中耳力学:再论骨传导听觉途径与机制

Middle ear mechanics:revisiting the pathways and mechanisms of bone conduction hearing

任柳杰;李辰龙;姚文娟;张天宇

1:复旦大学附属眼耳鼻喉科医院眼耳鼻整形外科

2:复旦大学附属眼耳鼻喉科医院耳鼻喉科研究院

3:国家卫生健康委员会听觉医学重点实验室(复旦大学)

4:上海大学力学与工程科学学院

摘要
<正>在人体听觉系统中,气传导和骨传导是实现声音感知的两条主要途径。前者依赖外耳和中耳将声波传递至耳蜗,而后者则通过头骨、软组织及颅内介质的机械振动直接激发耳蜗感受器。骨传导听觉不仅在临床听力学中具有重要的诊断价值,如区分传导性与感音神经性听力损失,也是多种听觉重建和助听技术(包括各类非植入式或植入式骨导助听装置~([1,2]))的理论基础。同时,骨传导在娱乐、通信与虚拟现实等新兴领域亦展现出独特优势。因此,深入理解骨传导听觉的传导途径及其力学机制,对于听觉生理研究、助听装置优化设计以及个体化听觉康复策略的制定均具有重要意义。
关键词
基金项目(Foundation):
国家自然科学基金重点项目(82101221、11932010)
作者
任柳杰;李辰龙;姚文娟;张天宇
参考文献

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.骨导助听装置规范命名及系统分类专家共识[J].中华耳鼻咽喉头颈外科杂志,2025,60(4):377-381.

[2] ELLSPERMAN S E,NAIRN E M,STUCKEN E Z.Review of bone conduction hearing devices[J].Audiology Research,2021,11(2):207-219.

[3] STENFELT S.Acoustic and physiologic aspects of bone conduction hearing[J].Adv Otorhinolaryngol,2011,71:10-21.

[4] 张天宇,任柳杰,谢友舟.先天性外中耳畸形(15)——骨导机制研究进展[J].听力学及言语疾病杂志,2021,29(4):476-478.

[5] GUAN X.A mechanical lumped-element model of the human middle ear for bone conduction hearing[J].Scientific Reports,2025,15(1):27434.

[6] CHANG Y,KIM N,STENFELT S.Simulation of the power transmission of bone-conducted sound in a finite-element model of the human head[J].Biomechanics and Modeling in Mechanobiology,2018,17(6):1741-1755.

[7] STENFELT S,PRODANOVIC S.Simulation of soft tissue stimulation—Indication of a skull bone vibration mechanism in bone conduction hearing[J].Hearing Research,2022,418:108471.

[8] LIM J,DOBREV I,R????SLI C,et al.Development of a finite element model of a human head including auditory periphery for understanding of bone-conducted hearing[J].Hearing Research,2022,421:108337.

[9] R????SLI C,CHHAN D,HALPIN C,et al.Comparison of umbo velocity in air-and bone-conduction[J].Hearing Research,2012,290(1-2):83-90.

[10] CARILLO K,DOUTRES O,SGARD F.Numerical investigation of the earplug contribution to the low-frequency objective occlusion effect induced by bone-conducted stimulation[J].The Journal of the Acoustical Society of America,2021,150(3):2006-2023.

[11] BRUMMUND M K,SGARD F,PETIT Y,et al.Three-dimensional finite element modeling of the human external ear:Simulation study of the bone conduction occlusion effect[J].The Journal of the Acoustical Society of America,2014,135(3):1433-1444.

[12] SURENDRAN S,STENFELT S.The outer ear pathway during hearing by bone conduction[J].Hearing Research,2022,421:108388.

[13] REINFELDT S,RIGATO C,H??KANSSON B,et al.Nasal sound pressure as objective verification of implant in active transcutaneous bone conduction devices[J].Medical Devices:Evidence and Research,2019,12,193-202.

[14] BERGER E H,KIEPER R W,GAUGER D.Hearing protection:surpassing the limits to attenuation imposed by the bone-conduction pathways[J].The Journal of the Acoustical Society of America,2003,114(4):1955-1967.

[15] STIEGER C,FARAHMAND R B,PAGE B F,et al.Pressures in the human cochlea during bone conduction[J].InAIP Conference Proceedings,2015,1703(1):060004.

[16] CHHAN D,BOWERS P,MCKINNON M L,et al.Middle-ear and inner-ear contribution to bone conduction in chinchilla:the development of Carhart’s notch[J].Hearing Research,2016,340:144-152.

[17] DOBREV I,FARAHMANDI T S,R????SLI C.Experimental investigation of the effect of middle ear in bone conduction[J].Hearing Research,2020,395:108041.

[18] HOMMA K,DU Y,SHIMIZU Y,et al.Ossicular resonance modes of the human middle ear for bone and air conduction[J].The Journal of the Acoustical Society of America,2009,125(2):968-979.

[19] KIM N,STEELE C,PURIA S.Carhart’s notch:a window into mechanisms of bone-conducted hearing[C].Proceedings of Meetings on Acoustics,2013:050133.

[20] STENFELT S.Inner ear contribution to bone conduction hearing in the human[J].Hearing Research,2015,329:41-51.

[21] LI J,REN L,WU T,et al.Experimental and numerical studies on vibration modes and transcranial attenuation characteristics in unilateral bone conduction hearing[J].Shock and Vibration,2020,2020(1):4962098.

[22] DOBREV I,SIM JH,STENFELT S,et al.Sound wave propagation on the human skull surface with bone conduction stimulation[J].Hearing Research,2017,355:1-3.

[23] CHAN W X,YOON Y J,KIM N.Mechanism of bone-conducted hearing:mathematical approach[J].Biomechanics and Modeling in Mechanobiology,2018,17(6):1731-1740.

[24] REN L J,YU Y,FANG Y Q,et al.Finite element simulation of cochlear traveling wave under air and bone conduction hearing[J].Biomechanics and Modeling in Mechanobiology,2021,20(4):1251-1265.

[25] STENFELT S.Investigation of mechanisms in bone conduction hyperacusis with third window pathologies based on model predictions[J].Frontiers in Neurology,2020,11:966.

[26] DOBREV I,LIM J,KIM N,et al,Pfiffner F.Exploration of the dynamics of otic capsule and intracochlear pressure:numerical insights with experimental validation[J].The Journal of the Acoustical Society of America,2025,157(1):554-568.

[27] DOBREV I,FARAHMANDI T,PFIFFNER F,et al.Intracochlear pressure in cadaver heads under bone conduction and intracranial fluid stimulation[J].Hearing Research,2022,421:108506.

[28] DOBREV I,PFIFFNER F,R????SLI C.Intracochlear pressure and temporal bone motion interaction under bone conduction stimulation[J].Hearing Research,2023,435:108818.

[29] VON MITZLAFF C,DOBREV I,FARAHMANDI T,et al.Influence of the intracranial contents on the head motion under bone conduction[J].Audiology and Neurotology,2024,29(4):322-333.

[30] WILS I,GEERARDYN A,PUTZEYS T,et al.Objective preclinical measures for bone conduction implants[J].Frontiers in Neuroscience,2024,18:1324971.

[31] SURENDRAN S,PRODANOVIC S,STENFELT S.Hearing through bone conduction headsets[J].Trends in Hearing,2023,27:23312165231168741.

[32] HOSOI H,NISHIMURA T,SHIMOKURA R,et al.Cartilage conduction as the third pathway for sound transmission[J].Auris Nasus Larynx,2019,46(2):151-159.

[33] NISHIMURA T,HOSOI H,SHIMOKURA R,et al.Cartilage conduction hearing and its clinical application[J].Audiology Research,2021,11(2):254-262.

[34] R????SLI C,DOBREV I,PFIFFNER F.Transcranial attenuation in bone conduction stimulation[J].Hearing Research,2022,419:108318.

[35] 任柳杰,段雅珊,谢友舟,等.骨导助听患者声源定位能力研究进展[J].听力学及言语疾病杂志,2022,30(3):323-327.

[36] REN L J,YU Y,HUA C,et al.Interference pattern caused by bilateral bone conduction stimulation impairs sound localization[J].Advanced Science,2025:e00302.

本文信息

PDF(215K)

本文关键词相关文章

本文作者相关文章

任柳杰李辰龙姚文娟张天宇