细菌生物膜对置换钛质听骨赝复物听力恢复的影响

目的 探讨生物膜不同成长时期对部分钛质听骨赝复物结构动力行为的影响,为临床治疗分泌性中耳炎等疾病提供理论依据。方法 基于人体正常右耳的CT扫描图像,结合自编程序,重建人耳三维有限元模型,对其进行声音传导动力分析,并与实验数据对比。采用频率响应方法对耳结构模型进行计算,同时分析不同生长时期的细菌生物膜生长在人工钛质听骨上对声音传导的影响。结果 模拟得到鼓膜凸和镫骨底板振幅与实验数据吻合,验证了模型的正确性。生物膜的存在会使患者听力在低频段有0~1.6 dB的损伤;生物膜沿部分听骨赝复物径向生长会使患者听力在中高频阶段有0~12 dB的损伤,尤其是在8 kHz时,听力损伤高达11.2 dB。结论 细菌生物膜对患者听力有影响,在低频段会使患者听力损失,在高频段听力有增加。细菌生物膜在人工听骨上的径向生长会降低听力,影响人工假体对听力恢复正常的工效。     

鼓膜穿孔对听力系统振动的影响

目的研究鼓膜穿孔尺寸及穿孔衍射对听力系统振动的影响。方法利用CT获取志愿者耳部结构临床资料,提取相关结构的边界,导入ANSYS并建立人耳结构数值有限元模型。结果穿孔面积分别为0.97、3.66和7.97mm2,随着穿孔尺寸增大,共振频率分别变为3.6、4.4和4.6kHz,镫骨底板位移振幅随之变小;镫骨底板位移振幅在衍射声波作用下明显变小;在1000Hz处,鼓膜位移云图位移最大值分别为0.32、0.20和0.19μm,在共振频率处,鼓膜位移云图位移最大值分别为0.20、0.14和0.09μm。结论鼓膜穿孔尺寸越大,镫骨底板位移振幅越小,尤其4kHz以下,共振频率升高。鼓膜云图位移振幅最大值随穿孔增大变小,有望对临床治疗提供参考。     

人耳鼓膜病变数值分析

目的研究鼓膜厚度和硬度对人耳传声的影响。方法利用CT获取志愿者耳部结构临床资料,使用Matlab软件提取相关结构的边界,将边界文件导入ANSYS建立人耳结构数值有限元模型。结果利用本文人耳数值模型,在外耳道口施加105dB声压,进行200～8000Hz频率范围的谐响应分析。以此研究在鼓膜病变情况下,鼓膜和镫骨底板位移幅值的变化规律。结论用数值方法解释了鼓膜病变对传声的影响,为鼓膜修补提供了力学参考。     

人工听骨不同接入方式对耳结构动力响应的影响

目的 研究人工听骨接入方式对听力恢复的影响。方法 通过CT扫描技术,结合自编C＋＋程序读取CT数据中体单元建立人耳结构几何模型,将几何模型导入PATRAN中建立有限元数值模型。采用频率响应方法对耳结构模型进行流固耦合计算,同时分析人工听骨不同接入方式及接入位置对耳结构声音传导的影响。结果 通过对正常人耳的动力响应分析,得到数值模型中计算出的鼓膜凸与镫骨底板振幅与试验数据吻合,验证本文模型的正确性。结论接在鼓膜凸的位置其动力响应最好,镫骨振幅高于其他连接方式。即人工听骨接在鼓膜凸的位置比较吻合人耳的生理功能,其重建听力效果更好。     

中耳结构动力响应对不同病理圆窗封闭的反馈

目的研究耳蜗圆窗病变对中耳结构力学行为的影响。方法依据临床健康志愿者右耳CT扫描结果,将CT扫描数据数值化导入PATRAN软件进行人耳三维有限元模型重建,并应用NASTRAN软件进行流固耦合频率响应分析,通过数值模拟方法探讨中耳结构动力响应对内耳耳蜗圆窗病变的反馈。结果硬化症导致的圆窗封闭比先天性圆窗封闭使镫骨振幅下降更多,最大达到30. 2 d B,且后者不会对镫骨振动速度产生明显影响。相位角方面,硬化症情况下镫骨和圆窗均最多产生90°变化,且两者保持180°差值;而先天性圆窗封闭情况下镫骨最大有270°变化,同时圆窗相位角变化消失。结论基于振幅、速度和相位角,镫骨动力行为会对先天性和硬化症导致的圆窗封闭形成不同的反馈表现,研究结果可为未来临床上诊断及修复圆窗病变提供理论支撑。     

中耳病变及人工镫骨形体研究

目的 研究听骨韧带、肌腱硬化和切除以及人工镫骨置换对声音传导的影响。方法 基于CT扫描数据,通过自编C＋＋程序读取CT数据中体单元建立人耳结构几何模型,将几何模型导入PATRAN中赋予材料参数、设置关节接触面以及相应其他边界条件生成数值模型。结果 利用本文人耳数值模型进行正常耳和病变耳的谐响应分析,得到正常耳和病变耳镫骨底板和鼓膜凸的振幅变化规律。并由此构建了套型人工镫骨。结论 正常耳的模拟结果与实验测试结果吻合,证明了本模型准确性,可以模拟人传声功能。本模型模拟病变耳的计算结果可以从力学角度解释病变对声音传导的影响,为病变耳治疗提供参考。本文的套型人工镫骨较我国临床用的环型人工镫骨更吻合人耳的生理功能,其重建听力效果更好。     

不同激振位置对压电式人工中耳听力补偿性能的影响

研究不同激振位置对压电式人工中耳听力补偿性能的影响,确定压电式人工中耳最优激振位置。建立人耳有限元模型,并通过和相关实验数据进行对比验证模型的可靠性。基于该模型,分别在鼓膜脐部、砧骨体、砧骨长突和圆窗施加相同的位移驱动,通过检测镫骨足底板位移及基底膜的最大位移,分析这些位置的激振对人工中耳听力补偿性能的影响。结果表明,以镫骨足底板位移为评估标准会低估圆窗激振的高频听力补偿效果。砧骨长突激振下的基底膜特征位置处的运动位移大于激振鼓膜脐部及激振砧骨体时的位移值,其中激振砧骨体时的基底膜特征位置处运动位移最小;激振圆窗时的基底膜特征位置处运动位移在低频段小于激振其他位置时对应的位移值,但在中、高频段其激振效果最好。在频率低于400 Hz时,砧骨长突激励听力补偿效果最好,圆窗激励听力补偿效果最差。当频率大于1 kHz时,圆窗激励听力补偿效果比其他位置好。以传统的镫骨足底板响应为评估标准,将低估圆窗激振式人工中耳的听力补偿效果。     

典型中耳病变对圆窗激振听力补偿性能影响的数值分析

目的研究典型中耳病变对圆窗激振听力补偿效果的影响,为圆窗激振式人工中耳的优化设计提供参考。方法利用CT扫描和逆向成型技术建立包括中耳和耳蜗的有限元模型,并验证模型的可靠性。再基于该模型,通过改变相应组织的材料属性,分别模拟镫骨环韧带硬化、镫骨不正常发育和锤骨前韧带硬化3种典型中耳病变。通过对比相应的基底膜响应,分析这3种病变对圆窗激振听力补偿效果的影响。结果镫骨不正常发育主要在高频处降低圆窗激振的效果,镫骨环韧带硬化和锤骨前韧带硬化主要恶化圆窗激振低频段的响应。3种病变中,镫骨环韧带硬化对圆窗激振听力补偿效果影响较大,等效声压的减小量可高达17 d B。结论中耳病变恶化圆窗激振的听力补偿效果,且恶化量较大,故在设计圆窗激振式人工中耳时需要针对性地提高其作动器的输出量。     

中耳畸形对能量吸收率影响的数值研究

为了研究中耳畸形对能量吸收率的影响,本文基于前期所建人耳有限元模型,构建了一个能够模拟人耳能量吸收的力学模型,并利用两组实验数据验证了该模型。基于该模型,通过改变相应组织的结构和材料属性,模拟了砧镫关节缺失、砧骨固定和锤骨固定、镫骨固定这三类常见的中耳畸形;对比分析这三类畸形相应的能量吸收率,研究了中耳畸形对能量吸收率的影响。结果表明:砧镫关节缺失会使能量吸收率在1000 Hz附近显著增大。砧骨固定和锤骨固定会使能量吸收率在低频阶段急剧减小,且在1000 Hz以下低于10%;与此同时,能量吸收率的峰值移向更高频率。对于这两类中耳畸形,在宽频声导抗测试中具有较为明显的特征。而镫骨固定会使能量吸收率在低频段减小、中频段增大,但变化程度较小,在宽频声导抗测试中无明显特征。本文研究结果或可为临床上中耳畸形的宽频声导抗诊断提供一些理论参考。     

高压对耳蜗的影响

目的研究高压环境对人耳蜗的影响,弥补试验手段不足导致的耳蜗在高压环境下听力行为特征研究的缺失,为今后对耳蜗进行针对性研究提供新的思路。方法基于健康人耳蜗CT扫描图像,结合自编程序,利用PATRAN软件建立三维螺旋耳蜗有限元模型。应用NASTRAN软件进行流固耦合频率响应分析和瞬态响应分析,通过数值模拟方法研究高压对耳蜗的影响。结果基底膜12 mm处与镫骨底板中心(卵圆窗的中心)处位移比值模拟结果与已报道的试验结果相吻合,验证了所建模型的正确性。高压环境下,耳蜗中基底膜特征频率点的幅值随着压强的增大而不断减小。结论高压环境最终导致人耳听力的降低。研究结果为临床上研制防治高压的缓冲装置提供理论支撑。     

Problems on analysing heart sounds and murmurs—II

A study on the standardization of phonocardiography was made, based upon the analysis of frequency-intensity of heart sounds and murmurs using a calibrated microphone system. In order to calibrate the microphone under the same conditions as in actual use, the authors devised a vibrometer which provided desirable results. The frequency distributions of various extra sounds and murmurs were classified in four groups, i.e. low, medium, high and medium-high frequency bands. The optimum frequency range of the low frequency band to be registered was from about 25 to 100 c/s, that of the medium frequency band from about 100 to 200 c/s and that of high was above about 300 c/s. The velocity of heart sounds and murmurs had a decline rate of about 12 to 18 dB/oct. in the high frequency range and of 6 to 12 dB/oct. in the low frequency range. The relation between the amplitude frequency spectrum of vibration phenomena and the decline rate of filters was clarified. Based upon these results three filters for clinical use were offered. The validity of the system was demonstrated by analysing the results overall responses of the phenomena after passing through these filters.     

Three-Dimensional Finite Element Modeling of Human Ear for Sound Transmission

An accurate, comprehensive finite element model of the human ear can provide better understanding of sound transmission, and can be used for assessing the influence of diseases on hearing and the treatment of hearing loss. In this study, we proposed a three-dimensional finite element model of the human ear that included the external ear canal, tympanic membrane (eardrum), ossicular bones, middle ear suspensory ligaments/muscles, and middle ear cavity. This model was constructed based on a complete set of histological section images of a left ear temporal bone. The finite element (FE) model of the human ear was validated by comparing model-predicted ossicular movements at the stapes footplate and tympanic membrane with published experimental measurements on human temporal bones. The FE model was employed to predict the effects of eardrum thickness and stiffness, incudostapedial joint material, and cochlear load on acoustic-mechanical transmission through the human ossicular chain. The acoustic-structural coupled FE analysis between the ear canal air column and middle ear ossicles was also conducted and the results revealed that the peak responses of both tympanic membrane and stapes footplate occurred between 3000 and 4000 Hz.     

Age-related differences in force variability and visual display

The objective of this study was to determine the importance of every frequency component on total physiological tremor (PT) amplitude. We suspect that since high frequencies of PT are of lower amplitude in displacement, removing them will have little to no impact on PT amplitude. PT of the index finger was measured with a laser displacement sensor while the finger was held horizontally. Amplitude of tremor was calculated in displacement, velocity and acceleration. PT amplitude was also calculated within five frequency bands. Although displacement amplitude of oscillations within the 7.5–12.5 and 16.5–30 Hz frequency bands represent 24 and 10% of total PT oscillation amplitude, respectively, their removal reduced PT amplitude by less than 3%. Conversely, the removal of the oscillations within 1–3.5 Hz band from the PT signal reduced the amplitude of the original PT signal by 56% in displacement. This suggests that when a task to be studied involves the measurement of a reduction in tremor, focus should be on the oscillations in the 1–3.5 Hz band.     

置换部分听骨赝复物后对人耳听力恢复的影响

目的探讨听骨部分置换术中不同的置换方式对患者术后听力的影响。方法根据人体正常右耳CT扫描结果,用自编程序将CT扫描数值化并导入PATRAN重建人耳三维有限元模型,对其进行声音传导动力分析,并与试验数据对比。结果通过正常人耳结构动力响应分析结果与实验数据吻合,验证了模型的正确性;在0.1～10 kHz频率下保留部分锤骨柄置换人工听骨比不保留锤骨柄术后听力恢复更好,听力恢复值在11.56～28.91 dB之间;保留部分锤骨柄时鼓膜处的最大应力值比不保留锤骨柄时更小;厚2.0 mm软骨片在0.1～0.6 kHz,2～10 kHz频率上听力恢复较好;厚0.1 mm软骨片在0.6～2 kHz频率上听力恢复较好。结论在听骨部分置换术中,保留部分锤骨柄比不保留锤骨柄听力恢复效果更好;鼓膜与人工听骨的接触面上垫置的软骨片厚度在0.1～2.0 mm之间对人耳听力恢复效果较好。     

Sinusoidal amplitude modulation alters contralateral noise suppression of evoked otoacoustic emissions in humans.

It is well established that low-level broad band noise can elicit an amplitude decrease in evoked otoacoustic emissions recorded in the opposite ear. However, the influence of the temporal characteristics of the contralateral stimulus on this effect remains largely unknown. In the present study, otoacoustic emissions evoked by 60 dB SPL clicks were recorded in 19 normal-hearing subjects using the Otodynamics IL088, successively in absence and presence of a contralateral noise that was either steady or modulated sinusoidally in amplitude at different depths (from 25% to 100% in 25 point steps) and rates (from 50 Hz to 800 Hz in half-octave steps). The energy was kept constant whatever the modulation depth. The results showed that the evoked otoacoustic-emission attenuation effect induced by contralateral stimulation varied depending on the modulation depth and frequency of the contralateral amplitude-modulated noise. The largest suppression effect was observed at the 100 Hz modulation frequency and the 100% modulation depth. The 50 Hz modulation resulted in less suppression than with unmodulated noise. An interpretation of these results in terms of the influence of temporal amplitude fluctuations falling within a certain range on medial olivocochlear bundle activity is discussed.