Voss Susan E, Horton Nicholas J, Woodbury Rebecca R, Sheffield Kathryn N
Picker Engineering Program Smith College, Northampton, MA 01063, USA.
Ear Hear. 2008 Aug;29(4):651-65. doi: 10.1097/AUD.0b013e318174f07c.
The development of acoustic reflectance measurements may lead to noninvasive tests that provide information currently unavailable from standard audiometric testing. One factor limiting the development of these tests is that normal-hearing human ears show substantial intersubject variations. This work examines intersubject variability that results from measurement location within the ear canal, estimates of ear-canal area, and variations in middle-ear cavity volume.
Energy reflectance (ER) measurements were made on nine human-cadaver ears to study three variables. (1) ER was measured at multiple ear-canal locations. (2) The ear-canal area at each measurement location was measured and the ER was calculated with the measured area, a constant area, and an acoustically estimated area. (3) The ER was measured with the middle-ear cavity in three conditions: (1) normal, (2) the mastoid widely opened (large air space), and (3) the mastoid closed off at the aditus ad antrum (small air space).
Measurement-location effects are generally largest at frequencies below about 2000 Hz, where in some ears reflectance magnitudes tend to decrease systematically as the measurement location moves away from the tympanic membrane but in other ears the effects seem minimal. Intrasubject variations in reflectance due to changes in either measurement location within the ear canal or differences in the estimate of the ear-canal area are smaller than variations produced by large variations in middle-ear cavity air volume or intersubject differences. At frequencies below 2000 Hz, large increases in cavity volume systematically reduce the ER, with more variable changes above 2000 Hz.
ER measurements depend on all variables studied: measurement location, ear-canal cross-sectional area, and middle-ear cavity volume. Variations within an individual ear in either measurement location or ear-canal cross-sectional area result in relatively small effects on the ER, supporting the notion that diagnostic tests (1) need not control for measurement location and (2) can assume a constant ear-canal area across most subjects. Variations in cavity volume produce much larger effects in ER than measurement location or ear-canal area, possibly explaining some of the intersubject variation in ER reported among normal ears.
声反射测量技术的发展可能会带来一些非侵入性检测方法,这些方法能够提供目前标准听力测试所无法获取的信息。限制这些检测方法发展的一个因素是,听力正常的人耳在个体之间存在显著差异。本研究探讨了耳道内测量位置、耳道面积估计值以及中耳腔体积变化所导致的个体间差异。
对九只人尸体耳朵进行了能量反射率(ER)测量,以研究三个变量。(1)在耳道的多个位置测量ER。(2)测量每个测量位置的耳道面积,并使用测量面积、恒定面积和声学估计面积来计算ER。(3)在三种情况下测量中耳腔的ER:(1)正常状态,(2)乳突广泛开放(大空气腔),(3)在鼓窦入口处封闭乳突(小空气腔)。
测量位置效应通常在约2000Hz以下的频率处最为显著,在某些耳朵中,随着测量位置远离鼓膜,反射率大小往往会系统性地降低,但在其他耳朵中,这种效应似乎很小。由于耳道内测量位置的变化或耳道面积估计值的差异导致的个体内反射率变化,小于中耳腔空气体积的大幅变化或个体间差异所产生的变化。在2000Hz以下的频率,腔体积的大幅增加会系统性地降低ER,在2000Hz以上则变化更为多样。
ER测量取决于所研究的所有变量:测量位置、耳道横截面积和中耳腔体积。个体耳朵内测量位置或耳道横截面积的变化对ER的影响相对较小,这支持了以下观点:诊断测试(1)无需控制测量位置,(2)可以假设大多数受试者的耳道面积恒定。腔体积的变化对ER的影响比测量位置或耳道面积大得多,这可能解释了正常耳朵之间报告的ER个体间差异的部分原因。