Abstract

ObjectiveTo determine the feasibility of measuring tympanic membrane (TM) vibrations at multiple locations on the TM to differentiate normal eardrums from those with associated ossicular pathologies.DesignCadaveric human temporal bone study.SettingBasic science laboratory.MethodsA mastoidectomy and facial recess approach was performed on four cadaveric temporal bones to obtain access to the ossicles without disrupting the TM. Ossicles were palpated to ensure normal mobility and an intact ossicular chain. Laser Doppler Vibrometry (LDV) measurements were then taken on all four TMs. LDV measurements were repeated on each TM following stapes footplate fixation, incudo-stapedial joint dislocation, and malleus head fixation.Main outcome measuresLDV measurements of TM vibration at the umbo, the lateral process of the malleus, and in each of the four quadrants of the TM.ResultsThe best signal-to-noise ratios were found between 2 and 4 kHz, at the umbo, the anterior superior quadrant, the anterior inferior quadrant, and the posterior inferior quadrant. Since our goal was to assess the ossicular chain, we selected the TM locations closest to the ossicular chain (the umbo and lateral process of the malleus) for further analysis. Differences could be seen between normals and the simulated ossicular pathologies, but values were not statistically significant.ConclusionsLDV measurements are technically challenging and require optimization to obtain consistent measurements. This study demonstrates the potential of LDV to differentiate ossicular pathologies behind an intact tympanic membrane. Future studies will further characterize the clinical role of this diagnostic modality.

Highlights

  • Laser Doppler Vibrometry (LDV) is a non-contacting optical technique which can be used to measure tympanic membrane (TM) vibration and middle ear function

  • This study demonstrates the potential of LDV to differentiate ossicular pathologies behind an intact tympanic membrane

  • A patient with a conductive hearing loss (CHL) and intact acoustic reflexes should be screened for vestibular symptoms and undergo a highresolution CT scan of the temporal bones to rule out Superior Semicircular Canal Dehiscence Syndrome

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Summary

Introduction

Laser Doppler Vibrometry (LDV) is a non-contacting optical technique which can be used to measure tympanic membrane (TM) vibration and middle ear function. This has previously been reported in fresh [1] and embalmed [2] cadaveric human temporal bones, and in live human subjects [3,4,5]. Previous studies have analyzed ossicular abnormalities with LDV [3,4,5,6], this method is not Diagnosis of the specific cause of a CHL in a patient with an intact TM is not presently possible with current testing modalities. An exploratory tympanotomy is required to definitively elucidate the cause of the CHL in these patients with an intact TM and an unremarkable high-resolution CT scan of the temporal bones

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