Tympanometric laser Doppler vibrometry measurements of middle ear function

鼓室导抗激光多普勒振动测量中耳功能

• 批准号: 10424361
• 负责人: Martin Patrick Feeney
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10424361
• 关键词: 3D Print; Acoustics; Air Pressure; Area; Audiology; Clinic; Clinical; Clinical Trials; Computers; Control Groups; Custom; Data; Data Collection; Diagnosis; Diagnostic; Diagnostic Sensitivity; Disease; Ear; Emerging Technologies; Enrollment; Evaluation; External auditory canal; Frequencies; Gaussian model; Goals; Grant Review; Healthcare Systems; Hearing; Hearing Tests; Hour; Individual; Lasers; Malleus; Masks; Measurement; Measures; Modeling; Movement; Otolaryngologist; Otosclerosis; Outcome Study; Pathology; Patients; Physiological; Positioning Attribute; Process; Publishing; Pump; Rehabilitation Centers; Research; Sampling; Sensorineural Hearing Loss; Speculums; Stapes; Stimulus; System; Tail; Techniques; Technology; Testing; Tympanic membrane; Tympanometry; United States National Institutes of Health; Veterans; Visit; Work; auditory rehabilitation; base; bone; data acquisition; data repository; hearing impairment; improved; middle ear; middle ear disorder; normal hearing; pressure; recruit; sample fixation; sound; tool; vibration

Laser Doppler vibrometry (LDV) is an emerging technology for assessing middle ear (ME) function that detects the sound-induced velocity (Vu) of one of the ME bones, the malleus, over a wide frequency range (300 to 6000 Hz) using a reflected laser beam. The PI seeks to develop LDV measures as a new research area in line with his previous work in the assessment of ME function using wideband acoustic immittance (WAI) measurements. Because LDV measures the movement of one of the ossicles, it is inherently sensitive to ossicular chain disorders such as otosclerosis, and is thus a potentially useful diagnostic tool. LDV obtained at ambient pressure in the ear canal has been shown to result in similar diagnostic sensitivity to WAI, but has wide variability. The diagnostic capability of LDV may be enhanced by making measurements at tympanometric peak pressure (TPP) rather than ambient pressure to control for the effects of varying middle- ear pressure from test to retest and across subjects. This ME pressure related variability may mask underlying ME disorders. Moreover, a comparison of Vu at TPP with tympanometric tail pressures (e.g. ±200 daPa) may provide additional information about the ME status that previously has not been measured. This will be the first study to evaluate the use of tympanometric (varying ear canal pressure) LDV measures for the assessment of ME function. Aim 1 is to make the first repeated measures of Vu at TPP and tympanometric tail pressures in control subjects with normal ME function using a custom ear speculum developed at the VA National Center for Rehabilitative Auditory Research (NCRAR). These test-retest differences will be compared with measurements obtained at ambient pressure by fitting a hierarchical Gaussian process regression model to these data, as well as comparing the data to published test-retest differences for Vu at ambient pressure. Aim 2, using the data from Aim 1, will establish reference limits as a function of frequency for ambient pressure, TPP, ±100 daPa, and ±200 daPa, and for tympanometric peak-to-tail differences for ±100 daPa and ±200 daPa. In Aim 3 the reference limits established in Aim 2 will be applied to the Vu data obtained from 10 subjects with a diagnosis of otosclerosis for ambient pressure and pressurized measures. A Bayesian hierarchical regression model will be used to compare mean differences in Vu between the control group and the otosclerosis group at each of the 9 stimulus frequencies in each test condition. Subjects will be recruited using the NCRAR data repository, through approved flyers posted in the VA Portland Health Care System (VAPORHCS) and handouts provided to patients from audiologists or otolaryngologists in VAPORHCS clinics. Enrollment in the study is for two study visits for both control subjects and those with otosclerosis: The first visit involves hearing evaluation and tympanometry as well as measurements of LDV for both ears at ambient pressure, tympanometric peak pressure determined by 226 Hz tympanometry, and for tympanometric tail pressures at ±100 and ±200 daPa. At the second study visit approximately one month later all tests will be repeated. Based on preliminary data collection, we anticipate that each visit will last approximately 2 hours. Subjects will be tested in a sound-treated booth for all tests. A clinical audiometer will be used for hearing tests followed by tympanometry using a clinical tympanometer. LDV measurements will be completed with a Polytec OFV 534 laser vibrometer. Two research audiologists are required for each measurement: one to position the speculum and manipulate the laser, and the second to assist in computer data acquisition. Air pressure will be varied using the pressure pump from the tympanometer connected to the custom speculum with standard tubing to make measurements at TPP and ±100 and ±200 daPa. The study outcomes will inform the specific aims for a VA Merit Review or NIH R01 study to compare ambient and tympanometric LDV in the assessment of various ME disorders with the long- term goal of moving to a clinical trial of this technology for Veterans with ME disorders.

激光多普勒振动法（LDV）是评估中耳功能（ME）功能的新兴技术 检测一个ME骨骼，麦龙的声音诱导的速度（VU） （300至6000 Hz）使用反射激光束。 PI试图开发LDV测量作为一项新研究 与他先前使用宽带声学限制评估ME功能的工作相一致的领域（WAI） 测量。由于LDV测量了其中一个Ossicles的运动，因此对 骨骼链疾病，例如耳鼻喉病​​，因此是一种潜在有用的诊断工具。 LDV获得 已显示耳道中的环境压力导致对WAI的诊断敏感性相似，但具有 广泛的可变性。通过在 鼓膜的峰值压力（TPP），而不是控制中间的影响的环境压力 从测试到重新测试和跨受试者的耳压。这与压力相关的变异性可能掩盖了基础 我的疾病。此外，将TPP与鼓尾压力（例如±200 DAPA）进行比较 提供有关以前尚未测量的ME状态的其他信息。这将是第一个 评估鼓膜法（变异耳道压力）LDV测量的研究 我的功能。 AIM 1是在TPP和鼓尾压力下进行第一次重复VU的措施 使用在VA国家中心开发的自定义镜头具有正常ME功能的控制对象 用于康复性听觉研究（NCRAR）。这些重测差异将与 通过将分层高斯过程回归模型拟合到环境压力下获得的测量 这些数据，以及将数据与在环境压力下的VU的重测差异进行比较。目的 2使用来自AIM 1的数据，将建立参考极限，作为环境压力频率的函数， TPP，±100 DAPA和±200 DAPA，对于±100 DAPA的鼓膜峰差异和±200 DAPA。在AIM 3中，AIM 2中建立的参考限制将应用于从10获得的VU数据 诊断为诊断为环境压力和加压措施的受试者。贝叶斯人 分层回归模型将用于比较对照组和对照组之间VU的平均差异 在每个测试条件下的9个刺激频率中的每个频率中的每个刺激频率中，耳螺症组。 将使用NCRAR数据存储库来招募主题，并通过VA中发布的批准的传单 波特兰医疗保健系统（Vaporhcs）和向听力学家或 Vaporhcs诊所的耳鼻喉科医生。该研究的入学率用于两个对照对象的两次研究访问 以及那些耳鼻喉性的：第一次访问涉及听力评估和鼓膜法以及 在环境压力下的两只耳朵的LDV测量，鼓膜计量压力由226 Hz确定 鼓板法和鼓尾压力为±100和±200 DAPA。在第二次研究中 大约一个月后，将重复所有测试。根据初步数据收集，我们预计 每次访问将持续大约2个小时。对受试者将在经过良好处理的摊位中进行测试，以进行所有测试。一个 临床听力计将用于听力测试，然后使用临床鼓计的鼓膜法进行鼓膜测试。 LDV 测量将使用V Polytec 534激光振动仪完成。两位研究听力学家是 每个测量所需 协助计算机数据采集。使用来自 加鼓计和标准管连接到自定义窥镜，以在TPP和TPP上进行测量 ±100和±200 DAPA。该研究结果将为VA功绩审查或NIH R01提供具体目的 研究在评估各种ME疾病中比较环境和鼓膜LDV的研究 对于我的疾病的退伍军人，转到该技术的临床试验的一项目标。