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目的研究典型中耳病变对圆窗激振听力补偿效果的影响,为圆窗激振式人工中耳的优化设计提供参考。方法利用CT扫描和逆向成型技术建立包括中耳和耳蜗的有限元模型,并验证模型的可靠性。再基于该模型,通过改变相应组织的材料属性,分别模拟镫骨环韧带硬化、镫骨不正常发育和锤骨前韧带硬化3种典型中耳病变。通过对比相应的基底膜响应,分析这3种病变对圆窗激振听力补偿效果的影响。结果镫骨不正常发育主要在高频处降低圆窗激振的效果,镫骨环韧带硬化和锤骨前韧带硬化主要恶化圆窗激振低频段的响应。3种病变中,镫骨环韧带硬化对圆窗激振听力补偿效果影响较大,等效声压的减小量可高达17 d B。结论中耳病变恶化圆窗激振的听力补偿效果,且恶化量较大,故在设计圆窗激振式人工中耳时需要针对性地提高其作动器的输出量。
Objective To study the effect of typical middle ear lesion on the round window excitation hearing compensation effect and provide a reference for the optimization design of the round window excitation-based artificial middle ear. Methods The finite element model including middle ear and cochlear was established by CT scanning and reverse forming technique and the reliability of the model was verified. Based on this model, the three typical middle ear lesions were simulated by changing the material properties of the corresponding tissues, respectively, including ligamentous ligament sclerosis, tarsal dysplasia and anterior malleolus ligament. By comparing the corresponding basement membrane response, analyze the three kinds of lesions on round window excitation hearing compensation effect. Results The abnormal tarsal development mainly reduced the effect of circular window excitation at high frequency. The posterior tarsal ligament stiffening and anterior malleolus stiffening mainly degenerated the response of low frequency vibration of circular window. Of the three lesions, the sagittal ligament sclerosis harbored the round window excitation hearing compensation effect, and the equivalent sound pressure reduction could be up to 17 days. Conclusion The middle ear lesion worsens the hearing compensation effect of round window excitation and has a large deterioration. Therefore, it is necessary to increase the output of its actuator when designing the middle round oscillating artificial middle ear.