Mechanisms of Conductive Presbycusis in Humans

人类传导性老年性耳聋的机制

基本信息

批准号：
10375453
负责人：
AARON KYLE REMENSCHNEIDER
金额：
$ 19.01万
依托单位：
MASSACHUSETTS EYE AND EAR INFIRMARY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2025-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10375453
关键词：
Acoustics Affect Age Aging Air Behavioral Biological Assay Bone Conduction Cadaver Clinical Conductive hearing loss Development Diagnosis Ensure Etiology Frequencies Functional disorder Goals Hearing Hearing Tests Hearing problem High-Frequency Hearing Loss Human Impairment Individual Investigation Joints Knowledge Lasers Lead Lesion Life Light Measurement Mechanics Methods Operative Surgical Procedures Otologic Surgical Procedures Output Pathology Patients Population Postoperative Period Presbycusis Prevalence Research Risk Role Secondary to Social isolation Sound Localization Source Speech Speech Sound Stimulus Temporal bone structure Testing Transducers United States Work accurate diagnostics age effect age related bone clinically relevant cost experience hearing impairment ineffective therapies interest middle ear novel novel therapeutics patient subsets repaired research clinical testing simulation sound sound frequency source localization targeted treatment transmission process trend

项目摘要

Mechanisms of Conductive Presbycusis In Humans Age-related high frequency hearing loss (presbycusis) is a near universally experienced condition, affecting tens of millions of individuals in the United States alone and costing worldwide more than $750 billion per year. Presbycusis results in difficulty understanding speech, problems hearing environmental sounds and, if unaddressed, can lead to social isolation. Given current demographic trends, the societal burden of presbycusis is expected to accelerate. Despite the prevalence of presbycusis, much remains unknown about its etiologic mechanisms. Presbycusis has long been assumed to be secondary to sensorineural dysfunction, but emerging evidence suggests conductive pathology contributes to presbycusis. The principal method for clinical evaluation of hearing is behavioral pure tone (500-8kHz) audiometry. Extended high frequency air conduction testing (>8kHz) is now commonly performed given new knowledge on the role of high frequency sound for speech understanding and sound localization. Unfortunately, clinical bone conduction testing stops at 4kHz. Above 4kHz, limitations in standard stimulus transducers that are largely unchanged from the 1950s, and a lack of normative bone conduction standards limit study of high frequency conductive loss. Differentiation between sensorineural and conductive presbycusis is not routinely performed, but is of interest because: 1) prior work demonstrates discrete changes within the middle ear can lead to isolated high frequency conductive loss (ie: with normal low-frequency thresholds) and 2) our ability to surgically repair the middle ear. Further investigation into the prevalence and functional significance of age- related middle ear change is necessary to ensure emerging therapies for presbycusis are appropriately directed. Newly developed bone conduction transducers without high frequency limitations permit comprehensive bone conduction testing at frequencies up to 16kHz. Novel transducers will help to finally establish whether a clinically relevant conductive or mixed presbycusis exists, shedding light on the functional effects of the aging middle ear. Development of reliable testing for high frequency conductive hearing loss carries implications beyond presbycusis, including post-middle-ear-surgery hearing assessment. Our goal is to identify mechanisms of conductive presbycusis and to establish methods to reliably diagnose high frequency conductive hearing loss. We hypothesize that a subset of patients with presbycusis have increased ossicular compliance resulting in conductive or mixed high frequency hearing loss.

人类传导性老年性耳聋的机制与年龄相关的高频听力损失（老年性耳聋）是一种几乎普遍存在的病症，影响仅在美国就有数千万个人，全世界每年的损失超过 7500 亿美元。老年性耳聋会导致理解言语困难、听到环境声音出现问题，如果如果不加以解决，可能会导致社会孤立。鉴于当前的人口趋势，社会负担老年性耳聋预计会加速。尽管老年性耳聋很普遍，但仍有很多未知之处其病因机制。长期以来，老年性耳聋一直被认为是继发于感觉神经功能障碍，但新出现的证据表明传导性病理学会导致老年性耳聋。临床评估听力的主要方法是行为纯音（500-8kHz）测听。鉴于以下方面的新知识，现在通常会进行扩展高频气导测试（>8kHz）高频声音对于语音理解和声音定位的作用。不幸的是，临床骨传导测试在 4kHz 停止。高于 4kHz，标准刺激传感器的局限性很大程度上在于与 20 世纪 50 年代相比没有变化，缺乏规范的骨传导标准限制了高频研究传导损耗。感音神经性老年性耳聋和传导性老年性耳聋之间的区别并不常规进行，但很有趣，因为：1）先前的工作表明中耳内的离散变化可能导致隔离高频传导损耗（即：具有正常低频阈值）和 2）我们的能力通过手术修复中耳。进一步调查年龄相关的患病率和功能意义相关的中耳改变对于确保老年性耳聋的新兴疗法得到适当的治疗是必要的指导。新开发的骨传导换能器没有高频限制，可实现全面的骨传导传导测试频率高达 16kHz。新型传感器将有助于最终确定是否存在临床相关的传导性或混合性老年性耳聋，揭示了衰老对功能的影响中耳。开发针对高频传导性听力损失的可靠测试具有重要意义除了老年性耳聋之外，还包括中耳手术后听力评估。我们的目标是确定传导性老年性耳聋的机制并建立可靠诊断高频的方法传导性听力损失。我们假设一部分老年性耳聋患者的听小骨增加顺应性导致传导性或混合性高频听力损失。