title: How do tympanic-membrane perforations affect human middle-ear sound transmission?
abstract: Although tympanic-membrane (TM) perforations are common sequelae of middle-ear disease, the hearing losses they cause have not been accurately determined, largely because additional pathological conditions occur in these ears. Our measurements of acoustic transmission before and after making controlled perforations in cadaver ears show that perforations cause frequency-dependent loss that: (1) is largest at low frequencies; (2) increases as perforation size increases; and (3) does not depend on perforation location. The dominant loss mechanism is the reduction in sound-pressure difference across the TM. Measurements of middle-ear air-space sound pressures show that transmission via direct acoustic stimulation of the oval and round windows is generally negligible. A quantitative model predicts the influence of middle-ear air-space volume on loss; with larger volumes, loss is smaller.
authors.affiliation: Easton-Peabody Laboratory of Auditory Physiology, Massachusetts Eye and Ear Infirmary, Boston 02144, USA. sev@epl.meei.harvard.edu
authors.forename: S E
authors.initials: SE
authors.lastname: Voss
authors.forename: J J
authors.initials: JJ
authors.lastname: Rosowski
authors.forename: S N
authors.initials: SN
authors.lastname: Merchant
authors.forename: W T
authors.initials: WT
authors.lastname: Peake
mesh_terms: D004432:Ear, Middle / Q000503:physiopathology*; D006314:Hearing Loss, Conductive / Q000503:physiopathology*; D006801:Humans; D010046:Oval Window, Ear / Q000503:physiopathology; D010898:Pitch Perception / Q000502:physiology*; D012405:Round Window, Ear / Q000503:physiopathology; D013199:Stapes / Q000503:physiopathology; D018058:Tympanic Membrane Perforation / Q000503:physiopathology*