro- pressure transducers will be employed in human cadaveric specimens to obtain previously unavailable knowledge and test new treatments.

描述（由申请人提供）：该拨款旨在解决有关人类听力疾病及其治疗的重要临床和科学问题。为此，我们对人类尸体颞骨耳蜗分区的每一侧进行同步压力测量。这种新的、强大的技术能够直接确定耳蜗分区上的压差，即激发耳蜗分区并启动耳蜗行波的刺激。因此，这种对尸体颞骨的耳蜗内压差测量可以代表具有正常感觉功能的活人所听到的声音，使我们能够在受控环境下研究人类听力并回答以前无法解决的问题，如以下 3 个目标： 目标 1) 确定当卵圆窗被阻挡并通过圆窗 (RW) 刺激耳蜗时是否可以达到有用的听力水平。在此目的下的实验将确定 RW 刺激是否可以有效治疗镫骨切除术禁忌症患者的镫骨固定。此外，他们还将测试耳蜗在多大程度上可以近似为含有不可压缩流体的刚性骨骼，只有两个柔性窗口（椭圆形和圆形窗口）负责耳蜗分区上的压力差。目标 2) 了解内耳病理性第三窗病变如何导致听力损失。上半规管裂开 (SCD) 是一种典型的第三窗病变，目前尚不清楚为什么一些 SCD 患者会出现听力损失，而其他人则不会。通过研究受控裂开对压差和其他测量的影响，我们将检验两个假设： 1. 病理性第三窗将流体分流远离耳蜗，导致耳蜗分区的压差减小，导致听力损失； 2.裂口的大小是判断听力损失的主要因素。这项研究将有助于了解第三窗病变何时以及如何产生听力损失，并确定裂开的大小是否是一个重要变量。目前对 SCD 的治疗具有高度侵入性，并且仅用于治疗使人衰弱的前庭症状。目标 3 提出了一种针对 SCD 引起的听力损失的新型替代疗法。目标 3) 研究 RW 刺激在治疗中耳和内耳各种疾病中的应用，包括： 1. 半规管裂开； 2.听骨链的不连续性； 3.非通气中耳； 4. 镫骨固定（如目标 1）。通过在尸体准备的受控环境中测量 RW 刺激引起的跨耳蜗压差，同时模拟各种疾病状态，我们将研究 RW 刺激是否是治疗各种中耳和内耳疾病的可行且有效的方法。预计这三个目标的研究结果将回答有关人类听力的基本问题，并在听力疾病的临床诊断和治疗方面取得进展。 公共卫生相关性：这笔赠款涉及中耳和内耳疾病的机制和治疗，这些疾病是听力损失的常见原因。基于光纤微压力传感器的新测量技术将用于人体尸体标本，以获得以前无法获得的知识并测试新的治疗方法。