Finite element analysis of round-window stimulation of the cochlea in patients with stapedial otosclerosis.

An active actuator coupled to the round window (RW) can transmit mechanical vibrations into the cochlea and has become a therapeutic option of hearing rehabilitation for patients with stapedial otosclerosis. A finite-element model of the human ear that includes sound transmission effects of the vestibular and cochlear aqueducts of the inner ear is adopted in this study for investigating the cochlear response to RW stimulation under stapes fixation. There are two effects due to otosclerosis of the stapes: the fixation of the stapedial annular ligament (SAL) and the increase of the stapes mass. The frequency responses of the middle ear and cochlea with normal and otosclerotic stapes are calculated under sound and RW stimulations. The results show that changes in the material property of the stapes have different effects on the cochlear responses under sound and RW stimulations. Because of the vestibuli aqueduct, the reduction in the low-frequency magnitude of the pressure difference across the cochlear partition due to SAL fixation is much smaller under RW stimulation than under sound stimulation. The results of this study help understand sound transmission during RW stimulation in patients with stapedial otosclerosis.