鼓室硬化对中耳传声影响的有限元分析

Effects of Tympanosclerosis on Middle Ear Sound Transmission: Finite Element Analysis

于仪;王心玥;吕杰;张天宇;任柳杰

1:上海健康医学院医疗器械学院

2:复旦大学附属眼耳鼻喉科医院眼耳鼻整形外科

3:上海健康医学院康复学院

摘要
目的 通过对中耳不同部位硬化的理想化有限元模拟,揭示不同鼓室硬化部位和程度对中耳传声特性的影响。方法 基于切片数据三维重建人类中耳有限元模型,对正常生理状态下的气导传声进行仿真;通过增大相关组织材料的杨氏模量模拟不同部位的鼓室硬化,计算鼓膜和听骨链各韧带、关节硬化后中耳传递函数的变化。结果 小范围的鼓膜硬化对传声性能影响不大(<5 dB)。锤骨上韧带、砧骨上韧带及砧骨后韧带附近部位硬化引起的听骨链固定导致鼓膜脐和镫骨底板的低中频运动下降,说明其造成不同程度以低频为主的听力损失,完全固定时听力损失可达40 dB左右。锤砧关节硬化对传声无影响,而砧镫关节硬化导致镫骨底板的高频响应略增大(0~6 dB)。镫骨硬化造成镫骨底板低中频运动显著下降,但是鼓膜脐的运动速度下降并不显著。结论 鼓室硬化引起中耳传声效率变化主要由中耳刚度增大导致,对硬化部位和程度敏感。此外,硬化部位越靠近传声链下游,鼓膜和镫骨底板运动变化的不一致越明显。
关键词
鼓室硬化;有限元;中耳力学;传递函数;听力损失
基金项目(Foundation):
国家自然科学基金(82101221、82305416);; 上海市科委启明星项目扬帆专项(23YF1418300);; 上海健康医学院校级科研项目(SSF-23-04-004)
作者
于仪;王心玥;吕杰;张天宇;任柳杰
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