Middle-ear transmission: acoustic versus ossicular coupling in cat and human.

Otologic surgeons consider the action of sound pressure on the cochlear windows to be of major importance in certain cases of middle-ear pathology, yet previously published network models of mammalian middle ears do not include such a mechanism. A unified middle-ear model is developed in which it is assumed that the difference of acoustic pressures acting on the windows adds to the ossicular-chain pressure to produce cochlear input. From a network model of the cat middle-ear cavities we estimate the contributions of pressures on the cochlear windows for both normal and abnormal cat ears. For the human ear we use the model of Kringlebotn (1988) and measurements of Békésy (1947). We determine that the pressure difference across the cochlear windows is negligibly small in normal cat and human ears. Thus, it is a reasonable approximation to ignore this mechanism in normal ears. For ears with a drastically altered tympanic membrane and/or ossicular chain, acoustic coupling to the cochlear windows can--to a considerable extent--explain residual hearing in human. The model predicts hearing levels for type IV tympanoplastic reconstructions that agree with the best results obtained surgically.