NDLI: Evaluation of round window stimulation using the floating mass transducer by intracochlear sound pressure measurements in human temporal bones.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Nakajima, Hideko Heidi Dong, Wei Olson, Elizabeth S. Rosowski, John J. Ravicz, Michael E. Merchant, Saumil N.
Description	Country affiliation: United States Author Affiliation: Nakajima HH ( Department of Otology and Laryngology, Harvard Medical School, Cambridge, Massachusetts, U.S.A. heidi_nakajima@meei.harvard.edu)
Abstract	HYPOTHESIS: Round window (RW) stimulation with a floating mass transducer (FMT) can be studied experimentally and optimized to enhance auditory transduction. BACKGROUND: The FMT (MED-EL Vibrant Soundbridge) has been recently implanted in patients with refractory conductive or mixed hearing loss to stimulate the RW with varying degrees of success. The mechanics of RW stimulation with the FMT have not been studied in a systematic manner. METHODS: In cadaveric human temporal bones, measurements of stapes velocity with laser vibrometry in response to FMT-RW stimulation were used to optimize FMT insertion. The effect of RW stimulation on hearing was estimated using simultaneous measurements of intracochlear pressures in both perilymphatic scalae with micro-optical pressure transducers. This enabled calculation of the differential pressure across the cochlear partition, which is directly tied to auditory transduction. RESULTS: The best coupling between the FMT and RW was achieved with a piece of fascia placed between the RW and the FMT, and by 'bracing' the free end of the FMT against the hypotympanic wall with dental impression material. FMT-RW stimulation provided differential pressures comparable with sound-induced oval window stimulation greater than 1 kHz. However, less than 1 kHz, the FMT was less capable. CONCLUSION: Measurements of stapes velocity and intracochlear sound pressures in scala vestibuli and scala tympani enabled experimental evaluation of FMT stimulation of the RW. The efficacy of FMT-RW coupling was influenced significantly by technical and surgical factors, which can be optimized. This temporal bone preparation also lays the foundation for future studies to investigate multiple issues of relevance to both basic and clinical science such as RW stimulation in stapes fixation, nonaerated middle ears, and third-window lesions, and to answer basic questions regarding bone conduction.
File Format	HTM / HTML
ISSN	15317129
e-ISSN	15374505
DOI	10.1097/MAO.0b013e3181c0ea9f
Journal	Otology & Neurotology
Issue Number	3
Volume Number	31
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Temporal Bone Research Support, N.i.h., Extramural Transducers Round Window, Ear Acoustic Stimulation Surgery Ear, Middle Discipline Otolaryngology Physiology Bone Conduction
Content Type	Text
Resource Type	Article
Subject	Otorhinolaryngology Sensory Systems Neurology (clinical)

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Evaluation of Round Window Stimulation Using the Floating Mass Transducer by Intracochlear Sound Pressure Measurements in Human Temporal Bones

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