Hsu R W, Margolis R H, Schachern P A, Javel E
Otitis Media Clinical Research Center and Department of Otolaryngology, University of Minnesota School of Medicine, Minneapolis 55455, USA.
Acta Otolaryngol. 2001 Sep;121(6):679-88. doi: 10.1080/00016480152583610.
Studies of auditory function in the human neonate indicate adult-like hearing sensitivity, mature cochlear function and well-developed responses in the auditory pathway. Paradoxically, measurements of middle ear function are characterized by responses that would be interpreted as abnormal in older subjects. Consequently, there is not an accepted clinical test for middle ear disease in the newborn population. Like human neonates, chinchillas have normal hearing sensitivity at birth, but middle ear function tested by multifrequency tympanometry is abnormal compared to the adult. A previous study from our laboratory indicated that the newborn chinchilla middle ear is free of mesenchyme and other debris. Over the first 2 weeks of life there were no significant changes in tympanic membrane thickness and diameter, tympanic membrane to promontory distance and stapes footplate length. There were small changes in mastoid bulla area and perimeter and in mastoid bulla bone thickness. The most striking difference between the newborn and adult temporal bone was in bone composition, the newborn bone having a less dense, spongy appearance. Impedance characteristics of the newborn chinchilla ear, measured by multifrequency tympanometry, were abnormal relative to adult animals and did not change over the first 2 weeks of life. This investigation is an extension of the previous study, designed to better understand the relationship between middle ear function, hearing sensitivity and the structural changes of the newborn chinchilla middle ear. Twenty animals, aged 2-8 weeks, were studied. Additional adult animals were used as controls. Middle ear function was assessed by a wideband reflectance impedance system. Hearing sensitivity was measured by auditory brainstem response in 2- and 8-week-old animals. Structural characteristics of the temporal bone were analyzed using histopathologic preparations. There was an orderly progression in middle ear impedance and reflectance characteristics as the chinchilla ear matured from 2 to 8 weeks of age. At 8 weeks of age, impedance and reflectance patterns approached, but did not match, those of the adult animal. Hearing sensitivity was unchanged throughout this maturational period. Finally, histological analysis demonstrated no age-related changes in distance from the tympanic membrane (TM) to the promontory and in stapes footplate length. There was a small significant decrease in the TM thickness from 2 weeks to adulthood. The most significant developmental changes were a reduction in mastoid bone thickness and concomitant increases in the perimeters and areas of the middle ear and posterior bulla.
对人类新生儿听觉功能的研究表明,其听力敏感度与成人相似,耳蜗功能成熟,听觉通路反应发育良好。矛盾的是,中耳功能测量结果显示,其反应在年龄较大的受试者中会被判定为异常。因此,目前尚无针对新生儿群体中耳疾病的公认临床检测方法。与人类新生儿一样,豚鼠出生时听力敏感度正常,但通过多频鼓室图测量的中耳功能与成年豚鼠相比是异常的。我们实验室之前的一项研究表明,新生豚鼠的中耳没有间充质和其他碎屑。在出生后的前两周,鼓膜厚度和直径、鼓膜到岬的距离以及镫骨足板长度均无显著变化。乳突泡面积和周长以及乳突泡骨厚度有微小变化。新生豚鼠和成年豚鼠颞骨最显著的差异在于骨成分,新生豚鼠的骨密度较低,呈海绵状外观。通过多频鼓室图测量,新生豚鼠耳朵的声阻抗特性相对于成年动物是异常的,并且在出生后的前两周内没有变化。本研究是之前研究的扩展,旨在更好地理解中耳功能、听力敏感度与新生豚鼠中耳结构变化之间的关系。研究了20只年龄在2至8周的动物。另外使用成年动物作为对照。通过宽带反射声阻抗系统评估中耳功能。通过听觉脑干反应测量2周龄和8周龄动物的听力敏感度。使用组织病理学标本分析颞骨的结构特征。随着豚鼠耳朵从2周龄成熟到8周龄,中耳声阻抗和反射特性呈有序进展。在8周龄时,声阻抗和反射模式接近但不匹配成年动物。在整个成熟阶段,听力敏感度没有变化。最后,组织学分析表明,从鼓膜(TM)到岬的距离以及镫骨足板长度没有与年龄相关的变化。从2周龄到成年,TM厚度有小幅显著下降。最显著的发育变化是乳突骨厚度减小,同时中耳和后鼓泡的周长和面积增加。