Experimental investigation of the effect of middle ear in bone conduction

Ivo Dobrev,Tahmine S Farahmandi,Christof Röösli

doi:10.1016/j.heares.2020.108041

Abstract

ObjectivesExperimental investigation of the contribution of the middle ear to bone conduction (BC) hearing sensation. MethodsExperiments were conducted on 6 fresh cadaver whole head specimens. The electromagnetic actuators from a commercial bone conduction hearing aid (BCHA), Baha® 5 SuperPower and BoneBridge (BB), were used to provide stepped sine stimulus in the range of 0.1–10 kHz. The middle ear transfer function (METF) of each cadaver head was checked against the ASTM F2504-05 standard. In a first step, the stapes stimulus into the cochlea, under BC, was estimated based on the differential velocity between the stapes footplate and the promontory. This was based on sequential measurements of the 3D velocity of the stapes footplate and the promontory. In parallel, the differential tympanic membrane (TM) pressure was recorded by measuring sound pressure in the middle ear and in the external auditory canal each measured 1–2 mm from the TM. The measurement procedure was then sequentially repeated, after: a) opening the middle ear cavity; b) ISJ interruption; c) closing the middle ear cavity. At the end, the velocity at each actuator is measured for comparison purposes. Stapes footplate and promontory motion was quantified as the 3D motion at a single measurement point via a three-dimensional laser Doppler vibrometer (3D LDV) system. The combined motion was used for all motion parameters. ResultsThe METF, based on the combined motion, matches better to the ASTM standard, making the measurements resilient to oblique measurement directions. The Baha actuator produced ∼10 dB SPL more output than the BB above 2 kHz. This resulted in 2–5 dB increase in the differential pressure across the TM, after middle ear cavity opening, for Baha stimulation, and up to 9 dB drop (around 2 kHz) for BB stimulation. The differential stapes motion follows linearly the level of motion of the stimulation area, however, it is affected by actuator resonances in a more complex way. Interruption of the ISJ, reduces the differential motion of the stapes with 1–5 dB, only at 1–3 kHz. ConclusionCombined velocity more objectively describes the stapes and skull motion, than any individual motion component. The state of the ME cavity and the ISJ affect the cochlear input of the stapes, however, the effect is limited in frequency and magnitude.

Highlights

Two different pathways exist of how sound reaches the inner ear
The differential tympanic membrane (TM) pressure was quantified based on acoustic pressure measurements in the ear canal and middle ear cavity, each measured at distance of 1e2 mm away from the lateral and medial surface of the TM, respectively
The middle ear transfer function (METF) was compared against the ASTM standard 2504e05 for normal footplate motion

Summary

Introduction

Two different pathways exist of how sound reaches the inner ear. I. Dobrev et al / Hearing Research 395 (2020) 108041 assumed that BC represents inner ear function and AC both, inner and middle ear function. It is expected that AC changes significantly in patients with conductive hearing loss whereas BC remains unchanged. In patients with a conductive hearing loss, BC shows a frequency dependent decrease mainly around 2 kHz. in patients with a conductive hearing loss, BC shows a frequency dependent decrease mainly around 2 kHz This finding is described as Carhart’s notch in patients with otosclerosis and implies that BC pathways involving the ossicles may be important in pathologic situations (Carhart, 1971)

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