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The middle ear is the portion of the ear medial to the eardrum, and distal to the oval window of the cochlea.
Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Cholesteatomas are not cancerous as the name may suggest, but can cause significant problems because of their erosive and expansile properties. This can result in the destruction of the bones of the middle ear (ossicles), as well as growth through the base of the skull into the brain. They often become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal.
The ossicles are three irregular bones in the middle ear of humans and other mammals, and are among the smallest bones in the human body. Although the term "ossicle" literally means "tiny bone" and may refer to any small bone throughout the body, it typically refers specifically to the malleus, incus and stapes of the middle ear.
The stapes or stirrup is a bone in the middle ear of humans and other tetrapods which is involved in the conduction of sound vibrations to the inner ear. This bone is connected to the oval window by its annular ligament, which allows the footplate to transmit sound energy through the oval window into the inner ear. The stapes is the smallest and lightest bone in the human body, and is so-called because of its resemblance to a stirrup.
Anotia describes a rare congenital deformity that involves the complete absence of the auricle, the outer projected portion of the ear, and narrowing or absence of the ear canal. This contrasts with microtia, in which a small part of the auricle is present. Anotia and microtia may occur unilaterally or bilaterally. This deformity results in conductive hearing loss, deafness.
Otosclerosis is a condition of the middle ear where portions of the dense enchondral layer of the bony labyrinth remodel into one or more lesions of irregularly-laid spongy bone. As the lesions reach the stapes the bone is resorbed, then hardened (sclerotized), which limits its movement and results in hearing loss, tinnitus, vertigo or a combination of these. The term otosclerosis is something of a misnomer: much of the clinical course is characterized by lucent rather than sclerotic bony changes, so the disease is also known as otospongiosis.
Stapedectomy is a surgical procedure in which the stapes bone is removed from the middle ear and replaced with a prosthesis.
Bone conduction is the conduction of sound to the inner ear primarily through the bones of the skull, allowing the hearer to perceive audio content even if the ear canal is blocked. Bone conduction transmission occurs constantly as sound waves vibrate bone, specifically the bones in the skull, although it is hard for the average individual to distinguish sound being conveyed through the bone as opposed to the sound being conveyed through the air via the ear canal. Intentional transmission of sound through bone can be used with individuals with normal hearing — as with bone-conduction headphones — or as a treatment option for certain types of hearing impairment. Bones are generally more effective at transmitting lower-frequency sounds compared to higher-frequency sounds.
In vertebrates, an ear is the organ that enables hearing and body balance using the vestibular system. In humans, the ear is described as having three parts: the outer ear, the middle ear and the inner ear. The outer ear consists of the auricle and the ear canal. Since the outer ear is the only visible portion of the ear, the word "ear" often refers to the external part (auricle) alone. The middle ear includes the tympanic cavity and the three ossicles. The inner ear sits in the bony labyrinth, and contains structures which are key to several senses: the semicircular canals, which enable balance and eye tracking when moving; the utricle and saccule, which enable balance when stationary; and the cochlea, which enables hearing. The ear canal is cleaned via earwax, which naturally migrates to the auricle.
The acoustic reflex is an involuntary muscle contraction that occurs in the middle ear in response to loud sound stimuli or when the person starts to vocalize.
Conductive hearing loss (CHL) occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles). If a conductive hearing loss occurs in conjunction with a sensorineural hearing loss, it is referred to as a mixed hearing loss.
The Weber test is a screening test for hearing performed with a tuning fork. It can detect unilateral (one-sided) conductive hearing loss and unilateral sensorineural hearing loss. The test is named after Ernst Heinrich Weber (1795–1878). Conductive hearing ability is mediated by the middle ear composed of the ossicles: the malleus, the incus, and the stapes. Sensorineural hearing ability is mediated by the inner ear composed of the cochlea with its internal basilar membrane and attached cochlear nerve. The outer ear consisting of the pinna, ear canal, and ear drum or tympanic membrane transmits sounds to the middle ear but does not contribute to the conduction or sensorineural hearing ability save for hearing transmissions limited by cerumen impaction.
Microtia is a congenital deformity where the auricle is underdeveloped. A completely undeveloped auricle is referred to as anotia. Because microtia and anotia have the same origin, it can be referred to as microtia-anotia. Microtia can be unilateral or bilateral. Microtia occurs in 1 out of about 8,000–10,000 births. In unilateral microtia, the right ear is most commonly affected. It may occur as a complication of taking Accutane (isotretinoin) during pregnancy.
An audiogram is a graph that shows the audible threshold for standardized frequencies as measured by an audiometer. The Y axis represents intensity measured in decibels (dB) and the X axis represents frequency measured in hertz (Hz). The threshold of hearing is plotted relative to a standardised curve that represents 'normal' hearing, in dB(HL). They are not the same as equal-loudness contours, which are a set of curves representing equal loudness at different levels, as well as at the threshold of hearing, in absolute terms measured in dB SPL.
A bone-anchored hearing aid (BAHA) is a type of hearing aid based on bone conduction. It is primarily suited for people who have conductive hearing losses, unilateral hearing loss, single-sided deafness and people with mixed hearing losses who cannot otherwise wear 'in the ear' or 'behind the ear' hearing aids. They are more expensive than conventional hearing aids, and their placement involves invasive surgery which carries a risk of complications, although when complications do occur, they are usually minor.
The semicircular canal dehiscence (SCD) is a category of rare neurotological diseases/disorders affecting the inner ears, which gathers the superior SCD, lateral SCD and posterior SCD. These SCDs induce SCD syndromes (SCDSs), which define specific sets of hearing and balance symptoms. This entry mainly deals with the superior SCDS.
Tympanosclerosis is a condition caused by hyalinization and subsequent calcification of subepithelial connective tissue of the tympanic membrane and middle ear, sometimes resulting in a detrimental effect to hearing.
SoundBite Hearing System is a non-surgical bone conduction prosthetic device that transmits sound via the teeth. It is an alternative to surgical bone conduction prosthetic devices, which require surgical implantation into the skull to conduct sound.
In medicine, an ossicular replacement prosthesis is a device intended to be implanted for the functional reconstruction of segments of the ossicles and facilitates the conduction of sound waves from the tympanic membrane to the inner ear. There are two common types of ossicular replacement prostheses, the total ossicular replacement prosthesis (TORP) and partial ossicular replacement prosthesis (PORP). A TORP replaces the entire ossicular chain while a PORP replaces only the incus and malleus but not the stapes. Indications for use of an ossicular replacement prosthesis include:
A middle ear implant is a hearing device that is surgically implanted into the middle ear. They help people with conductive, sensorineural or mixed hearing loss to hear.
References
- 1 2 Yao, Wen-juan; Zhou, Hua-cong; Hu, Bao-lin; Huang, Xin-sheng; Li, Xiao-qing (January 2010). Cattani, Carlo (ed.). "Research on Ossicular Chain Mechanics Model". Mathematical Problems in Engineering. 2010 (1). doi: 10.1155/2010/261826 . ISSN 1024-123X.
- 1 2 ELBROND, OLE; ELPERN, BARRY S. (1966-11-01). "Reconstruction of the Ossicular Chain". Archives of Otolaryngology. 84 (5): 490–494. doi:10.1001/archotol.1966.00760030492005. ISSN 0003-9977.
- 1 2 Walker, David D.; Babu, Seilesh C. (2020-03-01). "History of Ossicular Chain Reconstruction". Current Otorhinolaryngology Reports. 8 (1): 61–64. doi:10.1007/s40136-020-00259-w. ISSN 2167-583X.
- ↑ Henkemans, Sara (June 11 2021). "Congenital Anomalies of the Ossicular Chain: Surgical and Audiological Outcomes". Sage Choice.
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