Carl Gustav Carus Faculty of Medicine, Clinic and Policlinic for Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Dresden, Germany.
Clinica O.R.L., Ilfov Clinical Emergency Hospital - ENT Clinic, Titu Maiorescu University, Bucharest, Romania.
Otol Neurotol. 2018 Dec;39(10):e907-e920. doi: 10.1097/MAO.0000000000002029.
To evaluate electromechanical excitation as an alternative excitation mode for middle ear transfer function (METF) measurements as well as real-time feedback in prosthetic ossicular reconstruction.
In eight human cadaveric temporal bones, the ossicular chain was excited using acoustic and mechanical (floating mass transducer, FMT) stimulation to determine the METF. After disconnecting the ossicular chain and reconstruction with partial or total prosthesis the METFs were measured again. Continuous FMT stimulation was then applied to improve the prosthesis' position using real-time feedback of the METF.
Mechanical stimulation of ossicular vibration showed characteristic differences to acoustic excitation resulting from the force characteristics of the FMT. Furthermore, the interspecimen METF variability was greater with electromechanical than acoustic stimulation because of interspecimen variability in the FMT coupling conditions. When the METF with FMT excitation was used as a real-time feedback tool, a measurable improvement in the quality of ossicular reconstruction could be achieved.
Mechanical excitation is an effective and suitable alternative stimulation method in experimental METF measurements. The system provides real-time feedback for ossicular reconstruction in the experimental setting. Some influencing factors still need to be distinguished for reliable measurements. However, the method does not yet meet the requirements for clinical application as an intraoperative, real-time monitoring tool. However, the system could be an excellent model for high-end cadaveric temporal bone training in ossiculoplasty.
评估机电激励作为中耳传递函数（METF）测量的替代激励模式，以及在假体听小骨重建中的实时反馈。
在 8 个人体尸头颞骨中，使用声学和机械刺激（浮动质量换能器，FMT）来激发听骨链，以确定 METF。在断开听骨链并使用部分或全部假体重建后，再次测量 METFs。然后，通过 METF 的实时反馈，连续应用 FMT 刺激以改善假体的位置。
与声学激励相比，机械刺激听骨振动具有特征差异，这是由于 FMT 的力特性所致。此外，由于 FMT 耦合条件的个体间变异性，机电激励的 METF 变异性大于声学激励。当使用 FMT 激励的 METF 作为实时反馈工具时，可以实现听小骨重建质量的可测量改善。
机械激励是实验性 METF 测量中有效且合适的替代刺激方法。该系统为实验设置中的听小骨重建提供了实时反馈。为了进行可靠的测量，仍需要区分一些影响因素。然而，该方法还不能满足作为术中实时监测工具的临床应用要求。但是，该系统可以作为高端尸头颞骨听骨成形术培训的优秀模型。
