title: Vibromechanical assessment of active middle ear implant stimulation in simulated middle ear effusion: a temporal bone study.
abstract: OBJECTIVE
  Active middle ear implant (AMEI) generated vibromechanical stimulation of the ossicular chain (ossicular chain vibroplasty [OCV]) or the round window (round window vibroplasty [RWV]) is not significantly affected by simulated middle ear effusion in a human temporal bone model.
  
  
  BACKGROUND
  OCV and RWV may be employed for sensorineural, mixed, and conductive hearing losses. Although middle ear effusions may be encountered across patient populations, little is known about how effusions may affect AMEI vibromechanical efficiency.
  
  
  METHODS
  Laser Doppler vibrometry of stapes velocities (SVs) were performed in a human temporal bone model of simulated effusion (N = 5). Baseline measurements to acoustic sinusoidal stimuli, OCV, and RWV (0.25-8 kHz) were made without effusion. The measurements were repeated with simulated middle ear effusion and compared with baseline measurements. Data were analyzed across 3 frequency bands: low (0.25-1 kHz), medium (1-3 kHz), and high (3-8 kHz).
  
  
  RESULTS
  Acoustic stimulation with simulated middle ear effusion resulted in a significant (p < 0.001) frequency-dependent attenuation of SVs of 4, 10, and 7 dB (low, medium, and high ranges, respectively). OCV in simulated effusion resulted in attenuated SVs of 1, 5, and 14 dB (low, medium, and high) compared to without effusion; however, this attenuation was not significant (p = 0.07). Interestingly, in the setting of RWV, simulated effusion resulted in significantly (p = 0.001) increased SVs of 16, 11, and 8 dB (low, medium, and high). A 3-dB variance in AMEI efficiency was observed in repeated measurements in a single temporal bone.
  
  
  CONCLUSIONS
  The efficiency of OCV was not significantly affected by the presence of a middle ear effusion. Improved efficiency, however, was observed with RWV.
authors.affiliation: *Otolaryngology, and †Physiology and Biophysics Departments, University of Colorado School of Medicine, Aurora, Colorado, U.S.A.
authors.forename: J Eric
authors.initials: JE
authors.lastname: Lupo
authors.forename: Kanthaiah
authors.initials: K
authors.lastname: Koka
authors.forename: Herman A
authors.initials: HA
authors.lastname: Jenkins
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Tollin
mesh_terms: D000161:Acoustic Stimulation; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D009998:Ossicular Prosthesis; D010034:Otitis Media with Effusion / Q000503:physiopathology* / Q000601:surgery; D013199:Stapes / Q000503:physiopathology; D013701:Temporal Bone / Q000503:physiopathology* / Q000601:surgery