Finite Element Model Analysis of Hearing Loss Caused by Tympanic Membrane Perforation
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维普
万方数据
目的 探讨鼓膜穿孔导致听力下降的机制.方法 通过有限元分析法(finite element analysis,FEA)构建全耳有限元模型并验证;参照实际鼓膜穿孔病例,创建个性化的鼓膜穿孔有限元模型,模拟鼓膜穿孔导致的听力损失;使用基底膜的位移响应与基线的差异来模拟听力损失情况,分析中耳各个组分对听力损失的贡献程度,探讨鼓膜穿孔导致听力下降的机制.结果 如果将圆窗膜和中耳腔的耦合去掉,将导致低频约40 dB的听力下降,而高频段基本与基线情况下鼓膜穿孔所导致的听力损失持平;去除鼓膜内侧面和中耳腔气体的耦合,可部分减轻低频听力损失,而高频听力损失加重;切断外耳道气体和中耳腔气体之间的连续性,低频听力损失加重;但是去除圆窗膜和中耳腔之间耦合关系并且去除中耳腔气体和鼓膜内侧面的连接后,原先低频的40 dB听力损失将会恢复到10 dB左右;而去除中耳腔气体和听骨链之间的耦合,对听力损失无明显影响.结论 鼓膜穿孔导致听力下降的主要机制是鼓膜穿孔本身所导致的传声效能降低,以及鼓膜内外声压差的降低;圆窗膜处声压的增加可以部分弥补鼓膜穿孔所导致的听力损失.
Objective To investigate the mechanism of hearing loss caused by tympanic membrane(TM)per-foration.Methods We constructed a full ear finite element model,and the personalized finite element model of TM perforation was constructed to simulate hearing loss caused by TM perforation.The difference between the displace-ment response of the basement membrane and the baseline was applied to simulate hearing loss,and the contribution of various components of the middle ear to hearing loss was analyzed to study the mechanism of hearing loss caused by TM perforation.Results If the coupling of the round window membrane and the middle ear air was removed,the hearing loss at the low frequency was about 40 dB,while the high-frequency was the same as the baseline.Re-moval of the coupling between the inner side of the eardrum and the middle ear cavity resulted in a reduction in par-tial low-frequency hearing and an increase in high-frequency hearing loss.The continuous disconnection between the air in the external auditory canal and the air in the middle ear cavity increased the low-frequency hearing loss.How-ever,after the removal of the coupling between the round window membrane and the middle ear air and the connec-tion between the middle ear air and the lateral side of the TM,the original hearing loss of 40 dB at low-frequency dropped to 10 dB.While the removal of the coupling between the middle ear cavity air and the ossicular chain had no significant impact on hearing loss.Conclusion TM perforation may cause hearing loss by both the reduction of sound transmission and the reduction of sound pressure difference between the two sides of TM.The round window membrane can counteract the influence of the hearing loss caused by TM perforation.
Tympanic membrane perforationFinite element analysisHearing loss
维普
万方数据
