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。

Effects of bacterial biofilm on hearing restoration with titanium partial ossicular prosthesis replacement

Objective To study effects of the bacterial biofilm at different growth stages on dynamic behavior of the titanium partial ossicular replacement prosthesis (PORP), so as to provide theoretical references for clinical treatment of diseases such as secretory otitis media. Methods Based on the CT scan images of normal human right ear and combined with the self compiling program, a 3D finite element model of the ear was reconstructed for dynamic analysis on sound conduction, and compared with the experimental data. The model was computed by harmonic response analysis method, and the sound conduction effect of bacterial biofilm grown on PORP at different growth stages was analyzed. Results The simulated amplitude of umbo and stapes footplate was in accordance with experimental measurements, which confirmed the validity of this numerical model. The existence of biofilm would cause 0-1.6 dB hearing loss at low frequencies. The growth of biofilm in the radial direction of PORP would cause 0-12 dB hearing loss at intermediate and high frequencies, especially at 8 kHz, and the hearing loss could be as high as 11.2 dB. Conclusions The bacterial biofilm has an impact on hearing by reducing the hearing at low frequencies while raising a little at high frequencies. The biofilm grown in the radial direction of PORP will reduce hearing, and affect the working efficiency of PORP on hearing restoration.