Comparison of round-window membrane mechanics before and after experimental stapedotomy

Wysocki, Jarosław; Kwacz, Monika; Mrówka, Maciej; Skarżyńśki, Henryk

doi:10.1002/lary.22081

Cited by 9 publications

(17 citation statements)

References 20 publications

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“…The experimental displacement–frequency curves of the RW membrane were reported in our previous paper (Wysocki et al 2011 ). It should be noted that only four points at the center of the RW membrane were considered for validation.…”

Section: Resultsmentioning

confidence: 92%

“…The methods for temporal bone preparation, the experimental stapedotomy procedure, acoustic and optical pathway structure and calibration, and round window vibration patterns before and after stapedotomy have already been detailed elsewhere (Wysocki et al 2011 ).…”

Section: Methodsmentioning

confidence: 99%

“…It has been shown (Wysocki et al 2011 ) that the stapes piston prosthesis leads to an approximately 14 dB lower stimulation of perilymph vibration at RW compared to the physiological situation, in particular at frequencies exceeding 2 kHz. It has also been verified experimentally that the vibration amplitudes of the stapes piston prosthesis and the normal stapes are of the same order magnitude, while maintaining the same frequencies and sound pressure levels as the sounds supplied to the external auditory canal.…”

Section: Introductionmentioning

confidence: 99%

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A three-dimensional finite element model of round window membrane vibration before and after stapedotomy surgery

Kwacz

Marek

Borkowski

et al. 2013

Biomech Model Mechanobiol

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Piston stapes prostheses are implanted in patients with refractory conductive or mixed hearing loss due to stapes otosclerosis to stimulate the perilymph with varying degrees of success. The overclosure effect described by the majority of researchers affects mainly low and medium frequencies, and a large number of patients report a lack of satisfactory results for frequencies above 2 kHz. The mechanics of perilymph stimulation with the piston have not been studied in a systematic manner. The objective of this study was to assess the influence of stapedotomy surgery on round window membrane vibration and to estimate the postoperative outcomes using the finite element (FE) method. The study hypothesis is that the three-dimensional FE model developed of the human inner ear, which simulates the round window (RW) membrane vibration, can be used to assess the influence of stapedotomy on auditory outcomes achieved after the surgical procedure. An additional objective of the study was to enable the simulation of RW membrane vibration after stapedotomy using a new type of stapes prosthesis currently under investigation at Warsaw University of Technology. A three-dimensional finite element (FE) model of the human inner ear was developed and validated using experimental data. The model was then used to simulate the round window membrane vibration before and after stapedotomy surgery. Functional alterations of the RW membrane vibration were derived from the model and compared with the results of experimental measurements from temporal bones of a human cadaver. Piston stapes prosthesis implantation causes an approximately fivefold (14 dB) lower amplitude of the RW membrane vibrations compared with normal anatomical conditions. A satisfactory agreement between the FE model and the experimental data was found. The new prosthesis caused an increase of 20–30 dB in the RW displacement amplitude compared with the 0.4-mm piston prosthesis. In all frequencies, the FE model predicted a RW displacement curve that was above the experimental curves for the normal ear. The stapedotomy can be well simulated by the FE model to predict the auditory outcomes achieved following this otosurgery procedure. The 3D FE model developed in this study may be used to optimize the geometry of a new type of stapes prosthesis in order to achieve a similar sound transmission through the inner ear as for a normal middle ear. This should provide better auditory outcomes for patients with stapedial otosclerosis.

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Section: Resultsmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A three-dimensional finite element model of round window membrane vibration before and after stapedotomy surgery

Kwacz

Marek

Borkowski

et al. 2013

Biomech Model Mechanobiol

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show abstract

“…However, altered biomechanics of the middle ear leads to reduced perilymph stimulation [10, 11]. This results in lower BM vibration and lower excitation of the hair cells.…”

Section: Discussionmentioning

confidence: 99%

“…The measurement procedure was similar to that described in [10]. Briefly, an acoustic signal (90dB SPL, 0.8–8 kHz) was introduced to the EAC via a loudspeaker (ER-2, Etymotic Research, Elk Grove Village, IL, USA) attached to an adapter (ER3-04).…”

Section: Methodsmentioning

confidence: 99%

New chamber stapes prosthesis – A preliminary assessment of the functioning of the prototype

et al. 2017

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Piston-stapedotomy is the most common method for hearing restoration in patients with otosclerosis. In this study, we have experimentally examined a prototype of a new chamber stapes prosthesis. The prototype was implanted in a human cadaver temporal bone. The round window vibrations before and after implantation were measured for the acoustic signal (90 dB SPL, 0.8–8 kHz) in the external auditory canal. In comparison with a 0.4-mm piston prosthesis, the chamber prosthesis induced significantly higher vibration of the round window, especially for frequencies above 1.5 kHz. Based on the results, it can be surmised that stapedotomy with a chamber stapes prosthesis could provide better hearing results in comparison with the piston-stapedotomy.

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Does stapedotomy improve high frequency conductive hearing?

Roychowdhury

Polanik

Kempfle

et al. 2021

Laryngoscope Investig Oto

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Objectives Stapedotomy is performed to address conductive hearing deficits. While hearing thresholds reliably improve at low frequencies (LF), conductive outcomes at high frequencies (HF) are less reliable and have not been well described. Herein, we evaluate post‐operative HF air‐bone gap (ABG) changes and measure HF air conduction (AC) thresholds changes as a function of frequency. Methods Retrospective review of patients who underwent primary stapedotomy with incus wire piston prosthesis between January 2016 and May 2020. Pre‐ and postoperative audiograms were evaluated. LF ABG was calculated as the mean ABG of thresholds at 250, 500, and 1000 Hz. HF ABG was calculated at 4 kHz. Results Forty‐six cases met criteria. Mean age at surgery was 54.0 ± 11.7 years. The LF mean preoperative ABG was 36.9 ± 11.0 dB and postoperatively this significantly reduced to 9.35 ± 6.76 dB, (P < .001). The HF mean preoperative ABG was 31.1 ± 14.4 dB and postoperatively, this also significantly reduced to 14.5 ± 12.3 dB, (P < .001). The magnitude of LF ABG closure was over 1.5 times the magnitude of HF ABG closure (P < .001). The gain in AC decreased with increasing frequency (P < .001). Conclusion Hearing improvement following stapedotomy is greater at low than high frequencies. Postoperative air bone gaps persist at 4 kHz. Further biomechanical and histopathologic work is necessary to localize postoperative high frequency conductive hearing deficits and improve stapedotomy hearing outcomes. Level of Evidence 4, retrospective study.

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Comparison of round-window membrane mechanics before and after experimental stapedotomy

Abstract: After stapedotomy, with the use of a Teflon piston prosthesis, stimulation of inner ear structures diminishes, especially in higher frequencies.

Cited by 9 publications

References 20 publications

A three-dimensional finite element model of round window membrane vibration before and after stapedotomy surgery

A three-dimensional finite element model of round window membrane vibration before and after stapedotomy surgery

New chamber stapes prosthesis – A preliminary assessment of the functioning of the prototype

Does stapedotomy improve high frequency conductive hearing?

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