Abstract
Measurements of ossicular motion using laser Doppler vibrometry (LDV) in patients with various ear diseases, along with fresh cadaveric experiments, have increased our understanding of how sound is transduced to the cochlea and how this transduction is modified by various conductive pathologies. These studies have dispelled some misguided beliefs, changed clinical treatments, and shown the potential of LDV as a diagnostic. LDV, however, has substantial limitations as a clinical tool. For patients with conductive hearing loss of unknown etiology (where general otologic exam and conventional tympanometry are not diagnostic), another non-invasive measurement, wideband acoustic immittance (WAI, directly related to power reflectance), in conjunction with audiometric measurements, can differentiate between ossicular fixation, ossicular discontinuity and superior canal dehiscence (SCD). Furthermore, WAI measurements show a common pattern in power reflectance in patients with SCD, with or without a conductive hearing loss. An algorithm to identify this pattern in power reflectance suggests that WAI may be a simple, inexpensive screening tool for SCD. Evidence will be presented from our studies on patients with various otologic diseases, as well as from fresh cadaveric preparations simulating various diseases. Power reflectance can assist in treatment decisions and prevent unnecessary and inappropriate treatments and surgeries.
Published Version
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