Alexander Geerardyn , Irina Wils , Tristan Putzeys , Guy Fierens , Jan Wouters , Nicolas Verhaert
{"title":"圆窗加固对气导和骨导刺激下的中耳和内耳力学的影响","authors":"Alexander Geerardyn , Irina Wils , Tristan Putzeys , Guy Fierens , Jan Wouters , Nicolas Verhaert","doi":"10.1016/j.heares.2024.109049","DOIUrl":null,"url":null,"abstract":"<div><p>The round window (RW) membrane plays an important role in normal inner ear mechanics. Occlusion or reinforcement of the RW has been described in the context of congenital anomalies or after cochlear implantation and is applied as a surgical treatment for hyperacusis. Multiple lumped and finite element models predict a low-frequency hearing loss with air conduction of up to 20 dB after RW reinforcement and limited to no effect on hearing with bone conduction stimulation. Experimental verification of these results, however, remains limited.</p><p>Here, we present an experimental study measuring the impact of RW reinforcement on the middle and inner ear mechanics with air and bone conduction stimulation. In a within-specimen repeated measures design with human cadaveric specimens (<em>n</em> = 6), we compared the intracochlear pressures in scala vestibuli (P<sub>SV</sub>) and scala tympani (P<sub>ST</sub>) before and after RW reinforcement with soft tissue, cartilage, and bone cement. The differential pressure (P<sub>DIFF</sub>) across the basilar membrane – known to be closely related to the hearing sensation - was calculated as the complex difference between P<sub>SV</sub> and P<sub>ST</sub>.</p><p>With air conduction stimulation, both P<sub>SV</sub> and P<sub>ST</sub> <em>increased</em> on average up to 22 dB at frequencies below 1500 Hz with larger effect sizes for P<sub>ST</sub> compared to P<sub>SV</sub>. The P<sub>DIFF</sub>, in contrast, <em>decreased</em> up to 11 dB at frequencies between 700 and 800 Hz after reinforcement with bone cement.</p><p>With bone conduction, the average within-specimen effects were less than 5 dB for either P<sub>SV</sub>, P<sub>ST,</sub> or P<sub>DIFF</sub>. The inter-specimen variability with bone conduction, however, was considerably larger than with air conduction.</p><p>This experimental study shows that RW reinforcement impacts air conduction stimulation at low frequencies. Bone conduction stimulation seems to be largely unaffected. From a clinical point of view, these results support the hypothesis that delayed loss of air conduction hearing after cochlear implantation could be partially explained by the impact of RW reinforcement.</p></div>","PeriodicalId":12881,"journal":{"name":"Hearing Research","volume":"450 ","pages":"Article 109049"},"PeriodicalIF":2.5000,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378595524001023/pdfft?md5=9ec53bf0103cda19c441389bbc20d8ad&pid=1-s2.0-S0378595524001023-main.pdf","citationCount":"0","resultStr":"{\"title\":\"The impact of round window reinforcement on middle and inner ear mechanics with air and bone conduction stimulation\",\"authors\":\"Alexander Geerardyn , Irina Wils , Tristan Putzeys , Guy Fierens , Jan Wouters , Nicolas Verhaert\",\"doi\":\"10.1016/j.heares.2024.109049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>The round window (RW) membrane plays an important role in normal inner ear mechanics. Occlusion or reinforcement of the RW has been described in the context of congenital anomalies or after cochlear implantation and is applied as a surgical treatment for hyperacusis. Multiple lumped and finite element models predict a low-frequency hearing loss with air conduction of up to 20 dB after RW reinforcement and limited to no effect on hearing with bone conduction stimulation. Experimental verification of these results, however, remains limited.</p><p>Here, we present an experimental study measuring the impact of RW reinforcement on the middle and inner ear mechanics with air and bone conduction stimulation. In a within-specimen repeated measures design with human cadaveric specimens (<em>n</em> = 6), we compared the intracochlear pressures in scala vestibuli (P<sub>SV</sub>) and scala tympani (P<sub>ST</sub>) before and after RW reinforcement with soft tissue, cartilage, and bone cement. The differential pressure (P<sub>DIFF</sub>) across the basilar membrane – known to be closely related to the hearing sensation - was calculated as the complex difference between P<sub>SV</sub> and P<sub>ST</sub>.</p><p>With air conduction stimulation, both P<sub>SV</sub> and P<sub>ST</sub> <em>increased</em> on average up to 22 dB at frequencies below 1500 Hz with larger effect sizes for P<sub>ST</sub> compared to P<sub>SV</sub>. The P<sub>DIFF</sub>, in contrast, <em>decreased</em> up to 11 dB at frequencies between 700 and 800 Hz after reinforcement with bone cement.</p><p>With bone conduction, the average within-specimen effects were less than 5 dB for either P<sub>SV</sub>, P<sub>ST,</sub> or P<sub>DIFF</sub>. The inter-specimen variability with bone conduction, however, was considerably larger than with air conduction.</p><p>This experimental study shows that RW reinforcement impacts air conduction stimulation at low frequencies. Bone conduction stimulation seems to be largely unaffected. From a clinical point of view, these results support the hypothesis that delayed loss of air conduction hearing after cochlear implantation could be partially explained by the impact of RW reinforcement.</p></div>\",\"PeriodicalId\":12881,\"journal\":{\"name\":\"Hearing Research\",\"volume\":\"450 \",\"pages\":\"Article 109049\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0378595524001023/pdfft?md5=9ec53bf0103cda19c441389bbc20d8ad&pid=1-s2.0-S0378595524001023-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hearing Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0378595524001023\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hearing Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0378595524001023","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
The impact of round window reinforcement on middle and inner ear mechanics with air and bone conduction stimulation
The round window (RW) membrane plays an important role in normal inner ear mechanics. Occlusion or reinforcement of the RW has been described in the context of congenital anomalies or after cochlear implantation and is applied as a surgical treatment for hyperacusis. Multiple lumped and finite element models predict a low-frequency hearing loss with air conduction of up to 20 dB after RW reinforcement and limited to no effect on hearing with bone conduction stimulation. Experimental verification of these results, however, remains limited.
Here, we present an experimental study measuring the impact of RW reinforcement on the middle and inner ear mechanics with air and bone conduction stimulation. In a within-specimen repeated measures design with human cadaveric specimens (n = 6), we compared the intracochlear pressures in scala vestibuli (PSV) and scala tympani (PST) before and after RW reinforcement with soft tissue, cartilage, and bone cement. The differential pressure (PDIFF) across the basilar membrane – known to be closely related to the hearing sensation - was calculated as the complex difference between PSV and PST.
With air conduction stimulation, both PSV and PSTincreased on average up to 22 dB at frequencies below 1500 Hz with larger effect sizes for PST compared to PSV. The PDIFF, in contrast, decreased up to 11 dB at frequencies between 700 and 800 Hz after reinforcement with bone cement.
With bone conduction, the average within-specimen effects were less than 5 dB for either PSV, PST, or PDIFF. The inter-specimen variability with bone conduction, however, was considerably larger than with air conduction.
This experimental study shows that RW reinforcement impacts air conduction stimulation at low frequencies. Bone conduction stimulation seems to be largely unaffected. From a clinical point of view, these results support the hypothesis that delayed loss of air conduction hearing after cochlear implantation could be partially explained by the impact of RW reinforcement.
期刊介绍：
The aim of the journal is to provide a forum for papers concerned with basic peripheral and central auditory mechanisms. Emphasis is on experimental and clinical studies, but theoretical and methodological papers will also be considered. The journal publishes original research papers, review and mini- review articles, rapid communications, method/protocol and perspective articles.
Papers submitted should deal with auditory anatomy, physiology, psychophysics, imaging, modeling and behavioural studies in animals and humans, as well as hearing aids and cochlear implants. Papers dealing with the vestibular system are also considered for publication. Papers on comparative aspects of hearing and on effects of drugs and environmental contaminants on hearing function will also be considered. Clinical papers will be accepted when they contribute to the understanding of normal and pathological hearing functions.
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