Carolina Garbe

The Influence of the Mechanical Behaviour of the Middle Ear Ligaments: A Finite Element Analysis:

The interest in computer modelling of biomechanical systems, mainly by using the finite element method (FEM), has been increasing, in particular for analysis of the mechanical behaviour of the human ear. In this work, a finite element model of the middle ear was developed to study the dynamic structural response to harmonic vibrations for distinct sound pressure levels applied on the eardrum. The model includes different ligaments and muscle tendons with elastic and hyperelastic behaviour for these supportive structures. Additionally, the nonlinear behaviour of the ligaments and muscle tendons was investigated, as they are the connection between ossicles by contact formulation. Harmonic responses of the umbo and stapes footplate displacements, between 100 Hz and 100 kHz, were obtained and compared with previously published work. The stress state of ligaments (superior, lateral, and anterior of malleus and superior and posterior of incus) was analysed, with the focus on balance of the supportive structures of the middle ear, as ligaments make the link between the ossicular chain and the walls of the tympanic cavity. The results obtained in this work highlight the importance of using hyperelastic models to simulate the mechanical behaviour for the ligaments and tendons.

The influence of muscles activation on the dynamical behaviour of the tympano-ossicular system of the middle ear

The human ear is a complex biomechanical system and is divided into three parts: outer, middle and inner ear. The middle ear is formed by ossicles (malleus, incus and stapes), ligaments, muscles and tendons, which transfers sound vibrations from the eardrum to the inner ear, linking with mastoid and Eustachian tube. In this work, a finite element modelling of the tympano-ossicular system of the middle ear was developed. A dynamic study based on a structural response to harmonic vibrations, for a sound pressure level (SPL) of 110, 120 and 130 dB SPL applied in the eardrum, is presented. The connection between the ossicles is made using a contact formulation. The model includes the different ligaments considering its hyperelastic behaviour. The activation of the muscles is based on the constitutive model proposed by previous work. The harmonic responses of displacement and pressure obtained on the stapes footplate, for a frequency range between 100 Hz and 10 kHz, are obtained simulating the muscle activation. The results are compared considering the passive and active states. The results are discussed and they are in accordance with audiological data published with reference to the effects of the middle ear muscles contraction.

ANALYSIS OF EARDRUM PATHOLOGIES USING THE FINITE ELEMENT METHOD

This work investigates the effect of eardrum perforations and myringosclerosis in the mechanical behavior of the tympano-ossicular chain. A 3D model for the tympano-ossicular chain was created and different numerical simulations were made, using the finite element method. For the eardrum perforations, three different calibers of perforated eardrums were simulated. For the micro perforation (0.6 mm of diameter) no differences were observed between the perforated and normal eardrum. For the numerical simulation of the eardrum with the largest perforation caliber, small displacements were obtained in the stapes footplate, when compared with the model representative of normal ossicular-chain, at low frequencies, which is related with major hearing loss in this frequency range. For the numerical simulations of myringosclerosis, the larger differences in the displacement field between the normal and modified model were obtained in the umbo. When observing the results in the stapes footplate, there were no significant differences between the two models, which is in accordance to the clinical data. When simulating an eardrum perforation along with myringosclerosis, there is a decrease in the displacements, both from the umbo and the central part of the stapes footplate, often associated with a pronounced hearing loss. It could be concluded that the reduced displacement of the stapes footplate may be related to a greater hearing loss.

The biomechanical effects of stapes replacement by prostheses on the tympano-ossicular chain

Hearing is a sequence of processes in which the ear translates sound waves into electrical signals, which are then sent to the brain where they are interpreted as sound. The ossicular chain of the middle ear is formed by three ossicles (malleus, incus, and stapes), of which the last and smallest, the stapes, vibrates, thus communicating with the inner ear through the stapes footplate. When abnormal bone formation immobilizes the stapes (otosclerosis), the passage of sound does not correctly occur and hearing can be compromised. In most cases, surgery is an option for its treatment. The stapes is totally or partially replaced by a prosthesis (stapedectomy or stapedotomy, respectively) allowing the passage of sound to the inner ear. This work presents a study on the behavior of different stapes prostheses, considering their biomechanical characteristics. The stapes was replaced by different prostheses, made of dissimilar materials: stainless steel, teflon, and titanium. The umbo and stapes footplate displacements for the models with these prostheses were obtained and compared with the displacements obtained with the model representative of the normal ear. In the models with prostheses, the displacements are found in the hole where the prosthesis is attached.

Effects of the fibers distribution in the human eardrum: A biomechanical study

The eardrum separates the external ear from the middle ear and it is responsible to convert the acoustical energy into mechanical energy. It is divided by pars tensa and pars flaccida. The aim of this work is to analyze the susceptibility of the four quadrants of the pars tensa under negative pressure, to different lamina propria fibers distribution. The development of associated ear pathology, in particular the formation of retraction pockets, is also evaluated. To analyze these effects, a computational biomechanical model of the tympano-ossicular chain was constructed using computerized tomography images and based on the finite element method. Three fibers distributions in the eardrum middle layer were compared: case 1 (eardrum with a circular band of fibers surrounding all quadrants equally), case 2 (eardrum with a circular band of fibers that decreases in thickness in posterior quadrants), case 3 (eardrum without circular fibers in the posterior/superior quadrant). A static analysis was performed by applying approximately 3000Pa in the eardrum. The pars tensa of the eardrum was divided in four quadrants and the displacement of a central point of each quadrant analyzed. The largest displacements of the eardrum were obtained for the eardrum without circular fibers in the posterior/superior quadrant.

Finite element analysis of the transfer of sound in the myringosclerotic ear

This work presents a biomechanical study of myringosclerosis (MS), an abnormal condition of the ear that produces calcification of the lamina propria of the eardrum. The study researched the transfer of sound to the stapes depending on the localization, dimension and calcification degree of the MS plaques. Results were obtained using a validated finite element model of the ear. The mechanical properties of the lamina propria were modified, in order to model MS plaques, using the rule of mixtures for particle composites considering that the plaques are made of hydroxyapatite particles in a matrix of connective tissue. Results show that the localization and dimension of the plaques are a factor of higher importance than calcification for loss of hearing through MS. The mobility of the stapes decreased with the presence of larger plaques and also when the tympanic annulus and the area of the handle of the malleus were involved.

STAPEDOTOMY-HOUGH TECHNIQUE TO CORRECT OTOSCLEROSIS

The stapes, the smallest bone in the human body, is the third component in the tympano-ossicular chain of the middle ear. Otosclerosis is a disease that can cause stapes fixation, resulting in different kind of hearing losses. It is a disorder that involves the growth of abnormal bone around stapes footplate. The tonal and vocal audiometry, tympanometry, and acoustic reflexes, are the most used diagnostic tests. The treatment can be done by amplification with hearing aids or more effective, by surgery. To correct small focus of otosclerosis, Hough, in 1960, suggested the implementation of a technique (Figure 1) in which part of the anterior crura is breached and the posterior one is rotated, getting only the connection between the stapes footplate and the inner ear made through the posterior crura [Glasscock et al., 1995].