2. Fundamentals of Hearing
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Sound and the Ear Chapter 2
© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter© Jones & Bartlett 2 Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Sound and the Ear © Jones Karen &J. Kushla,Bartlett ScD, Learning, CCC-A, FAAA LLC © Jones & Bartlett Learning, LLC Lecturer NOT School FOR of SALE Communication OR DISTRIBUTION Disorders and Deafness NOT FOR SALE OR DISTRIBUTION Kean University © Jones & Bartlett Key Learning, Terms LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR Acceleration DISTRIBUTION Incus NOT FOR SALE OR Saccule DISTRIBUTION Acoustics Inertia Scala media Auditory labyrinth Inner hair cells Scala tympani Basilar membrane Linear scale Scala vestibuli Bel Logarithmic scale Semicircular canals Boyle’s law Malleus Sensorineural hearing loss Broca’s area © Jones & Bartlett Mass Learning, LLC Simple harmonic© Jones motion (SHM) & Bartlett Learning, LLC Brownian motion Membranous labyrinth Sound Cochlea NOT FOR SALE OR Mixed DISTRIBUTION hearing loss Stapedius muscleNOT FOR SALE OR DISTRIBUTION Compression Organ of Corti Stapes Condensation Osseous labyrinth Tectorial membrane Conductive hearing loss Ossicular chain Tensor tympani muscle Decibel (dB) Ossicles Tonotopic organization © Jones Decibel & hearing Bartlett level (dB Learning, HL) LLC Outer ear © Jones Transducer & Bartlett Learning, LLC Decibel sensation level (dB SL) Outer hair cells Traveling wave theory NOT Decibel FOR sound SALE pressure OR level DISTRIBUTION -
Perforated Eardrum
Vinod K. Anand, MD, FACS Nose and Sinus Clinic Perforated Eardrum A perforated eardrum is a hole or rupture m the eardrum, a thin membrane which separated the ear canal and the middle ear. The medical term for eardrum is tympanic membrane. The middle ear is connected to the nose by the eustachian tube. A perforated eardrum is often accompanied by decreased hearing and occasional discharge. Paih is usually not persistent. Causes of Eardrum Perforation The causes of perforated eardrum are usually from trauma or infection. A perforated eardrum can occur: if the ear is struck squarely with an open hand with a skull fracture after a sudden explosion if an object (such as a bobby pin, Q-tip, or stick) is pushed too far into the ear canal. as a result of hot slag (from welding) or acid entering the ear canal Middle ear infections may cause pain, hearing loss and spontaneous rupture (tear) of the eardrum resulting in a perforation. In this circumstance, there may be infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation. On rare occasions a small hole may remain in the eardrum after a previously placed P.E. tube (pressure equalizing) either falls out or is removed by the physician. Most eardrum perforations heal spontaneously within weeks after rupture, although some may take up to several months. During the healing process the ear must be protected from water and trauma. Those eardrum perforations which do not heal on their own may require surgery. Effects on Hearing from Perforated Eardrum Usually, the larger the perforation, the greater the loss of hearing. -
A Pictorial Review of Round Window Pathologies
REVIEW ARTICLE The Forgotten Second Window: A Pictorial Review of Round Window Pathologies J.C. Benson, F. Diehn, T. Passe, J. Guerin, V.M. Silvera, M.L. Carlson, and J. Lane ABSTRACT SUMMARY: The round window serves to decompress acoustic energy that enters the cochlea via stapes movement against the oval window. Any inward motion of the oval window via stapes vibration leads to outward motion of the round window. Occlusion of the round window is a cause of conductive hearing loss because it increases the resistance to sound energy and con- sequently dampens energy propagation. Because the round window niche is not adequately evaluated by otoscopy and may be incompletely exposed during an operation, otologic surgeons may not always correctly identify associated pathology. Thus, radiol- ogists play an essential role in the identification and classification of diseases affecting the round window. The purpose of this review is to highlight the developmental, acquired, neoplastic, and iatrogenic range of pathologies that can be encountered in round window dysfunction. ABBREVIATIONS: LO 4 labyrinthitis ossificans; RW 4 round window he round window (RW) serves as a boundary between the considerations of the round window that can be encoun- Tbasal turn of the cochlea anteriorly and the round win- tered on imaging are reviewed. dow niche posteriorly.1 It, along with the oval window, is 1 of 2 natural openings between the inner and middle ear. The Physiology and Functionality “ ” round window is often overshadowed by the first window The inner ear “windows” refer to openings in the otic capsule “ ” (the oval window) and pathologic third windows (eg, that connect the fluid in the inner ear to either the middle ear or superior semicircular canal dehiscence). -
The Round Window Region and Contiguous Areas: Endoscopic Anatomy and Surgical Implications
Eur Arch Otorhinolaryngol DOI 10.1007/s00405-014-2923-8 OTOLOGY The round window region and contiguous areas: endoscopic anatomy and surgical implications Daniele Marchioni · Matteo Alicandri-Ciufelli · David D. Pothier · Alessia Rubini · Livio Presutti Received: 16 October 2013 / Accepted: 28 January 2014 © Springer-Verlag Berlin Heidelberg 2014 Abstract The round window region is a critical area of window region. Exact anatomical knowledge of this region the middle ear; the aim of this paper is to describe its anat- can have important advantages during surgery, since some omy from an endoscopic perspective, emphasizing some pathology can invade inside cavities or tunnels otherwise structures, the knowledge of which could have important not seen by instrumentation that produces a straight-line implications during surgery, as well as to evaluate what view (e.g. microscope). involvement cholesteatoma may have with these structures. Retrospective review of video recordings of endoscopic Keywords Retrotympanum · Endoscopic ear surgery · ear surgeries and retrospective database review were con- Cholesteatoma · Middle ear anatomy · Round window ducted in Tertiary university referral center. Videos from endoscopic middle ear procedures carried out between June 2010 and September 2012 and stored in a shared data- Introduction base were reviewed retrospectively. Surgeries in which an endoscopic magnification of the round window region and The surgical management of cholesteatoma is still a contro- the inferior retrotympanum area was performed intraop- versial issue. Endoscopic instrumentation, techniques and eratively were included in the study. Involvement by cho- knowledge have improved considerably over the last few lesteatoma of those regions was also documented based years, and we believe that, in the future, endoscopic surgi- on information obtained from the surgical database. -
Status and Strategies Analysis on International Standardization of Auricular Acupuncture Points
Online Submissions:http://www.journaltcm.com J Tradit Chin Med 2013 June 15; 33(3): 408-412 [email protected] ISSN 0255-2922 © 2013 JTCM. All rights reserved. REVIEWTOPIC Status and strategies analysis on international standardization of auricular acupuncture points Lei Wang, Baixiao Zhao, Liqun Zhou aa Lei Wang, Baixiao Zhao, School of Acupuncture-Moxibus- Germany. Clinical AAP research was done in Italy, tion and Tuina, Beijing University of Chinese Medicine, Bei- Austria, Switzerland, Spain, the UK, Holland, Japan, jing 100029, China Russia, and Africa. However, AAP research was not Liqun Zhou, Department of Humanities of Traditional Chi- communicated internationally. The World Federa- nese Medicine, School of Basic Medical Sciences, Beijing Uni- tion of Acupuncture-Moxibustion Societies recom- versity of Chinese Medicine, Beijing 100029, China Supported by a Grant of Key Technology Standard Promo- mended international standard of auricular acu- tion Project (No. 2006BAK04A20) from the Ministry of Sci- puncture points (ISAAPs). Standardized nomencla- ence and Technology of China, and a Grant (No. 2009B26) ture and locations of AAPs would provide a solid from the World Federation of Acupuncture and Moxibustion basis to draft an international standard organiza- Societies tion. Correspondence to: Prof. Baixiao Zhao, School of Acu- puncture-Moxibustion and Tuina, Beijing University of Chi- CONCLUSION: Experts need to find common nese Medicine, Beijing 100029, China. baixiao100@gmail. points from different countries or regions, provide com evidence of different ideas, and list the proposal as Telephone: +86-10-64286737; +86-13911040781 a recommendation for an international standard. Accepted: January 27, 2013 © 2013 JTCM. All rights reserved. Abstract Key words: Acupuncture, ear; Reference standards; Information storage and retrieval OBJECTIVE: To supply literature for developing an international standard of auricular acupuncture points. -
Eardrum Regeneration: Membrane Repair
OUTLINE Watch an animation at: Infographic: go.nature.com/2smjfq8 Pages S6–S7 EARDRUM REGENERATION: MEMBRANE REPAIR Can tissue engineering provide a cheap and convenient alternative to surgery for eardrum repair? DIANA GRADINARU he eardrum, or tympanic membrane, forms the interface between the outside world and the delicate bony structures Tof the middle ear — the ossicles — that conduct sound vibrations to the inner ear. At just a fraction of a millimetre thick and held under tension, the membrane is perfectly adapted to transmit even the faintest of vibrations. But the qualities that make the eardrum such a good conductor of sound come at a price: fra- gility. Burst eardrums are a major cause of conductive hearing loss — when sounds can’t pass from the outer to the inner ear. Most burst eardrums are caused by infections or trauma. The vast majority heal on their own in about ten days, but for a small proportion of people the perforation fails to heal natu- rally. These chronic ruptures cause conductive hearing loss and group (S. Kanemaru et al. Otol. Neurotol. 32, 1218–1223; 2011). increase the risk of middle ear infections, which can have serious In a commentary in the same journal, Robert Jackler, a head complications. and neck surgeon at Stanford University, California, wrote that, Surgical intervention is the only option for people with ear- should the results be replicated, the procedure represents “poten- drums that won’t heal. Tympanoplasty involves collecting graft tially the greatest advance in otology since the invention of the material from the patient to use as a patch over the perforation. -
Vestibular Neuritis, Labyrinthitis, and a Few Comments Regarding Sudden Sensorineural Hearing Loss Marcello Cherchi
Vestibular neuritis, labyrinthitis, and a few comments regarding sudden sensorineural hearing loss Marcello Cherchi §1: What are these diseases, how are they related, and what is their cause? §1.1: What is vestibular neuritis? Vestibular neuritis, also called vestibular neuronitis, was originally described by Margaret Ruth Dix and Charles Skinner Hallpike in 1952 (Dix and Hallpike 1952). It is currently suspected to be an inflammatory-mediated insult (damage) to the balance-related nerve (vestibular nerve) between the ear and the brain that manifests with abrupt-onset, severe dizziness that lasts days to weeks, and occasionally recurs. Although vestibular neuritis is usually regarded as a process affecting the vestibular nerve itself, damage restricted to the vestibule (balance components of the inner ear) would manifest clinically in a similar way, and might be termed “vestibulitis,” although that term is seldom applied (Izraeli, Rachmel et al. 1989). Thus, distinguishing between “vestibular neuritis” (inflammation of the vestibular nerve) and “vestibulitis” (inflammation of the balance-related components of the inner ear) would be difficult. §1.2: What is labyrinthitis? Labyrinthitis is currently suspected to be due to an inflammatory-mediated insult (damage) to both the “hearing component” (the cochlea) and the “balance component” (the semicircular canals and otolith organs) of the inner ear (labyrinth) itself. Labyrinthitis is sometimes also termed “vertigo with sudden hearing loss” (Pogson, Taylor et al. 2016, Kim, Choi et al. 2018) – and we will discuss sudden hearing loss further in a moment. Labyrinthitis usually manifests with severe dizziness (similar to vestibular neuritis) accompanied by ear symptoms on one side (typically hearing loss and tinnitus). -
Inner Ear Infection (Otitis Interna) in Dogs
Hurricane Harvey Client Education Kit Inner Ear Infection (Otitis Interna) in Dogs My dog has just been diagnosed with an inner ear infection. What is this? Inflammation of the inner ear is called otitis interna, and it is most often caused by an infection. The infectious agent is most commonly bacterial, although yeast and fungus can also be implicated in an inner ear infection. If your dog has ear mites in the external ear canal, this can ultimately cause a problem in the inner ear and pose a greater risk for a bacterial infection. Similarly, inner ear infections may develop if disease exists in one ear canal or when a benign polyp is growing from the middle ear. A foreign object, such as grass seed, may also set the stage for bacterial infection in the inner ear. Are some dogs more susceptible to inner ear infection? Dogs with long, heavy ears seem to be predisposed to chronic ear infections that ultimately lead to otitis interna. Spaniel breeds, such as the Cocker spaniel, and hound breeds, such as the bloodhound and basset hound, are the most commonly affected breeds. Regardless of breed, any dog with a chronic ear infection that is difficult to control may develop otitis interna if the eardrum (tympanic membrane) is damaged as it allows bacteria to migrate down into the inner ear. "Dogs with long, heavy ears seem to bepredisposed to chronic ear infections that ultimately lead to otitis interna." Excessively vigorous cleaning of an infected external ear canal can sometimes cause otitis interna. Some ear cleansers are irritating to the middle and inner ear and can cause signs of otitis interna if the eardrum is damaged and allows some of the solution to penetrate too deeply. -
Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond
Published August 25, 2016 as 10.3174/ajnr.A4922 REVIEW ARTICLE Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond X M.-L. Ho, X G. Moonis, X C.F. Halpin, and X H.D. Curtin ABSTRACT SUMMARY: Third window abnormalities are defects in the integrity of the bony structure of the inner ear, classically producing sound-/ pressure-induced vertigo (Tullio and Hennebert signs) and/or a low-frequency air-bone gap by audiometry. Specific anatomic defects include semicircular canal dehiscence, perilabyrinthine fistula, enlarged vestibular aqueduct, dehiscence of the scala vestibuli side of the cochlea, X-linked stapes gusher, and bone dyscrasias. We discuss these various entities and provide key examples from our institutional teaching file with a discussion of symptomatology, temporal bone CT, audiometry, and vestibular-evoked myogenic potentials. ABBREVIATIONS: EVAS ϭ enlarged vestibular aqueduct syndrome; SSCCD ϭ superior semicircular canal dehiscence hird window abnormalities are defects in the integrity of the ing effects decrease air conduction. The 2 physiologic windows Tbony structure of the inner ear, first described by Minor et al between the middle and inner ear are the oval window, which in 1998.1 In 2008, Merchant and Rosowski2 proposed a universal transmits vibrations from the auditory ossicles, and the round theory for the underlying mechanism of hearing loss accompany- window of the cochlea. With air conduction, there is physiologic ing these defects. Normal sound conduction is transmitted entrainment of the oval and round windows due to coupling by through the oval and round windows, which serve as fluid inter- incompressible perilymph. Pressure differences between the co- faces between air in the middle ear and perilymphatic fluid spaces chlear perilymphatic spaces activate hair cells and create the per- of the inner ear. -
The Eardrum Moves When the Eyes Move
bioRxiv preprint doi: https://doi.org/10.1101/156570; this version posted June 29, 2017. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. The eardrum moves when the eyes move: A multisensory effect on the mechanics of hearing Short title: The eardrum moves when the eyes move K. G. Gruters*, D. L. K. Murphy*, D. W. Smith§, C. A. Shera‡, J. M. Groh*† *Department of Psychology and Neuroscience; Department of Neurobiology; Duke Institute for Brain Sciences, Duke University, Durham, NC 27708 §Program in Behavioral and Cognitive Neuroscience, Department of Psychology, University of Florida, Gainesville, FL 32611 ‡Caruso Department of Otolaryngology; Department of Physics and Astronomy, University of Southern California, Los Angeles, CA 90033 †To whom correspondence should be addressed Section: Biological Sciences: Neuroscience Acknowledgments: We are grateful to Tom Heil, Jessi Cruger, Karen Waterstradt, Christie Holmes, and Stephanie Schlebusch for technical assistance. We thank Marty Woldorff, Jeff Beck, Tobias Overath, Barbara Shinn-Cunningham, Valeria Caruso, Daniel Pages, Shawn Willett, Jeff Mohl for numerous helpful discussions and comments during the course of this project. bioRxiv preprint doi: https://doi.org/10.1101/156570; this version posted June 29, 2017. The copyright holder for this preprint (which was not certified by peer review) is the author/funder. All rights reserved. No reuse allowed without permission. ABSTRACT Interactions between sensory pathways such as the visual and auditory systems are known to occur in the brain, but where they first occur is uncertain. Here we show a novel multimodal interaction evident at the eardrum. -
Tonic Tensor Tympani Syndrome (TTTS)
Tonic Tensor Tympani Syndrome (TTTS) http://www.dineenandwestcott.com.au/hyperacusis.php?fid=1 Retrieved 15ththth May 2009 In the middle ear, the tensor tympani muscle and the stapedial muscle contract to tighten the middle ear bones (the ossicles) as a reaction to loud, potentially damaging sound. This provides protection to the inner ear from these loud sounds. In many people with hyperacusis, an increased, involuntary activity can develop in the tensor tympani muscle in the middle ear as part of a protective and startle response to some sounds. This lowered reflex threshold for tensor tympani contraction is activated by the perception/anticipation of sudden, unexpected, loud sound, and is called tonic tensor tympani syndrome (TTTS). In some people with hyperacusis, it appears that the tensor tympani muscle can contract just by thinking about a loud sound. Following exposure to intolerable sounds, this heightened contraction of the tensor tympani muscle: • tightens the ear drum • stiffens the middle ear bones (ossicles) • can lead to irritability of the trigeminal nerve, which innervates the tensor tympani muscle; and to other nerves supplying the ear drum • can affect the airflow into the middle ear. The tensor tympani muscle functions in coordination with the tensor veli palatini muscle. When we yawn or swallow, these muscles work together to open the Eustachian tube. This keeps the ears healthy by clearing the middle ear of any accumulated fluid and allows the ears to “pop” by equalising pressure caused by altitude changes. TTTS can lead to a range of symptoms in and around the ear(s): ear pain; pain in the jaw joint and down the neck; a fluttering sensation in the ear; a sensation of fullness in the ear; burning/numbness/tingling in and around the ear; unsteadiness; distorted hearing. -
ANATOMY of EAR Basic Ear Anatomy
ANATOMY OF EAR Basic Ear Anatomy • Expected outcomes • To understand the hearing mechanism • To be able to identify the structures of the ear Development of Ear 1. Pinna develops from 1st & 2nd Branchial arch (Hillocks of His). Starts at 6 Weeks & is complete by 20 weeks. 2. E.A.M. develops from dorsal end of 1st branchial arch starting at 6-8 weeks and is complete by 28 weeks. 3. Middle Ear development —Malleus & Incus develop between 6-8 weeks from 1st & 2nd branchial arch. Branchial arches & Development of Ear Dev. contd---- • T.M at 28 weeks from all 3 germinal layers . • Foot plate of stapes develops from otic capsule b/w 6- 8 weeks. • Inner ear develops from otic capsule starting at 5 weeks & is complete by 25 weeks. • Development of external/middle/inner ear is independent of each other. Development of ear External Ear • It consists of - Pinna and External auditory meatus. Pinna • It is made up of fibro elastic cartilage covered by skin and connected to the surrounding parts by ligaments and muscles. • Various landmarks on the pinna are helix, antihelix, lobule, tragus, concha, scaphoid fossa and triangular fossa • Pinna has two surfaces i.e. medial or cranial surface and a lateral surface . • Cymba concha lies between crus helix and crus antihelix. It is an important landmark for mastoid antrum. Anatomy of external ear • Landmarks of pinna Anatomy of external ear • Bat-Ear is the most common congenital anomaly of pinna in which antihelix has not developed and excessive conchal cartilage is present. • Corrections of Pinna defects are done at 6 years of age.