Division of Otolaryngology, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Laryngoscope. 2013 Apr;123(4):1021-7. doi: 10.1002/lary.23711. Epub 2012 Nov 20.
OBJECTIVES/HYPOTHESIS: Many otologic disorders have been attributed to dysfunction of the tensor tympani muscle, including tinnitus, otalgia, Meniere's disease and sensorineural hearing loss. The objective of this study was to determine adequate stimuli for tensor tympani contraction in humans and determine markers of the hypercontracted state that could be used to detect this process in otologic disease.
Multiple types of studies.
Studies included 1) measuring middle ear impedance changes in response to orbital puffs of air, facial stroking, and self-vocalization; 2) measuring changes in stapes and eardrum vibrations and middle ear acoustic impedance in response to force loading of the tensor tympani in fresh human cadaveric temporal bones; 3) measuring changes in acoustic impedance in two subjects who could voluntarily contract their tensor tympani, and performing an audiogram with the muscle contracted in one of these subjects; and 4) developing a lumped parameter computer model of the middle ear while simulating various levels of tensor tympani contraction.
Orbital jets of air are the most effective stimuli for eliciting tensor tympani contraction. As markers for tensor tympani contraction, all investigations indicate that tensor tympani hypercontraction should result in a low-frequency hearing loss, predominantly conductive, with a decrease in middle ear compliance.
These markers should be searched for in otologic pathology states where the tensor tympani is suspected of being hypercontracted.
目的/假设:许多耳科疾病都归因于鼓膜张肌功能障碍,包括耳鸣、耳痛、梅尼埃病和感音神经性听力损失。本研究的目的是确定引起人类鼓膜张肌收缩的适当刺激,并确定可用于检测耳科学疾病中这种过程的高收缩状态标志物。
多种类型的研究。
研究包括 1)测量中耳阻抗变化对眶内空气吹气、面部抚摸和自发声的反应;2)测量镫骨和鼓膜振动以及中耳声阻抗对鼓膜张肌力加载的响应变化在新鲜的人类尸体颞骨;3)测量两名可自愿收缩鼓膜张肌的受试者的声阻抗变化,并在其中一名受试者收缩肌肉时进行听力图检查;4)在模拟各种鼓膜张肌收缩水平的同时,开发中耳的集中参数计算机模型。
眶内喷气是引起鼓膜张肌收缩的最有效刺激。作为鼓膜张肌收缩的标志物,所有研究均表明,鼓膜张肌高收缩应导致低频听力损失,主要为传导性,中耳顺应性降低。
在怀疑鼓膜张肌高收缩的耳科学病理状态下,应寻找这些标志物。