Department of Mechanics and Tianjin Key Laboratory of Nonlinear Dynamics and Control, Tianjin University, Tianjin 300350, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100730, China; Beijing Engineering Research Center of Audiological Technology, Beijing 100730, China.
Comput Methods Programs Biomed. 2024 Jan;243:107868. doi: 10.1016/j.cmpb.2023.107868. Epub 2023 Oct 16.
As for repairing the perforated tympanic membranes (TM), temporalis fascia and tragal cartilage are popular in clinics as autologous graft materials. However, there is a significant hearing loss after repairing the TM with autologous graft materials, which needs to be addressed in biomechanical engineering.
The finite element model of normal middle ear is improved from two aspects: the repair method of tympanic fibrous layer and the bionic spider web tympanic scaffold. By creating the solid-shell coupling condition and strong coupling boundary condition to simulate the repair, TM umbo and stapes footplate displacement-frequency response are explored in 200-8000 Hz.
The tympanic membrane perforation (TMP) causes a significant conductive hearing loss in high frequency region, which is positively correlated with perforation area. Both temporalis fascia and tragal cartilage still perform a certain degree of high-frequency hearing loss after repairing TMP. The TM attachment the magnesium alloy scaffold (MAS) prevents appropriately the high frequency hearing loss after autologous graft repair and makes the sound transmission closer to the normal condition. Significantly, the density of graft material has a negative effect on high-frequency sound transmission without the MAS. The modal-motion of TM repaired with temporalis fascia and tragal cartilage is improved significantly after attaching the MAS. In addition, the MAS restores effectively the configuration and vibration frequency of the repaired TM, which is similar to that of the native TM.
The area size of TMP is studied through the finite element method, which includes autologous graft materials, the MAS, parameter sensitivity analysis, modal analysis of graft material and the MAS in biological form on the effect of middle ear sound transmission. Relevant conclusions provide some references for clinical trial protocol and the follow-up repair ideas of TM of tympanoplasty.
对于鼓膜穿孔的修复，自体颞筋膜和耳屏软骨是临床上常用的自体移植物材料。然而，采用自体移植物材料修复鼓膜后会导致显著的听力损失，这需要在生物力学工程方面加以解决。
正常中耳的有限元模型从两个方面进行了改进：鼓膜纤维层的修复方法和仿生蜘蛛网膜鼓膜支架。通过创建实体壳耦合条件和强耦合边界条件来模拟修复，研究了 200-8000 Hz 范围内鼓膜顶点和镫骨底板的位移-频率响应。
鼓膜穿孔（TMP）会导致高频区域的显著传导性听力损失，且与穿孔面积呈正相关。在修复 TMP 后，颞筋膜和耳屏软骨仍会导致一定程度的高频听力损失。鼓膜附着镁合金支架（MAS）可适当防止自体移植物修复后的高频听力损失，并使声音传输更接近正常状态。重要的是，在没有 MAS 的情况下，移植物材料的密度对高频声音传输有负面影响。MAS 可显著改善附着在 MAS 上的颞筋膜和耳屏软骨修复后的鼓膜模态运动。此外，MAS 有效地恢复了修复后鼓膜的结构和振动频率，使其与天然鼓膜相似。
通过有限元方法研究了 TMP 的面积大小，包括自体移植物材料、MAS、参数敏感性分析、移植物材料的模态分析以及 MAS 在生物形式下对中耳声音传输的影响。相关结论为临床实验方案和鼓膜成形术的 TM 后续修复思路提供了一些参考。
