The impact of round window reinforcement on middle and inner ear mechanics with air and bone conduction stimulation.

Autor: Geerardyn A; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven Belgium., Wils I; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium., Putzeys T; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Laboratory of Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, Leuven, Belgium., Fierens G; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Cochlear Technology Centre, Mechelen, Belgium., Wouters J; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium., Verhaert N; ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven Belgium. Electronic address: nicolas.verhaert@kuleuven.be.
Jazyk: angličtina
Zdroj: Hearing research [Hear Res] 2024 Sep 01; Vol. 450, pp. 109049. Date of Electronic Publication: 2024 May 31.
DOI: 10.1016/j.heares.2024.109049
Abstrakt: The round window (RW) membrane plays an important role in normal inner ear mechanics. Occlusion or reinforcement of the RW has been described in the context of congenital anomalies or after cochlear implantation and is applied as a surgical treatment for hyperacusis. Multiple lumped and finite element models predict a low-frequency hearing loss with air conduction of up to 20 dB after RW reinforcement and limited to no effect on hearing with bone conduction stimulation. Experimental verification of these results, however, remains limited. Here, we present an experimental study measuring the impact of RW reinforcement on the middle and inner ear mechanics with air and bone conduction stimulation. In a within-specimen repeated measures design with human cadaveric specimens (n = 6), we compared the intracochlear pressures in scala vestibuli (P SV ) and scala tympani (P ST ) before and after RW reinforcement with soft tissue, cartilage, and bone cement. The differential pressure (P DIFF ) across the basilar membrane - known to be closely related to the hearing sensation - was calculated as the complex difference between P SV and P ST . With air conduction stimulation, both P SV and P ST increased on average up to 22 dB at frequencies below 1500 Hz with larger effect sizes for P ST compared to P SV . The P DIFF , in contrast, decreased up to 11 dB at frequencies between 700 and 800 Hz after reinforcement with bone cement. With bone conduction, the average within-specimen effects were less than 5 dB for either P SV , P ST, or P DIFF . The inter-specimen variability with bone conduction, however, was considerably larger than with air conduction. This experimental study shows that RW reinforcement impacts air conduction stimulation at low frequencies. Bone conduction stimulation seems to be largely unaffected. From a clinical point of view, these results support the hypothesis that delayed loss of air conduction hearing after cochlear implantation could be partially explained by the impact of RW reinforcement.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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