The Mechanics of the Middle-Ear at Static Air Pressures:<i>The Role of the Ossicular Joints, the Function of the Middle-Ear Muscles and the Behaviour of Stapedial Prostheses</i>

In an experimental study, the mechanical behaviour of the ossicle-chain during changes of the static air pressure was analyzed microscopically and with a radiographic magnification technique in temporal bone preparations. Several preliminary experiments served to pinpoint methodological problems, like exsiccation-artifacts, storage procedures, preparation defects, missing air-cushion effect with the opened middle-ear cavity, absent labyrinthine pressure, relation of the optical axis to middle-ear structures and statistical reproducibility of the measured values. Variations of the static air pressure in the external ear canal ranging from 0 to +/- 400 mmH2O induce an inward-outward movement of the malleus. In the regular middle-ear, the direction of this movement is changed within the ossicular chain into a predominantly upward-downward direction of the lenticular process, due to a gliding function of the incudo-malleal (IM) joint. This results in a gliding movement of the surfaces of the incudostapedial joint (IS). In this way, the stapes and the inner-ear are decoupled from the excessive displacements of the drum membrane and malleus. This change in the mode of motion explains many former results of ossicle vibration, aroused by unphysiologically high sound pressures, like v. Békésy's description of the tilting footplate. This mode of motion, however, changes completely if the gliding function of the IM-joint is cancelled by experimental ankylosis. In that case, the predominant direction of movement at the incus and stapes is inward and outward, too. This mode of motion has been the generally accepted concept of the ossicle-chain mechanics up to now. This isodirectional motion also occurs with progressive exsiccation of the temporal bone preparations, explicable with drying and shrinking of the capsular ligament of the IM-joint. It is conceivable, therefore, that our concepts of the mechanics of the ossicle-chain were partly based on experiments with insufficiently moistened temporal bone preparations, as the methodological problem of the exsiccation became known only during recent decades. In further experiments with static air pressure, the mechanics of the reconstructed ossicle-chain, i.e. tympanoplasty and stapedial prostheses, were studied. In the columella-like chain reconstruction, the displacement of the stapes equals the values measured with the ankylosed IM-joint. This displacement is limited by the strength of the annular ligament, whose function, however, is eliminated in the case of stapedial prostheses. Now the displacement is limited by the friction of the piston at the perforation in the footplate.(ABSTRACT TRUNCATED AT 400 WORDS)