The goal of our work is to understand sound transmission in normal, diseased and reconstructed middle ears so as to develop better diagnostic tests and surgical procedures for patients with middle-ear disease. Middle ear diseases, such as chronic otitis media (COM), which affect over 10 million people in the U.S., are common causes of significant conductive hearing loss that range in severity up to 60 dB. Hearing losses of 30-60 dB have significant adverse effects on patients'lives and their ability to communicate. It is acknowledged by otologic surgeons that postoperative hearing results after tympanoplasty procedures for COM are often unsatisfactory. Factors contributingto failures after surgical procedures include lack of clear understanding of structure-function relationshipsin the reconstructed ear and failure of current diagnostic tests (otoscopy,audiometry, tympanometry) to identify such relationships. Over the past five years, we have utilized a unique and powerful combination of methods to study middle-ear mechanics including in-vlvo measurements using laser Doppler vibrometry, In-vltro measurements in cadaveric human temporal bones, and physics-based, quantitativemodeling. Our work has a) resulted in new tests employing laser vibrometry for improved preoperative differential diagnosis of ossicular lesions in patients with an intact tympanic membrane, and b) provided specific surgical recommendations to optimize postoperative hearing results in certain types of middle-ear surgical procedures (examples: type III tympanoplasty, stapedectomy). Over the next five years, we aim to develop and exploit these methods further in a) normal ears, b) diseased ears with tympanic membrane perforations and superior canal dehiscence, and c) ears that have undergone ossicular or tympanic membrane reconstructions for COM. We will also perform in-vitro evaluation of a novel, hand-held probe for objective, intra-operativediagnosis of ossicular fixation. We anticipate that our work will lead to better understandingof structure-function relationships in normal and pathological middle ears, improved differential diagnosis of conductive hearing loss, better preoperative patient counseling and surgical planning, reduction in the number of failed surgeries and optimization of surgical techniques and hearing results.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC004798-10
Application #
7788164
Study Section
Auditory System Study Section (AUD)
Program Officer
Watson, Bracie
Project Start
2001-04-01
Project End
2012-03-31
Budget Start
2010-04-01
Budget End
2012-03-31
Support Year
10
Fiscal Year
2010
Total Cost
$275,068
Indirect Cost
Name
Massachusetts Eye and Ear Infirmary
Department
Type
DUNS #
073825945
City
Boston
State
MA
Country
United States
Zip Code
02114
Rosowski, John J; Bowers, Peter; Nakajima, Hideko H (2018) Limits on normal cochlear 'third' windows provided by previous investigations of additional sound paths into and out of the cat inner ear. Hear Res 360:3-13
Merchant, Gabrielle R; Merchant, Saumil N; Rosowski, John J et al. (2016) Controlled exploration of the effects of conductive hearing loss on wideband acoustic immittance in human cadaveric preparations. Hear Res 341:19-30
Farahmand, Rosemary B; Merchant, Gabrielle R; Lookabaugh, Sarah A et al. (2016) The Audiometric and Mechanical Effects of Partial Ossicular Discontinuity. Ear Hear 37:206-15
Cheng, Yew Song; Kozin, Elliott D; Remenschneider, Aaron K et al. (2016) Characteristics of Wax Occlusion in the Surgical Repair of Superior Canal Dehiscence in Human Temporal Bone Specimens. Otol Neurotol 37:83-8
Creighton, Francis Pete X; Guan, Xiying; Park, Steve et al. (2016) An Intracochlear Pressure Sensor as a Microphone for a Fully Implantable Cochlear Implant. Otol Neurotol 37:1596-1600
Niesten, Marlien E F; Stieger, Christof; Lee, Daniel J et al. (2015) Assessment of the effects of superior canal dehiscence location and size on intracochlear sound pressures. Audiol Neurootol 20:62-71
Merchant, Gabrielle R; Röösli, Christof; Niesten, Marlien E F et al. (2015) Power reflectance as a screening tool for the diagnosis of superior semicircular canal dehiscence. Otol Neurotol 36:172-7
Ravicz, Michael E; Chien, Wade W; Rosowski, John J (2015) Restoration of middle-ear input in fluid-filled middle ears by controlled introduction of air or a novel air-filled implant. Hear Res 328:8-23
Ulku, Cagatay Han; Cheng, Jeffrey Tao; Guignard, Jeremie et al. (2014) Comparisons of the mechanics of partial and total ossicular replacement prostheses with cartilage in a cadaveric temporal bone preparation. Acta Otolaryngol 134:776-84
Niesten, Marlien E F; Hamberg, Leena M; Silverman, Joshua B et al. (2014) Superior canal dehiscence length and location influences clinical presentation and audiometric and cervical vestibular-evoked myogenic potential testing. Audiol Neurootol 19:97-105

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