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Purpose
Injury or inflammation of the middle ear often results in the persistent tympanic membrane (TM) perforations, leading to conductive hearing loss (HL). However, in some cases the magnitude of HL exceeds that attributable by the TM perforation alone. The aim of the study is to better understand the effects of location and size of TM perforations on the sound transmission properties of the middle ear.
Methods
The middle ear transfer functions (METF) of six human temporal bones (TB) were compared before and after perforating the TM at different locations (anterior or posterior lower quadrant) and to different degrees (1 mm, ¼ of the TM, ½ of the TM, and full ablation). The sound-induced velocity of the stapes footplate was measured using single-point laser-Doppler-vibrometry (LDV). The METF were correlated with a Finite Element (FE) model of the middle ear, in which similar alterations were simulated.
Results
The measured and calculated METF showed frequency and perforation size dependent losses at all perforation locations. Starting at low frequencies, the loss expanded to higher frequencies with increased perforation size. In direct comparison, posterior TM perforations affected the transmission properties to a larger degree than anterior perforations. The asymmetry of the TM causes the malleus-incus complex to rotate and results in larger deflections in the posterior TM quadrants than in the anterior TM quadrants. Simulations in the FE model with a sealed cavity show that small perforations lead to a decrease in TM rigidity and thus to an increase in oscillation amplitude of the TM mainly above 1 kHz.
Conclusion
Size and location of TM perforations have a characteristic influence on the METF. The correlation of the experimental LDV measurements with an FE model contributes to a better understanding of the pathologic mechanisms of middle-ear diseases. If small perforations with significant HL are observed in daily clinical practice, additional middle ear pathologies should be considered. Further investigations on the loss of TM pretension due to perforations may be informative.
This study describes a non-contact measuring and system identification procedure for evaluating inhomogeneous stiffness and damping characteristics of the annular ligament in the physiological amplitude and frequency range without the application of large static external forces that can cause unnatural displacements of the stapes. To verify the procedure, measurements were first conducted on a steel beam. Then, measurements on an individual human cadaveric temporal bone sample were performed. The estimated results support the inhomogeneous stiffness and damping distribution of the annular ligament and are in a good agreement with the multiphoton microscopy results which show that the posterior-inferior corner of the stapes footplate is the stiffest region of the annular ligament.
Investigation of tympanic membrane influences on middle-ear impedance measurements and simulations
(2020)
This study simulates acoustic impedance measurements in the human ear canal and investigates error influences due to improperly accounted evanescence in the probe’s near field, cross-section area changes, curvature of the ear canal, and pressure inhomogeneities across the tympanic membrane, which arise mainly at frequencies above 10 kHz. Evanescence results from strongly damped modes of higher order, which can only be found in the near field of the sound source and are excited due to sharp cross-sectional changes as they occur at the transition from the probe loudspeaker to the ear canal. This means that different impedances are measured depending on the probe design. The influence of evanescence cannot be eliminated completely from measurements, however, it can be reduced by a probe design with larger distance between speaker and microphone. A completely different approach to account for the influence of evanescence is to evaluate impedance measurements with the help of a finite element model, which takes the precise arrangement of microphone and speaker in the measurement into account. The latter is shown in this study exemplary on impedance measurements at a tube terminated with a steel plate. Furthermore, the influences of shape changes of the tympanic membrane and ear canal curvature on impedance are investigated.