Institute of Micromechanics and Photonics, Warsaw University of Technology, Warsaw, Poland.
Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland.
Ear Hear. 2019 Nov/Dec;40(6):1437-1444. doi: 10.1097/AUD.0000000000000725.
The aim of this study was to investigate the following: (1) the vibration pattern of the round window (RW) membrane in human cadavers during air (AC) and bone conduction (BC) stimulation at different excitation sites; (2) the effect of the stimulation on the fluid volume displacement (VD) at the RW and compare the VD between BC and AC stimulation procedures; (3) the effectiveness of cochlear stimulation by the bone implant at different excitation sites.
The RW membrane vibrations were measured by using a commercial scanning laser Doppler vibrometer. The RW vibration amplitude was recorded at 69 measurement points evenly distributed in the measurement field covering the entire surface of the RW membrane and a part of the surrounding bony surface. RW vibration was induced first with AC and then with BC stimulation through an implant positioned at two sites. The first site was on the skull surface at the squamous part of the temporal bone (implant no. 1), a place typical for bone-anchored hearing aids. The second site was close to the cochlea at the bone forming the ampulla of the lateral semicircular canal (implant no. 2). The displacement amplitude (dP) of the point P on the promontory was determined and used to calculate the relative displacement (drRW) of points on the RW membrane, drRW = dRW - dP. VD parameter was used to analyze the effectiveness of cochlear stimulation by the bone implant screwed at different excitation sites.
RW membrane displacement amplitude of the central part of the RW was similar for AC and BC implant no. 1 stimulation, and for BC implant no. 2 much larger for frequency range >1 kHz. BC implant no. 2 causes a larger displacement amplitude of peripheral parts of the RW and the promontory than AC and BC implant no. 1, and BC implant no. 1 causes larger than AC stimulation. The effect of BC stimulation exceeds that of AC with identical intensity, and that the closer BC stimulation to the otic capsule, the more effective this stimulation is. A significant decrease in the value of VD at the RW is observed for frequencies >2 kHz for both AC and BC stimulation with BC at both locations of the titanium implant placement. For frequencies >1 kHz, BC implant no. 2 leads to a significantly larger VD at the RW compared to BC implant no. 1. Thus, the closer to the otic capsule the BC stimulation is located, the more effective it is.
Experimental conditions allow for an effective acoustic stimulation of the inner ear by an implant screwed to the osseous otic capsule. The mechanical effect of BC stimulation with a titanium implant placed in the bone of the ampulla of the lateral semicircular canal significantly exceeds the effect of an identical stimulation with an implant placed in the temporal squama at a conventional site for an implant anchored in the bone. The developed research method requires the implementation on a larger number of temporal bones in order to obtain data concerning interindividual variability of the observed mechanical phenomena.
本研究旨在调查以下内容:(1)在不同激发部位对人尸体进行空气(AC)和骨导(BC)刺激时,圆窗(RW)膜的振动模式;(2)刺激对 RW 处流体体积位移(VD)的影响,并比较 BC 和 AC 刺激过程之间的 VD;(3)不同激发部位骨植入物对耳蜗刺激的效果。
使用商用扫描激光多普勒测振仪测量 RW 膜的振动。在覆盖 RW 膜整个表面和周围部分骨表面的测量场中,RW 振动幅度记录在 69 个测量点上均匀分布。RW 振动首先通过置于两个部位的植入物进行 AC 刺激,然后进行 BC 刺激。第一个部位位于颞骨鳞部的颅骨表面(植入物 1 号),这是骨锚式助听器的典型位置。第二个部位靠近形成外侧半规管壶腹的骨(植入物 2 号)。确定了点 P 的位移幅度(dP),并用于计算 RW 膜上各点的相对位移(drRW),drRW=dRW-dP。VD 参数用于分析不同激发部位骨植入物对耳蜗刺激的效果。
AC 和 BC 植入物 1 刺激时 RW 中央部分的 RW 膜位移幅度相似,而 BC 植入物 2 刺激时频率范围>1 kHz 的 RW 膜位移幅度更大。BC 植入物 2 引起 RW 和岬部的外周部分的位移幅度比 AC 和 BC 植入物 1 更大,而 BC 植入物 1 引起的位移幅度比 AC 更大。BC 刺激的效果超过相同强度的 AC 刺激,并且 BC 刺激越接近耳囊,刺激效果越好。对于 AC 和 BC 两种刺激,在钛植入物放置的两个位置处,RW 处的 VD 值在>2 kHz 频率下均显著降低。对于>1 kHz 的频率,BC 植入物 2 引起的 RW 处 VD 明显大于 BC 植入物 1。因此,BC 刺激越接近耳囊,刺激效果越好。
实验条件允许通过植入物对骨耳囊进行有效的内耳声学刺激。将钛植入物置于外侧半规管壶腹骨中的 BC 刺激的力学效果明显超过将植入物置于传统的骨锚植入物的颞骨鳞部的相同刺激的效果。所开发的研究方法需要在更多的颞骨上进行实施,以便获得有关观察到的机械现象的个体间变异性的相关数据。