Numerical study on the effect of middle ear malformations on energy absorbance_Journal of Biomedical Engineering

Authors：

ZHANG Ruining ¹ , ZHAO Yu ¹ ,  LIU Houguang ¹ , YANG Jianhua ¹ , ZHOU Lei ² , HUANG Xinsheng ² , YANG Shanguo ¹

1. School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, Jiangsu 221116, P.R.China;
2. Department of Otorhinolaryngology, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, P.R.China;

Corresponding author：

LIU Houguang, Email: liuhg@cumt.edu.cn

Keywords：

middle ear malformations; energy absorbance; finite element analysis; incudostapedial joint defect; auditory ossicles fixation

DOI：

10.7507/1001-5515.202002051

Video：

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In order to study the effect of middle ear malformations on energy absorbance, we constructed a mechanical model that can simulate the energy absorbance of the human ear based on our previous human ear finite element model. The validation of this model was confirmed by two sets of experimental data. Based on this model, three common types of middle ear malformations, i.e. incudostapedial joint defect, incus fixation and malleus fixation, and stapes fixation, were simulated by changing the structure and material properties of the corresponding tissue. Then, the effect of these three common types of middle ear malformations on energy absorbance was investigated by comparing the corresponding energy absorbance. The results showed that the incudostapedial joint defect significantly increased the energy absorbance near 1 000 Hz. The incus fixation and malleus fixation dramatically reduced the energy absorbance in the low frequency, which made the energy absorbance less than 10% at frequencies lower than 1 000 Hz. At the same time, the peak of energy absorbance shifted to the higher frequency. These two kinds of middle ear malformations had obvious characteristics in the wideband acoustic immittance test. In contrast, the stapes fixation only reduced the energy absorbance in the low frequency and increased energy absorbance in the middle frequency slightly, which had no obvious characteristic in the wideband acoustic immittance test. These results provide a theoretical reference for the wideband acoustic immittance diagnosis of middle ear malformations in clinic.

Citation： ZHANG Ruining, ZHAO Yu, LIU Houguang, YANG Jianhua, ZHOU Lei, HUANG Xinsheng, YANG Shanguo. Numerical study on the effect of middle ear malformations on energy absorbance. Journal of Biomedical Engineering, 2021, 38(1): 89-96. doi: 10.7507/1001-5515.202002051 Copy

1.	史文迪, 张盼盼. 先天性中耳畸形患儿听力诊断及干预过程 1 例报告. 中国听力语言康复科学杂志, 2019, 17(6): 466-468.
2.	赵守琴. 先天性中耳畸形的诊断与治疗. 听力学及言语疾病杂志, 2016, 24(2): 113-115.
3.	Zahnert T, Löwenheim H, Beutner D, et al. Multicenter clinical trial of vibroplasty couplers to treat mixed/conductive hearing loss: first results. Audiol Neurootol, 2016, 21(4): 212-222.
4.	邹艺辉, 李佳楠, 陈爱婷, 等. 振动声桥在先天性中外耳畸形患者的应用. 中华耳科学杂志, 2012, 10(1): 1-5.
5.	Roman S, Nicollas R, Triglia J M. Middle ear implant for mixed hearing loss with malformation in a 9-year-old child. Eur Ann Otorhinolaryngol Head Neck Dis, 2010, 127(1): 11-14.
6.	Liu H, Zhang H, Yang J, et al. Influence of ossicular chain malformation on the performance of round-window stimulation: a finite element approach. Proc Inst Mech Eng H, 2019, 233(5): 584-594.
7.	朱丽烨, 李海峰, 张治华, 等. 宽频声导抗测试的临床应用进展. 中国听力语言康复科学杂志, 2018, 16(5): 354-357.
8.	Stinson M R, Shaw E A, Lawton B W. Estimation of acoustical energy reflectance at the eardrum from measurements of pressure distribution in the human ear canal. J Acoust Soc Am, 1982, 72(3): 766-773.
9.	Keefe D H, LING R, Bulen J C. Method to measure acoustic impedance and reflection coefficient. J Acoust Soc Am, 1992, 91(1): 470-485.
10.	Liu Y W, Sanford C A, Ellison J C, et al. Wideband absorbance tympanometry using pressure sweeps: system development and results on adults with normal hearing. J Acoust Soc Am, 2008, 124(6): 3708-3719.
11.	Feeney M P, Grant I L, Mills D M. Wideband energy reflectance measurements of ossicular chain discontinuity and repair in human temporal bone. Ear Hear, 2009, 30(4): 391-400.
12.	Voss S E, Merchant G R, Horton N J. Effects of middle-ear disorders on power reflectance measured in cadaveric ear canals. Ear Hear, 2012, 33(2): 195-208.
13.	Wegner I, Shahnaz N, Grolman W, et al. Wideband acoustic immittance measurements in assessing crimping status following stapedotomy: a temporal bone study. Int J Audiol, 2017, 56(1): 1-7.
14.	Zhang X, Gan R Z. Finite element modeling of energy absorbance in normal and disordered human ears. Hear Res, 2013, 301: 146-155.
15.	Wang X, Keefe D H, Gan R Z. Predictions of middle-ear and passive cochlear mechanics using a finite element model of the pediatric ear. J Acoust Soc Am, 2016, 139(4): 1735-1746.
16.	Liu H, Zhao Y, Yang J, et al. The influence of piezoelectric transducer stimulating sites on the performance of implantable middle ear hearing devices: a numerical analysis. Micromachines (Basel), 2019, 10(11): 782-797.
17.	Zhang X, Gan R Z. A comprehensive model of human ear for analysis of implantable hearing devices. IEEE Trans Biomed Eng, 2011, 58(10): 3024-3027.
18.	Tian J, Huang X, Rao Z, et al. Finite element analysis of the effect of actuator coupling conditions on round window stimulation. J Mech Med Biol, 2015, 15(4): 1550048.
19.	薛林, 刘后广, 王志华, 等. 中耳炎病变对圆窗激振听力补偿影响的数值分析. 生物医学工程学杂志, 2019, 36(5): 745-754.
20.	Homma K, Shimizu Y, Kim N, et al. Effects of ear-canal pressurization on middle-ear bone- and air-conduction responses. Hear Res, 2010, 263(1/2): 204-215.
21.	Funasaka S. Congenital ossicular anomalies without malformations of the external ear. Arch Otorhinolaryngol, 1979, 224(3/4): 231-240.
22.	Park K, Choung Y H. Isolated congenital ossicular anomalies. Acta Otolaryngol, 2009, 129(4): 419-422.
23.	Mansour S, Magnan J, Nicolas K, et al. Diagnosis and clinico-radiologic correlations in conductive hearing loss with a normal appearing tympanic membrane. Cham: Springer, 2018: 415-467.
24.	Teunissen E, Cremers C W. Surgery for congenital anomalies of the middle ear with Mobile stapes. Eur Arch Otorhinolaryngol, 1993, 250(6): 327-331.
25.	House H P. Congenital stapes footplate fixation; a preliminary report of twenty-six operated cases. Acta Otolaryngol, 1959, 50(1): 69-70.
26.	Rosowski J J, Stenfelt S, Lilly D. An overview of wideband immittance measurements techniques and terminology: you say absorbance, I say reflectance. Ear Hear, 2013, 34(01): 9S-16S.
27.	杜功焕, 朱哲民, 龚秀芬. 声学基础[M]. 南京: 南京大学出版社, 2001: 188-189.
28.	Iemoto Y, Watanabe Y. Measurements of phase velocity of a sound wave propagating in a tube in low frequency region. Jpn J Appl Phys, 2004, 43(1): 401-402.
29.	Rabinowitz W M. Measurement of the acoustic input immittance of the human ear. J Acoust Soc Am, 1981, 70(4): 1025-1035.
30.	Voss S E, Rosowski J J, Merchant S N, et al. Acoustic responses of the human middle ear. Hear Res, 2000, 150(1/2): 43-69.
31.	Stepp C E, Voss S E. Acoustics of the human middle-ear air space. J Acoust Soc Am, 2005, 118(2): 861-871.
32.	Margolis R H, Saly G L, Keefe D H. Wideband reflectance tympanometry in normal adults. J Acoust Soc Am, 1999, 106(1): 265-280.
33.	Allen J B, Jeng P S, Levitt H. Evaluation of human middle ear function via an acoustic power assessment. J Rehabil Res Dev, 2005, 42(4): 63-78.
34.	Shahnaz N, Bork K. Wideband reflectance norms for Caucasian and Chinese young adults. Ear Hear, 2006, 27(6): 774-788.
35.	Feng B, Gan R Z. Lumped parametric model of the human ear for sound transmission. Biomech Model Mechanobiol, 2004, 3(1): 33-47.
36.	Zwislocki J J. Analysis of the middle-ear function. Part I: input impedance. J Acoust Soc Am, 1962, 34(9B): 1514-1523.
37.	Voss S E, Horton N J, Woodbury R R, et al. Sources of variability in reflectance measurements on normal cadaver ears. Ear Hear, 2008, 29(4): 651-665.
38.	刘迎曦, 李生, 孙秀珍. 人耳传声数值模型. 力学学报, 2008, 40(1): 107-113.
39.	姚文娟, 李武, 付黎杰, 等. 中耳结构数值模拟及传导振动分析. 系统仿真学报, 2009, 21(3): 651-654.
40.	Wang Xuelin, Wang Liling, Zhou Jianjun, et al. Finite element modelling of human auditory periphery including a feed-forward amplification of the cochlea. Comput Methods Biomech Biomed Engin, 2014, 17(10): 1096-1107.
41.	Nakajima H H, Pisano D V, Roosli C, et al. Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss: a preliminary study. Ear Hear, 2012, 33(1): 35-43.
42.	Zwislocki J J, Feldman A S. Acoustic impedance of pathological ears. ASHA Monogr, 1970, 15: 1-42.
43.	Margolis R H, Osguthorpe J D, Popelka G R. The effects of experimentally-produced middle ear lesions on tympanometry in cats. Acta Otolaryngol, 1978, 86(5/6): 428-436.
44.	Huber A, Koike T, Wada H, et al. Fixation of the anterior mallear ligament: diagnosis and consequences for hearing results in stapes surgery. Ann Otol Rhinol Laryngol, 2003, 112(4): 348-355.

1. 史文迪, 张盼盼. 先天性中耳畸形患儿听力诊断及干预过程 1 例报告. 中国听力语言康复科学杂志, 2019, 17(6): 466-468.
2. 赵守琴. 先天性中耳畸形的诊断与治疗. 听力学及言语疾病杂志, 2016, 24(2): 113-115.
3. Zahnert T, Löwenheim H, Beutner D, et al. Multicenter clinical trial of vibroplasty couplers to treat mixed/conductive hearing loss: first results. Audiol Neurootol, 2016, 21(4): 212-222.
4. 邹艺辉, 李佳楠, 陈爱婷, 等. 振动声桥在先天性中外耳畸形患者的应用. 中华耳科学杂志, 2012, 10(1): 1-5.
5. Roman S, Nicollas R, Triglia J M. Middle ear implant for mixed hearing loss with malformation in a 9-year-old child. Eur Ann Otorhinolaryngol Head Neck Dis, 2010, 127(1): 11-14.
6. Liu H, Zhang H, Yang J, et al. Influence of ossicular chain malformation on the performance of round-window stimulation: a finite element approach. Proc Inst Mech Eng H, 2019, 233(5): 584-594.
7. 朱丽烨, 李海峰, 张治华, 等. 宽频声导抗测试的临床应用进展. 中国听力语言康复科学杂志, 2018, 16(5): 354-357.
8. Stinson M R, Shaw E A, Lawton B W. Estimation of acoustical energy reflectance at the eardrum from measurements of pressure distribution in the human ear canal. J Acoust Soc Am, 1982, 72(3): 766-773.
9. Keefe D H, LING R, Bulen J C. Method to measure acoustic impedance and reflection coefficient. J Acoust Soc Am, 1992, 91(1): 470-485.
10. Liu Y W, Sanford C A, Ellison J C, et al. Wideband absorbance tympanometry using pressure sweeps: system development and results on adults with normal hearing. J Acoust Soc Am, 2008, 124(6): 3708-3719.
11. Feeney M P, Grant I L, Mills D M. Wideband energy reflectance measurements of ossicular chain discontinuity and repair in human temporal bone. Ear Hear, 2009, 30(4): 391-400.
12. Voss S E, Merchant G R, Horton N J. Effects of middle-ear disorders on power reflectance measured in cadaveric ear canals. Ear Hear, 2012, 33(2): 195-208.
13. Wegner I, Shahnaz N, Grolman W, et al. Wideband acoustic immittance measurements in assessing crimping status following stapedotomy: a temporal bone study. Int J Audiol, 2017, 56(1): 1-7.
14. Zhang X, Gan R Z. Finite element modeling of energy absorbance in normal and disordered human ears. Hear Res, 2013, 301: 146-155.
15. Wang X, Keefe D H, Gan R Z. Predictions of middle-ear and passive cochlear mechanics using a finite element model of the pediatric ear. J Acoust Soc Am, 2016, 139(4): 1735-1746.
16. Liu H, Zhao Y, Yang J, et al. The influence of piezoelectric transducer stimulating sites on the performance of implantable middle ear hearing devices: a numerical analysis. Micromachines (Basel), 2019, 10(11): 782-797.
17. Zhang X, Gan R Z. A comprehensive model of human ear for analysis of implantable hearing devices. IEEE Trans Biomed Eng, 2011, 58(10): 3024-3027.
18. Tian J, Huang X, Rao Z, et al. Finite element analysis of the effect of actuator coupling conditions on round window stimulation. J Mech Med Biol, 2015, 15(4): 1550048.
19. 薛林, 刘后广, 王志华, 等. 中耳炎病变对圆窗激振听力补偿影响的数值分析. 生物医学工程学杂志, 2019, 36(5): 745-754.
20. Homma K, Shimizu Y, Kim N, et al. Effects of ear-canal pressurization on middle-ear bone- and air-conduction responses. Hear Res, 2010, 263(1/2): 204-215.
21. Funasaka S. Congenital ossicular anomalies without malformations of the external ear. Arch Otorhinolaryngol, 1979, 224(3/4): 231-240.
22. Park K, Choung Y H. Isolated congenital ossicular anomalies. Acta Otolaryngol, 2009, 129(4): 419-422.
23. Mansour S, Magnan J, Nicolas K, et al. Diagnosis and clinico-radiologic correlations in conductive hearing loss with a normal appearing tympanic membrane. Cham: Springer, 2018: 415-467.
24. Teunissen E, Cremers C W. Surgery for congenital anomalies of the middle ear with Mobile stapes. Eur Arch Otorhinolaryngol, 1993, 250(6): 327-331.
25. House H P. Congenital stapes footplate fixation; a preliminary report of twenty-six operated cases. Acta Otolaryngol, 1959, 50(1): 69-70.
26. Rosowski J J, Stenfelt S, Lilly D. An overview of wideband immittance measurements techniques and terminology: you say absorbance, I say reflectance. Ear Hear, 2013, 34(01): 9S-16S.
27. 杜功焕, 朱哲民, 龚秀芬. 声学基础[M]. 南京: 南京大学出版社, 2001: 188-189.
28. Iemoto Y, Watanabe Y. Measurements of phase velocity of a sound wave propagating in a tube in low frequency region. Jpn J Appl Phys, 2004, 43(1): 401-402.
29. Rabinowitz W M. Measurement of the acoustic input immittance of the human ear. J Acoust Soc Am, 1981, 70(4): 1025-1035.
30. Voss S E, Rosowski J J, Merchant S N, et al. Acoustic responses of the human middle ear. Hear Res, 2000, 150(1/2): 43-69.
31. Stepp C E, Voss S E. Acoustics of the human middle-ear air space. J Acoust Soc Am, 2005, 118(2): 861-871.
32. Margolis R H, Saly G L, Keefe D H. Wideband reflectance tympanometry in normal adults. J Acoust Soc Am, 1999, 106(1): 265-280.
33. Allen J B, Jeng P S, Levitt H. Evaluation of human middle ear function via an acoustic power assessment. J Rehabil Res Dev, 2005, 42(4): 63-78.
34. Shahnaz N, Bork K. Wideband reflectance norms for Caucasian and Chinese young adults. Ear Hear, 2006, 27(6): 774-788.
35. Feng B, Gan R Z. Lumped parametric model of the human ear for sound transmission. Biomech Model Mechanobiol, 2004, 3(1): 33-47.
36. Zwislocki J J. Analysis of the middle-ear function. Part I: input impedance. J Acoust Soc Am, 1962, 34(9B): 1514-1523.
37. Voss S E, Horton N J, Woodbury R R, et al. Sources of variability in reflectance measurements on normal cadaver ears. Ear Hear, 2008, 29(4): 651-665.
38. 刘迎曦, 李生, 孙秀珍. 人耳传声数值模型. 力学学报, 2008, 40(1): 107-113.
39. 姚文娟, 李武, 付黎杰, 等. 中耳结构数值模拟及传导振动分析. 系统仿真学报, 2009, 21(3): 651-654.
40. Wang Xuelin, Wang Liling, Zhou Jianjun, et al. Finite element modelling of human auditory periphery including a feed-forward amplification of the cochlea. Comput Methods Biomech Biomed Engin, 2014, 17(10): 1096-1107.
41. Nakajima H H, Pisano D V, Roosli C, et al. Comparison of ear-canal reflectance and umbo velocity in patients with conductive hearing loss: a preliminary study. Ear Hear, 2012, 33(1): 35-43.
42. Zwislocki J J, Feldman A S. Acoustic impedance of pathological ears. ASHA Monogr, 1970, 15: 1-42.
43. Margolis R H, Osguthorpe J D, Popelka G R. The effects of experimentally-produced middle ear lesions on tympanometry in cats. Acta Otolaryngol, 1978, 86(5/6): 428-436.
44. Huber A, Koike T, Wada H, et al. Fixation of the anterior mallear ligament: diagnosis and consequences for hearing results in stapes surgery. Ann Otol Rhinol Laryngol, 2003, 112(4): 348-355.

Journal of Biomedical Engineering

Numerical study on the effect of middle ear malformations on energy absorbance

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