Mechanics of Total Drum Replacement Tympanoplasty Studied With Wideband Acoustic Immittance
Bibliographic record
Abstract
Objective Poor hearing outcomes often persist following total drum replacement tympanoplasty. To understand the mechanics of the reconstructed eardrum, we measured wideband acoustic immittance and compared the mechanical characteristics of fascia‐grafted ears with the normal tympanic membrane. Study Design Prospective comparison study. Setting Tertiary care center. Methods Patients who underwent uncomplicated total drum replacement with temporalis fascia grafts were identified. Ears with healed grafts, an aerated middle ear, and no other conductive abnormalities were included. All patients underwent pre‐ and postoperative audiometry. Wideband acoustic immittance was measured with absorbance and impedance computed. Fascia‐grafted ears were compared with normal unoperated ears. Results Eleven fascia‐grafted ears without complications were included. Postoperatively, the median air‐bone gap was 15 dB (250‐4000 Hz), with variation across frequency and between ears. Fifty‐six control ears were included. Absorbance of fascia‐grafted ears was significantly lower than that of normal ears at 1 to 4 kHz ( P <. 05) but similar below 1 kHz. Impedance magnitude demonstrated deeper and sharper resonant notches in fascia‐grafted ears than normal ears ( P <. 05), suggesting lower mechanical resistance of the fascia graft. Conclusion The mechanics of fascia‐grafted ears differ from the normal tympanic membrane by having lower absorbance at mid‐ to high frequencies and thus poor sound transmission. The lower resistance in fascia‐grafted ears may be due to poor coupling of the graft to the malleus. To improve sound transmission, grafts for tympanic membrane reconstructions would benefit from refined mechanical properties.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".