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Das Gehör ist mehr als jedes andere Sinnesorgan für die menschliche Sprache und ihre Entwicklung verantwortlich und stellt auf kleinstem Raum ein anatomisch und physiologisch einzigartiges Gebilde dar. Es beeindruckt vor allem durch seinen großen Dynamikbereich.
Während im Bereich der Hörschwelle der eben hörbare Schalldruck etwa 20 μPa beträgt, können die Drucke und Amplituden bis zur Schmerzgrenze noch etwa zweimillionenfach gesteigert werden. Derartige physiologische Schalldrücke sind jedoch immer noch verschwindend klein gegenüber den ebenfalls auf das Ohr einwirkenden statischen Luftdruckschwankungen, wie sie beispielsweise beim Treppensteigen, Zug- bzw. Autofahren, Fliegen oder beim Naseputzen vorkommen. Zwar führen diese zu einer veränderten Wahrnehmung, jedoch nicht zu einer Schäadigung des Ohrs. Diese Fähigkeit, trotz großer statischer Druckschwankungen in der Umgebung, gleichzeitig winzige physiologische Schalldrücke wahrnehmen zu können, ist hauptsächlich in den nichtlinearen, viskoelastischen Eigenschaften der Gelenke und Bänder des Mittelohrs sowie des Trommelfells begründet.
Das Ziel dieser Arbeit ist es, dieses nichtlineare Verhalten des Mittelohrs bei großen Belastungen und großen Verschiebungen durch nichtlineare, räumliche Ersatzmodelle auf mechanischer Basis abzubilden. Zur Charakterisierung der nichtlinearen Eigenschaften der Gerhörknöchelchenkette werden statische und dynamische Messungen an humanen Felsenbeinen durchgeführt. Ein besonderes Augenmerk ist auf die Charakterisierung der nichtlinearen, viskoelastischen Eigenschaften des Ringbands, des Trommelfells, der Trommelfellsehne und der beiden Mittelohrgelenke gerichtet. Im Blick auf die klinische Praxis wird zum einen anhand von Messergebnissen das Schädigungsrisiko bei einer Stapeschirurgie diskutiert sowie die Auswirkungen von Vorspannungen im Mittelohrapparat am Beispiel des aktiven Implantats Carina untersucht.
Model-based hearing diagnosis based on wideband tympanometry measurements utilizing fuzzy arithmetic
(2019)
Today's audiometric methods for the diagnosis of middle ear disease are often based on a comparison of measurements with standard curves that represent the statistical range of normal hearing responses. Because of large inter-individual variances in the middle ear, especially in wideband tympanometry (WBT), specificity and quantitative evaluation are greatly restricted. A new model-based approach could transform today's predominantly qualitative hearing diganostics into a quantitative and tailored, patient-specific diagnosis, by evaluating WBT measurements with the aid of a middle-ear model. For this particular investigation, a finite element model of a human ear was used. It consisted of an acoustic ear canal and a tympanic cavity model, a middle-ear with detailed nonlinear models of the tympanic membrane and annular ligament, and a simplified inner-ear model. This model has made it possible to identify pathologies from measurements, by analyzing the parameters through senstivity studies and parameter clustering. Uncertainties due to the lack of knowledge, subjectivity in numerical implementation and model simplification are taken into account by the application of fuzzy arithmetic. The most confident parameter set can be determined by applying an inverse fuzzy method on the measurement data. The principle and the benefits of this model-based approach are illustrated by the example of a two-mass oscillator, and also by the simulation of the energy absorbance of an ear with malleus fixation, where the parameter changes that are introduced can be determined quantitatively through the system identification.
Due to the large interindividual variances and the poor optical accessibility of the ear, the specificity of hearing diagnostics today is severely restricted to a certain clinical picture and quantitative assessment. Often only a yes or no decision is possible, which depends strongly on the subjective assessment of the ENT physician. A novel approach, in which objectively obtainable, non invasive audiometric measurements are evaluated using a numerical middle ear model, makes it possible to make the hidden middle ear properties visible and quantifiable. The central topic of this paper is a novel parameter identification algorithm that combines inverse fuzzy arithmetic with an artificial neural network in order to achieve a coherent diagnostic overall picture in the comparison of model and measurement. Its usage is shown at a pathological pattern called malleus fixation where the upper ligament of the malleus is pathologically stiffened.
This study describes a non-contact measuring and parameter identification procedure designed to evaluate 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. This method can potentially help to establish a correlation between stiffness and damping characteristics of the annular ligament and inertia properties of the stapes and, thus, help to reduce the number of independent parameters in the model-based hearing diagnosis.
Hearing contact lens (HCL) is a new type of hearing aid devices. One of its main components is a piezo-electric actuator (PEA). In order to evaluate and maximizethe HCL´s performance, a model of the HCL coupled to the middle ear was developed using finite element (FE)approach. To validate the model, vibrational measurements on the HCL and temporal bones were performed using a Laser-Doppler-Vibrometer (LDV). The model was validated step by step starting with HCL only. Then a silicone cap was fitted onto the HCL to provide an interface between the HCL and the tympanic membrane. The HCL was placed on the tympanic membrane and additional measurements were performed to validate the coupled model. The model was used to evaluate the sensitivity of geometrical and material parameters with respect to performance measures of the HCL. Moreover, deeper insight was gained into the feedback behavior, which causes whistling sounds, and the contact between the HCL and tympanic membrane.
Knochenleitungshörgerät
(2021)
Bei einem Knochenleitungshörgerät (1) umfassend eine Audioeinheit (2) und einen Hautkontaktteil (3), wobei der Hautkontaktteil (3) eine Klebeschicht (4) zur Befestigung auf der Haut (5) eines Benutzers, ein erstes Kupplungsstück (6) zum Verbinden mit einem gegengleichen zweiten Kupplungsstück (7) der Audioeinheit (2), und einen Schwingungsübertragungsteil (8) mit einer Kontaktfläche (9) zum direkten Kontakt mit der Haut (5) aufweist, wird vorgeschlagen, dass das Schwingungsübertragungsteil (8) in einem Anpassungszustand durch Andrücken an die Haut (5) mit einer ersten Anpresskraft plastisch verformbar ist, dass das Schwingungsübertragungsteil (8) in einem Betriebszustand im Wesentlichen formstabil ist, und dass das Schwingungsübertragungsteil (8) durch einen Verfestigungsschritt von dem Anpassungszustand in den Betriebszustand verbringbar ist.
The incudo-malleal joint (IMJ) in the human middle ear is a true diarthrodial joint and it has been known that the flexibility of this joint does not contribute to better middle-ear sound transmission. Previous studies have proposed that a gliding motion between the malleus and the incus at this joint prevents the transmission of large displacements of the malleus to the incus and stapes and thus contributes to the protection of the inner ear as an immediate response against large static pressure changes. However, dynamic behavior of this joint under static pressure changes has not been fully revealed. In this study, effects of the flexibility of the IMJ on middle-ear sound transmission under static pressure difference between the middle-ear cavity and the environment were investigated. Experiments were performed in human cadaveric temporal bones with static pressures in the range of +/- 2 kPa being applied to the ear canal (relative to middle-ear cavity). Vibrational motions of the umbo and the stapes footplate center in response to acoustic stimulation (0.2-8 kHz) were measured using a 3D-Laser Doppler vibrometer for (1) the natural IMJ and (2) the IMJ with experimentally-reduced flexibility. With the natural condition of the IMJ, vibrations of the umbo and the stapes footplate center under static pressure loads were attenuated at low frequencies below the middle-ear resonance frequency as observed in previous studies. After the flexibility of the IMJ was reduced, additional attenuations of vibrational motion were observed for the umbo under positive static pressures in the ear canal (EC) and the stapes footplate center under both positive and negative static EC pressures. The additional attenuation of vibration reached 4~7 dB for the umbo under positive static EC pressures and the stapes footplate center under negative EC pressures, and 7~11 dB for the stapes footplate center under positive EC pressures. The results of this study indicate an adaptive mechanism of the flexible IMJ in the human middle ear to changes of static EC pressure by reducing the attenuation of the middle-ear sound transmission. Such results are expected to be used for diagnosis of the IMJ stiffening and to be applied to design of middle-ear prostheses.
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.
Current clinical practice is often unable to identify the causes of conductive hearing loss in the middle ear with sufficient certainty without exploratory surgery. Besides the large uncertainties due to interindividual variances, only partially understood cause–effect principles are a major reason for the hesitant use of objective methods such as wideband tympanometry in diagnosis, despite their high sensitivity to pathological changes. For a better understanding of objective metrics of the middle ear, this study presents a model that can be used to reproduce characteristic changes in metrics of the middle ear by altering local physical model parameters linked to the anatomical causes of a pathology. A finite-element model is, therefore, fitted with an adaptive parameter identification algorithm to results of a temporal bone study with stepwise and systematically prepared pathologies. The fitted model is able to reproduce well the measured quantities reflectance, impedance, umbo and stapes transfer function for normal ears and ears with otosclerosis, malleus fixation, and disarticulation. In addition to a good representation of the characteristic influences of the pathologies in the measured quantities, a clear assignment of identified model parameters and pathologies consistent with previous studies is achieved. The identification results highlight the importance of the local stiffness and damping values in the middle ear for correct mapping of pathological characteristics and address the challenges of limited measurement data and wide parameter ranges from the literature. The great sensitivity of the model with respect to pathologies indicates a high potential for application in model-based diagnosis.
The hearing contact lens® (HCL) is a new type of hearing aid devices. One of its main components is a piezo-electric actuator. In order to evaluate and maximize the HCL's performance, a model of the HCL coupled to a middle-ear model was developed using finite element approach. The model was validated step by step starting with the HCL only. To validate the HCL model, vibrational measurements on the HCL were performed using a laser-doppler-vibrometer (LDV). Then, a silicone cap was placed onto the HCL to provide an interface between the HCL and the tympanic membrane of the middle-ear model, and additional LDV measurements on temporal bones were performed to validate the coupled model that was used to evaluate the equivalent sound pressure of the HCL. Moreover, a de-eper insight was gained into the contact between the HCL and tympanic membrane and its effects on the HCL performance. The model can be used to investigate the sensitivity of geometrical and material parameters with respect to performance measures of the HCL and evaluate the feedback behavior.
