A Simple Egg Membrane Patch Bridging Method for Repairing Tympanic Membrane Perforation

Objective:To analyze the clinical effect of a simple egg membrane patch bridging method in repairing tympanic membrane perforation.Methods:A total of 93 tympanic membrane perforation patients admitted to the hospital between September 2022 and October 2023 were selected and divided into two groups according to the random number table method.The control group implemented the conventional treatment(n=46 cases),and the patch group adopted the simple egg membrane patch bridging method(n=47 cases).The healing rate of the tympanic membrane,the air-bone gap,the air conduction hearing threshold,the dry ear rate,and the incidence of complications in both groups were compared before and after treatment.Results:The healing rate of the tympanic membrane in the patch group was significantly higher than that of the control group(95.75%vs.76.09%),with P<0.05;there was no difference in the air-bone gap and air conduction hearing threshold levels between the two groups before treatment(P>0.05),and the hearing indexes of the patch group were significantly lower than those of the control group 3 months after treatment(P<0.05);the dry ear rate in the patch group was significantly higher than that of the control group after treatment(85.11%vs.67.39%),and the total incidence of complications was also significantly lower than that of the control group(6.38%vs.21.74%),with P<0.05.Conclusion:The simple egg membrane patch bridging method is effective in repairing tympanic membrane perforation,which can effectively improve patients’hearing levels and reduce the occurrence of post-treatment complications.Thus,it is worth popularizing and applying in the clinic.

Disagreement in middle ear volume estimation between tympanometry and three-dimensional volume reconstruction in the context of tympanic membrane perforation

Introduction: Middle ear volume(MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes(TMs).Methods: Middle ears were identified from 36 patients ranging 18-89 years of age with TM perforations who underwent tympanometry and temporal bone computed tomography(CT) between 2005 and 2015. MEVs calculated by both tympanometry and three-dimensional volume reconstruction(3DVR) were analyzed for agreement using Bland Altman plots. The differences between tympanometric and 3DVR MEV values for each given middle ear were characterized across MEV quartiles(1= smallest; 4= largest) and across increasing states of middle ear disease using Kruskale Wallis and Wilcoxon testing with Bonferroni correction.Results: Bland Altman plots demonstrated significant disagreement between MEV measurement techniques. Differences between tympanometric(T) and 3DVR MEV values were significantly greater with increasing average(i.e.(Tt3DVR)/2)) MEV per linear regression(p < 0.0001). Significance was demonstrated between fourth and first average MEV quartiles(p= 0.0024), fourth and second quartiles(p= 0.0024), third and first quartiles(p= 0.0048), and third and second quartiles(p= 0.048). Absolute MEV difference was not significantly different across varying states of middle ear disease(p= 0.44).Conclusion: Statistically and clinically significant disagreement was demonstrated between tympanometric and 3DVR MEV values. Studies that vary in MEV estimation techniques may be expected to demonstrate significantly different results. These preliminary results suggest that clinicians should endeavor to seek further confirmation when interpreting high tympanometric MEV values.

Geometrical Reconstruction and CNC Process of Spurious Tympanic Membrane Based on Reverse Engineering

Perforation of tympanic membrane is one of the main reasons for both deafness and dyssaudia.We could improve and restore audition by restoring or replacing the tympanic membrane.So,whether you can make the spurious tympanic membrane successfully is one of the keys to a successful operation.Utilizing CMM (Coordinate Measuring Machine) measurement equipment, we measured tympanic membrane model precisely and digitally.We also analysed the measured data by point to surface and we have successfully reconstructed the CAD model of the spurious tympanic membrane.Using the model we have got,we schemed out the mold of spurious tympanic membrane.In addition,we utilized MasterCAM compiling CNC (Computerized Numerical Con- trol) code and simulating the course of working.Ultimately,we obtained the mold of spurious tympanic membrane.Our research in this article has great significance to the success of spurious tympanic membrane grafting operation.

Does central tympanic membrane perforation affect infrared tympanic thermometer measurements in adults?

Objective: Infrared Tympanic Thermometer(ITT) is one of the most useful instruments for accurately measuring temperature. The effects of ear pathologies on ITT measurement remain unclear. The purpose of this study is to determine if tympanic membrane perforation(TMP) affects ITT measurements in adult patients.Material and methods: A total of 90 adult patients with monaural central TMP were enrolled in this study.Patients were categorized into three subgroups according to perforation size(1-3 mm, 4-7 mm, and 8-10 mm).The tympanic temperatures of the affected and unaffected sites, and subgroups were compared with each other.Results: This study contained 54(60%) males and 36(40%) females ranging from 20 to 58 years of age(mean age: 30.74 ± 9.61 years). The mean tympanic temperature of the side affected with TMP was 36.34 oC ± 0.61 oC.The mean tympanic temperature of the unaffected side with healthy and intact tympanic membrane was 36.33 oC ± 0.6 oC. The Pearson correlation score for the tympanic temperatures and the size of TMP was 0.22 which was not significant(r=-0.12).Conclusion: TMP and perforation size do not affect ITT measurements in adult patients.

Self-monitoring of the tympanic membrane:An opportunity for telemedicine during times of COVID-19 and beyond

The interest for telemedicine has increased since the COVID-19 pandemic because of the risk of infection.Recently,commercial companies started selling digital USB-otoscopes(DUO)that can be connected to a mobile phone.These DUOs are inexpensive(costing approximately$6e35 each)and make it possible to visualize the whole tympanic membrane.Here,we illustrate the case of a patient who had operative correction of a tympanic membrane retraction,and who self-monitored the tympanic membrane in the course of time.Additionally,we discuss the use of DUOs in otolaryngology telemedicine practice.The use of simple digital USB otoscopes provides a promising method to assess and monitor the tympanic membrane remotely.However,more research is needed to establish the role of DUOs in telemedicine.

New Tympanic Membrane Temperature Shows Good Correlation with the Esophageal Temperature <br/>—Accuracy of a Noncontact Continuous Tympanic Thermometer

Background: An ear-fitting thermometer probe “NIPRO CE THERMO?” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accuracy of the new CE thermo. In this time, the accuracy of the CE thermo was investigated. Methods: The correlation between the tympanic membrane temperature, measured using the new CE thermo, and the esophageal temperature of 30 patients (right ear: 16 patients, left ear: 14 patients) was measured in the prospective observational study. Results: A good correlation (r = 0.721) and no measurement error (within 1?C in mean ± 2SD) between the two temperatures were observed using Bland-Altman analysis. The correlation and measurement error for each ear yielded the same results. Conclusion: The tympanic membrane temperature, measured using the new CE thermo, showed good correlation with the esophageal temperature and could be used as a central temperature in the perioperative period.

Postoperative complications of concomitant fat embolism syndrome, pulmonary embolism and tympanic membrane perforation after tibiofibular fracture: A case report

BACKGROUND Fat embolism syndrome(FES)is a rare disease characterized by pulmonary distress,neurologic symptoms,and petechial rash and seriously threatens human life and health.It is still neglected clinically because of the lack of verifiable diagnostic criteria and atypical clinical symptoms.No studies on FES with pulmonary embolism(PE)and tympanic membrane perforation have been reported to date.Here,we report a rare case of concomitant FES,PE and tympanic membrane perforation after surgery in a patient with a tibiofibular fracture.CASE SUMMARY A 39-year-old man presented with right lower extremity pain due to a car accident while driving a motorbike on the road.X-ray and computed tomography scans revealed a fracture of the right mid-shaft tibia and proximal fibula categorized as a type A2 fracture according to the AO classification.A successful minimally invasive operation was performed 3 d after the injury.Postoperatively,the patient developed sudden symptoms of respiratory distress and hearing loss.Early diagnosis was made,and supportive treatments were used at the early stage of FES.Seven days after surgery,he presented a clear recovery from respiratory symptoms.The outcome of fracture healing was excellent,and his hearing of the left ear was mildly impaired at the last follow-up of 4 mo.CONCLUSION Concomitant FES,PE and tympanic membrane perforation are very rare but represent potentially fatal complications of trauma or orthopedic surgery and present with predominantly pulmonary symptoms.Early diagnosis and treatment can reduce the mortality of FES,and prevention is better than a cure.

A Rare Case of Tarceva Resulting in Tympanic Membrane Necrosis

Objective: To report a novel case of Tarceva? treatment for small cell lung carcinoma resulting in tympanic membrane necrosis. Patient: A 49-year-old male with tympanic membrane necrosis and presumed resistant acute otitis externa and chronic inflammation of the left ear. Patient is status post chemotherapy and radiation diagnosed with non-small cell lung cancer in December 2008 with on-going therapy with Tarceva? for residual disease. Intervention: Tympanoplasty of left ear. Results: Improvement of symptoms of irritation and improvement of hearing and speech reception thresholds. All acid fast bacilli, fungal and bacterial cultures of the intra-op specimen were negative. Conclusions: The possibility that long term Tarceva? therapy could have caused the tympanic membrane necrosis and acute otitis media like symptoms is feasible since Tarceva? is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase. Upon activation of EGFRs it undergoes a transition from inactive monomeric form to active homodimer or hertodimer with another member of the ErbB receptor family. This then initiates several signal transduction cascades, leading to DNA synthesis and cell proliferation. Activation of the receptor is important in the innate immune response in human skin. Some of the common side effects include an aceiform skin rash but this is the first reported link between tympanic membrane necrosis and Tarceva?.

Comparison of endoscopic tympanoplasty to microscopic tympanoplasty in anterior tympanic membrane perforation

Objective:Tympanoplasty aims to eradicate lesions and restore middle ear function in chronic otitis media.This study was conducted to compare the surgical and functional outcomes of endoscopic tympanoplasty(ET)and microscopic tympanoplasty(MT)in anterior tympanic membrane perforation.Methods:The clinical data of 42 patients undergoing tympanoplasty with anterior quadrants tympanic membrane perforation between January 2018 and July 2019 were retrospectively analyzed.Patients were classified into the ET group(n?22)or the MT group(n?20).Patients’demographics,clinical characteristics,surgical and functional outcomes were assessed between the two groups.Results:External auditory canal widening was not necessary in the ET group and was performed in 55.0%of patients in the MT group.The operation time of the ET group was significantly shorter than that of the MT group(61.23±11.48 min vs.78.65±11.79 min,p=0.034).The pain scale score of the ET group at 24 hours after surgery was significantly lower than that of the MT group(0.86±0.64 vs.2.40±1.14,p=0.029).The grafting success rate was 95.5%(21/22)in the ET group and 95.0%(19/20)in the MT group.In the ET group,the pre-and postoperative air-bone gap were 35.60±8.43 dB and 18.79±5.80 dB,respectively,which was a significant improvement(p=0.016).The respective values in the MT group(33.33±7.88 dB and 19.58±6.24 dB)also represented a significant improvement(p=0.004).Conclusion:ET is more beneficial for patients with anterior tympanic membrane perforations,which helps minimize the surgical trauma and reduces operation time and postoperative pain.

Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty

Objective Endoscopic tympanoplasty includes various surgical methods,such as internal repair,interlayer repair,and external overlay.This technique requires autologous materials,allografts,and xenografts,which are used to repair tympanic membrane(TM)perforation.To obtain good results,appropriate surgical methods and repair materials should be selected.This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa(SIS)during transcanal endoscopic type I tympanoplasty.Method A retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Perforation size,tympanic status,pre-and postoperative symptoms,follow-up data,wound healing rates,and hearing improvement were analysed.Results Of the 115 patients included in the study,56 underwent interlayer repair with porcine SIS of the TM,and 59 patients underwent internal repair with tragus cartilage.No significant difference was found between the two groups at baseline in terms of age,sex,disease course,perforation side,tympanic status,underlying disease,or preoperative infection.The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07%(51 patients),and that of internal implantation with tragus cartilage was 88.14%(52 patients).No significant difference was found in terms of the graft success rate between the two surgical methods(p=0.887).Postoperative pure tone auditory(PTA)and air-bone gap(ABG)density significantly increased in both groups compared with before surgery(p<0.05).However,the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups(p>0.05).Compared to those in the internal implantation group,the patients in the interlayer group had a shorter operation duration(51.36±6.76 min vs.59.71±7.45 min,t=6.298,p<0.001)and less blood loss(11.91±2.61 mL vs.15.27±2.57 mL,t=7.019,p<0.001).Conclusions Our study suggests that the porcine SIS,as well as the tragus cartilage,has a high success rate in repairing irreversible TM perforation.Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages,including the absence of donor-site incision and scar formation,and ease of graft modification and manipulation.

Chronic model of tympanic perforation in rats with mitomycin C and dexamethasone

A rat model of chronic tympanic membrane perforation was developed to be used in the search of new materials for the sealing of these perforations. A longitudinal study was carried out in rats subjected to incisional myr-ingotomy followed by the application of mitomycin C alone or with dexamethasone. Rats were checked at days 3, 7,1 0,1 4 and weekly thereafter until perforation closure, for up to 6 months. The addition of dexamethasone is a key component in order to obtain a chronic opening. Myringotomies treated w ith saline had a mean healing time of 8.5 days. At 8 weeks, between 62.5% and 77.7% of tympanic membranes treated w ith mitomycin C and dexamethasone remained perforated and at 6 months this number fell to 21.4%. This technique is able to maintain most tympanic membrane perforations patent for at least 8 weeks. This rat model is adequate for its use in preclinical or translational research.

Experimental study of exogenous collagen membrane in myringoplasty: a preliminary report

Myringoplasty using exogenous collagen membrane was performed in 20 earsof 10 rabbits after complete removal of drumhead.Healing results were observed at 10,20,40and 60d after operation.Nineteen ears were transplanted successfully.Meanwhile,thehistology and ultrastructural morphology of the rabbit tympanic membranes were com-pared before and after transplantation.The results confirmed that the graft has a goodproperty of biocompatibility,and that it is useful in tympanic membrane transplantation.

生物凝胶辅助空气悬浮技术在耳内镜鼓膜修补术中的应用

目的 介绍一种简易的利用生物凝胶辅助空气悬浮技术耳内镜下鼓膜修补的手术方式,并观察手术效果。方法 选择2023年2月—6月在南京明基医院就诊的鼓膜穿孔患者24例(25耳),其中男13例,女11例;年龄(42.3±10.1)岁。行耳内镜下生物凝胶辅助空气悬浮技术修补鼓膜。术中利用内植法植入耳屏软骨膜,鼓室内外不填塞,术后第3天、第6天及第2、4、8、12周门诊随访,行耳内镜检查。结果 24例(25耳)患者平均每耳手术时间(34.2±10.5)min, 2耳术后3 d漏气,1例术后3周感染,均进行积极处理,无耳闷、出血、过敏等并发症,随访时间1~3个月,穿孔鼓膜均愈合良好。结论 生物凝胶辅助空气悬浮技术修补鼓膜简便、微创、快速,术后无耳闷,为唯一听力耳手术提供了一种新选择,同时方便双耳同时手术、局麻手术及无法配合术后换药的儿童手术。

耳内镜下鼓膜修补术后穿孔再修补的疗效分析

目的 探讨人工硬脑膜和表皮生长因子在耳内镜下鼓膜修补术后鼓膜穿孔再修补中的临床疗效。方法 选择该院耳内镜下鼓膜修补术后复查时仍有鼓膜穿孔未愈合的患者58例,随机分为A组和B组,各29例。A组采用明胶海绵修补鼓膜穿孔,B组采用人工硬脑膜和表皮生长因子修补鼓膜穿孔,每个月复查鼓膜愈合情况,3个月后复查纯间测听。结果 A组修补成功率为34.48%(10/29),B组修补成功率为75.86%(22/29),两组患者比较,差异有统计学意义(P <0.05);A组气骨导差改善(7.32±2.68) dB HL,B组气骨导差改善(21.77±4.65)dB HL,两组患者比较,差异有统计学意义(P <0.05)。结论 人工硬脑膜是合适的鼓膜再生支架,表皮生长因子可促进鼓膜穿孔愈合,两者结合使用是鼓膜再修补的一种可行的治疗方案。

银杏叶提取物在外伤性鼓膜大穿孔中的应用效果分析

目的探讨银杏叶提取物在外伤性鼓膜大穿孔中的应用效果。方法选取2018年1月至2022年12月武汉市汉口医院收治的86例外伤性鼓膜大穿孔患者作为研究对象,按照不同治疗方法将其分为观察组(43例)和对照组(43例),观察组患者采用湿润烧伤膏棉片贴补联合银杏叶提取物注射液治疗,对照组患者单纯采用湿润烧伤膏棉片贴补治疗,对比观察两组患者鼓膜穿孔愈合率和愈合时间以及听力改善情况与药物不良反应发生情况。结果治疗14 d后,观察组患者鼓膜穿孔愈合率为9302%,与对照组患者的鼓膜穿孔愈合率9070%无明显差异(χ^(2)=0156,P=0693)。观察组患者鼓膜穿孔愈合时间为(109±26)d,与对照组患者的鼓膜穿孔愈合时间(116±29)d无明显差异(t=1179,P=0242)。治疗结束后,观察组患者听力改善总有效率为9535%,明显高于对照组患者的听力改善总有效率7674%(χ^(2)=6198,P=0013)。治疗期间,两组患者均未发生药物不良反应。结论银杏叶提取物虽不能提高外伤性鼓膜大穿孔愈合率,但可改善听力下降等症状,且不会引发明显不良反应,值得临床推广应用。

耳内镜下耳屏软骨-软骨膜复合体修补鼓膜大穿孔的疗效观察

目的分析耳内镜下耳屏软骨-软骨膜复合体修补鼓膜大穿孔的疗效。方法选取60例(60耳)实施耳内镜手术修补鼓膜大穿孔的患者,随机分为对照组和实验组各30例,其中对照组采用耳屏软骨膜修补,实验组采用耳屏软骨-软骨膜复合体修补。所有患者术后1、3、6个月复查,对比分析两组患者鼓膜愈合情况及听力改善情况,听力观察指标主要0.5、1、2、4 kHz的气导、骨导听力。结果(1)实验组鼓膜愈合率96.7%(29/30),对照组86.7%(26/30),实验组鼓膜愈合率高于对照组,但差异并无统计学意义(χ^(2)=0.873,P=0.350);(2)两组患者比较术前与术后6个月平均气导听阈及气骨导差,差异有统计学意义(P<0.05)。结论经外耳道入路的耳内镜手术符合微创治疗理念,耳屏软骨-软骨膜复合体是可靠的自体修补材料,术后能达到较好的鼓膜愈合状态,并获得良好的听力提高,是一种可靠的鼓膜大穿孔修补手术的方法选择,值得临床应用推广。

慢性化脓性中耳炎鼓膜穿孔特征与听力损失的相关性研究

目的探讨慢性化脓性中耳炎鼓膜穿孔特征与听力损失的相关性。方法回顾性分析2022年7月~2023年7月于兰州大学第二医院耳鼻咽喉头颈外科确诊为慢性化脓性中耳炎并行Ⅰ型鼓室成形术治疗的80例患者(104耳)的纤维耳内镜图像及完整的听力学资料。采用ImageJ图像软件测量鼓膜穿孔面积,以穿孔边界面积占完整鼓膜边界面积的百分比(RAp值)为鼓膜穿孔相对面积。分析不同面积鼓膜穿孔、穿孔涉及象限、穿孔边缘是否钙化以及穿孔范围是否累及锤骨柄与气骨导差(ABG)的关系。结果慢性化脓性中耳炎鼓膜穿孔患者的鼓膜穿孔面积与平均气骨导差之间呈显著正相关关系(R^(2)=0.141,P<0.0001),相对穿孔面积越大者ABG越大;穿孔累及锤骨柄的患者较未累及锤骨柄的患者气骨导差更大(P<0.05);鼓膜穿孔边缘钙化情况和穿孔位置对听力损失的影响很小,几乎可以忽略不计。结论鼓膜穿孔引起的传导性听力损失与穿孔大小和穿孔是否累及锤骨柄有关,穿孔相对面积越大及穿孔累及锤骨柄患者的传导性听力损失往往更重。

耳内镜下蝶形软骨嵌入法与耳屏软骨膜内置法修补鼓膜中等穿孔的临床效果

目的:探讨耳内镜下蝶形软骨嵌入法与耳屏软骨膜内置法修补鼓膜中等穿孔的临床效果及其差别。方法:回顾性分析2021年6月至12月在宁波市第二医院耳鼻咽喉科住院接受耳内镜下不翻瓣鼓室成形术I型的鼓膜中等穿孔患者临床资料。根据手术方式分为两组,其中观察组采用蝶形软骨嵌入法修补鼓膜穿孔,对照组采用耳屏软骨膜内置法修补鼓膜穿孔。两组术后6、12、18个月定期随访,并行耳内镜、纯音听阈检查。比较两组术后鼓膜穿孔愈合、听力恢复、并发症、耳闷感及手术时间等情况。结果:纳入研究病例56例,其中观察组32例,对照组24例。两组在性别、年龄、鼓膜穿孔病因、位置、鼓膜钙化斑、干湿耳方面差异无统计学意义(均P>0.05)。术后6、12个月两组鼓膜穿孔愈合率均为100%。术后18个月观察组鼓膜穿孔愈合30例(93.75%),对照组22例(91.67%),差异无统计学意义(P>0.05)。观察组平均气导由术前(35.29±7.25)dB HL下降至术后18个月(19.06±4.96)dB HL(t=27.848,P<0.01),平均气骨导差由术前(16.72±4.95)dB HL下降至术后18个月(7.66±3.37)dB HL(t=18.166,P<0.01)。对照组平均气导由术前(33.23±5.71)dB HL下降至术后18个月(17.76±2.55)dB HL(t=20.276,P<0.01),平均气骨导差由术前(15.36±4.73)d B HL下降至术后18个月(7.45±2.67)dB HL(t=16.108,P<0.01)。两组平均气导下降程度及平均气骨导下降程度比较,差异均无统计学意义(t=0.804,P=0.425;t=1.599,P=0.116)。观察组手术时间为(27.72±3.03)min,明显短于对照组(31.71±3.95)min,观察组术后耳闷感VAS评分为(2.09±0.69),明显低于对照组(3.42±0.72),差异均有统计学意义(t=-8.949,P<0.01;t=-6.987,P<0.01)。结论:耳内镜下蝶形软骨嵌入法修补鼓膜中等穿孔的临床效果与耳屏软骨膜内置法均良好,成功率高、并发症少,较耳屏软骨膜内置法耗时短、术后耳闷感轻。

耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗鼓膜大穿孔的效果

目的 观察耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗鼓膜大穿孔的效果。方法 选取上海交通大学医学院苏州九龙医院2018年1月至2022年8月收治的80例鼓膜大穿孔患者为研究对象,采用随机数字表法分为显微镜组和耳内镜组,每组各40例。显微镜组和耳内镜组分别给予显微镜下和耳内镜下耳屏软骨膜双瓣鼓膜修补术治疗,比较2组患者治疗效果。结果 耳内镜组手术时间[(49.02±7.77) min]、住院时间[(4.89±1.02) d]短于显微镜组[(78.96±9.85) min、(6.22±1.41) d],术中出血量[(7.21±2.25) ml]少于显微镜组[(14.55±5.23) ml],并发症发生率与显微镜组比较,差异无统计学意义(P>0.05)。与术前比较,2组患者术后3个月气导听阈、骨导听阈及气骨导差均下降(P<0.05)。与术前比较,2组患者术后3个月耳鸣分级均降低(P<0.05)。与术前比较,2组患者术后3个月物质生活、社会关系、躯体功能、心理功能评分均升高,且耳内镜组高于显微镜组(P<0.05)。2组患者术后1个月、3个月鼓膜愈合率比较,差异无统计学意义(P>0.05)。结论 耳内镜下鼓膜修补术手术时间短,出血少,术后恢复快,可改善听力,减轻耳鸣症状,提高患者生活质量。

基于自由场爆炸的猪鼓膜破裂规律实验研究

听觉系统各组成部分的机械损伤是爆炸后造成听力损失的主要原因,强脉冲声致听觉损害风险准则仍然存在许多争议,例如:指标选择冲量还是超压峰值,正压持续时间是否重要等。本研究基于自由场实爆条件,设计并搭建了大动物爆炸致伤平台,探究了不同爆炸参数对鼓膜破裂的影响规律,并建立了基于自由场超压峰值和正压持续时间的鼓膜创伤量效关系。通过笔形压力传感器测量自由场超压,通过Friedlander公式拟合超压时程曲线,确定冲击波超压峰值和正压持续时间,并对时域中记录的波形进行归一化能量频谱分析,以确定冲击波在频域上的信号能量分布。对爆炸后的小型猪进行解剖,记录不同爆炸参数下鼓膜创伤程度。以超压峰值和正压持续时间为自变量,对实验数据进行二元逻辑回归分析,并给出鼓膜破裂风险曲线。研究发现,当自由场超压峰值低于170 kPa时,鼓膜无明显损伤;当自由场超压峰值高于237 kPa时,部分鼓膜出现不同程度的破裂和充血。距爆心越近,超压峰值越大,但鼓膜创伤的严重程度并未随之单调增加。在8.0 kg TNT当量的爆炸实验中,鼓膜破裂的严重程度随爆心距的减小呈现先提高再降低的趋势。通过对冲击波载荷特征的分析可知,距爆心越近,正压持续时间越短,高频段能量占比相对更大,小型猪鼓膜破裂的概率可能反而降低,此时仍然出现显著的听力损失和耳蜗损伤。鼓膜作为通过振动传递声信号的黏弹性薄膜结构,其动力学响应可能与载荷频率成分密切相关。除了超压峰值,冲击波波形频谱分布对鼓膜破裂程度影响显著。