Maassen Marcus M, Rodriguez Jorge Jesus, Herberhold Stephan, Vonthein Reinhard, Zimmermann Rainer, Baumann Ingo, Brosch Sibylle, Mauz Paul S, Pfister Markus, Zalaman Ilse M, Löwenheim Hubert, Zenner Hans P
Department of Otolaryngology, University of Tübingen, Tübingen, Germany.
Laryngoscope. 2004 Nov;114(11):2012-20. doi: 10.1097/01.mlg.0000147938.52132.4b.
The aim of the study was to evaluate the safety and feasibility of piezoelectric malleus vibration audiometer (MVA), which presents micromechanical vibrations to the umbo membranae tympani.
Phase I study performed in a tertiary referral center (University Hospital).
The coupling rod of the MVA was moved slowly through the outer ear canal toward the eardrum with a micromanipulator. Coupling was completed when the rod tip touched the umbo membranae tympani. Basic audiologic measures of sound threshold obtained with direct stimulation of the malleus are presented. We used MANOVA (multivariate repeated measures ANOVA) to investigate the repeatability of MVA thresholds from one day to the other and when decoupling and retracting the coupling rod 2 mm off the umbo. We also selected the MANOVA to test for unwanted bone-conduction threshold shifts after MVA application. We assessed normality of the data by quantile-quantile plots of the residuals.
Twenty-eight male and 10 female subjects with normal hearing, 22.2 to 34.6 years old (median age, 27.2 yr) underwent an examination. Thirty-six subjects underwent MVA, because 2 of the 38 subjects who volunteered for the study have not undergone the procedure due to the external auditory canal anatomy preventing application of the MVA. The results show that it is possible to safely and reliably measure thresholds of direct vibration of the ossicular chain. Using pure tone audiograms, no pure tone bone- and/or air-conduction threshold shifts occurred after the procedure. None of the subjects reported any other ear-related symptoms such as vertigo, tinnitus, or dizziness. Geometric mean vibratory displacements at threshold ranged from 0.55 nm at 250 Hz to 0.03 nm at 6 kHz. MANOVA demonstrated a repeatability of MVA thresholds.
Malleus vibration audiometry will not allow exact linkage of actual implantable hearing aid. But the present study demonstrates that MVA can provide an audiometric tool for assessing ossicular function and integrity prior to implantation of an electronic hearing amplifier.
本研究旨在评估向鼓膜脐部施加微机械振动的压电锤骨振动听力计（MVA）的安全性和可行性。
在三级转诊中心（大学医院）进行的I期研究。
使用显微操作器将MVA的耦合杆通过外耳道缓慢移向鼓膜。当杆尖接触到鼓膜脐部时完成耦合。呈现了通过直接刺激锤骨获得的基本听力学阈值测量结果。我们使用多变量重复测量方差分析（MANOVA）来研究MVA阈值从一天到另一天以及当耦合杆从脐部解耦并缩回2毫米时的可重复性。我们还选择MANOVA来测试MVA应用后不必要的骨导阈值变化。我们通过残差的分位数 - 分位数图评估数据的正态性。
28名男性和10名女性听力正常的受试者接受了检查，年龄在22.2至34.6岁之间（中位年龄27.2岁）。36名受试者接受了MVA检查，因为在38名自愿参加该研究的受试者中，有2名由于外耳道解剖结构妨碍MVA的应用而未接受该操作。结果表明，可以安全可靠地测量听骨链直接振动的阈值。使用纯音听力图，术后未出现纯音骨导和/或气导阈值变化。没有受试者报告任何其他与耳朵相关的症状，如眩晕、耳鸣或头晕。阈值处的几何平均振动位移范围从250Hz时的0.55nm到6kHz时的0.03nm。MANOVA证明了MVA阈值的可重复性。
锤骨振动听力测定法无法实现与实际可植入助听器的精确连接。但本研究表明，MVA可为在植入电子听力放大器之前评估听骨功能和完整性提供一种听力测量工具。
