Comprehensive Stroke Certification Fees and Benefits. The Joint Commission and American Heart Association / American Stroke Associationâs Comprehensive Stroke Center Certification includes a new and exclusive suite of benefits. The annual fee for the first year is prorated depending on the date of application for certification.
1 When the bones of the middle ear do not vibrate and become stiff, it can give rise to a hissing and vibrating sound in the ears. 2  Rupture of ear drum either due to trauma or due to loud sound can cause vibration in the ear during the initial stage. 3  Infection in the ear, cold and sinusitis can also cause vibration.
Sound is conducted through the ear as follows: The outer ear collects and directs sound waves from the environment through the ear canal to the tympanic membrane. The tympanic membrane (ear drum) is a thin membrane that separates the outer ear from the middle ear. Sound waves cause the vibration of the ear drum, which in turn transmits those vibrations to three tiny bones in the middle ear, called the ossicles, which causes the ossicles to vibrate. The stapes, the innermost of the three ossicles, is connected to the oval window.