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Fetal sheep in utero hear through bone conduction.

PURPOSE: Although the air-conduction pathway is the principal mode of sound transmission to the inner ear, this may not be true for the fetus in utero. The fetus detects and responds to sounds in the maternal environment. Exogenous sounds can reach the fetal inner ear through the ear canal and middle ear system, bone conduction, or both. This study was designed to compare the effectiveness of these two routes of sound transmission by recording cochlear microphonic potentials from the fetus in utero in response to airborne sounds. MATERIALS AND METHODS: Cochlear microphonics (CMs) recorded from one round window (RW) of fetal sheep in utero were obtained in three conditions: (1) head uncovered; (2) head covered with a neoprene hood; and (3) head covered with a neoprene hood fashioned with a hole that permitted the pinna and ear canal to be exposed. Tone bursts (0.5, 1.0, and 2.0 kHz) were delivered through a loudspeaker at high intensities (100 to 135 dB sound pressure level) to the flank of the ewe. CMs were detected with indwelling electrodes, amplified, and averaged. CM input-output functions were obtained from the fetus in each of the three conditions described above. RESULTS: CMs recorded with the head uncovered were more sensitive than were the CMs recorded with the hood in place. There was no difference in sensitivity between the condition during which the head was completely covered and the condition in which the pinna and ear canal are exposed. CONCLUSION: The principal mode of sound transmission into the fetal inner ear is through bone conduction.

Acoustic Stimulation↗

Test-retest variability of the auditory brainstem response to bone-conducted clicks in newborn infants.

The variability of the auditory brainstem response (ABR) to bone- and air-conducted clicks was investigated utilizing a test-retest paradigm with 20 normal full-term newborn infants. ABRs to bone-conducted clicks at 15 and 30 dB nHL and air-conducted clicks at 30 dB nHL were obtained. The delivery of the bone-conducted signal was controlled. ABR wave V latencies were measured from each test-retest stimulus condition. The results indicated no statistically significant difference in test-retest variability of ABR wave V latencies or amplitudes between bone- and air-conducted clicks. ABRs to bone-conducted clicks, under controlled clinical conditions, are as reproducible and reliable as ABRs to air-conducted clicks in newborn infants.

Acoustic Stimulation↗

The effect of preoperative bone conduction threshold levels on the results of stapes surgery.

The effect of preoperative bone conduction (BC) threshold levels on the results of stapedectomy was evaluated in 378 adult patients with otosclerosis. The mean follow-up period was 8.8 years. Both short-term and long-term postoperative hearing levels were found to be significantly dependent on preoperative BC levels. Only 2 of 31 patients (7%) with preoperative BC thresholds > 40 dB had postoperative hearing levels of 30 dB or better. However, hearing still improved by > or = 21 dB as often in patients with elevated preoperative BC thresholds as in patients with normal BC thresholds. These findings support the use of stapes surgery being worthwhile even in patients with highly elevated BC thresholds.

Adult↗

Preliminary study on vestibular-evoked myogenic potential induced by bone-conducted stimuli.

OBJECTIVE: To study the relationship between vestibular-evoked myogenic potential evoked by air-conducted stimuli (A-VEMP) and those evoked by bone-conducted stimuli (B-VEMP). STUDY DESIGN: Prospective study. SETTING: University Hospital. PATIENTS: To determine the optimum stimulus conditions for B-VEMP, 40 ears of 20 healthy volunteers were used. To compare results of A-VEMP and B-VEMP, 60 ears of 30 healthy volunteers and 70 ears of 35 patients with unilateral vestibular disorder without conductive hearing loss were used. MAIN OUTCOME MEASURE: A-VEMP and B-VEMP were measured. Both examinations involved evaluation of the interaural ratio (IAR) of the p13-n23 peak-to-peak amplitude. To compare the relationship between A-VEMP and B-VEMP in healthy subjects and patients with unilateral vestibular disorder. RESULTS: The optimum stimulus for B-VEMP seemed to be a tone-burst sound with 8-ms duration at 250 Hz. In all healthy subjects, both A-VEMP and B-VEMP could be recorded. The mean IAR of B-VEMP (0.5 +/- 21.0%) was not significantly different from that of A-VEMP (0.2 +/- 19.4%). In patients with unilateral vestibular disorder, B-VEMP could not be detected in 10 ears in which A-VEMP also could not be detected. The IAR of A-VEMP was strongly correlated with that of B-VEMP (correlation coefficient, 0.98). CONCLUSION: The results of B-VEMP were almost the same as those for A-VEMP, at least, for patients without conductive hearing loss.

Acoustic Stimulation↗

Normal infant and adult auditory brainstem responses to bone-conducted tones.

Auditory brainstem responses (ABRs) were recorded to 500- and 2000-Hz bone-conducted (BC) tones from normal infants and adults. Infant ABR thresholds for the 500-Hz BC tones are significantly lower than their thresholds to 2000-Hz BC tones. Infant wave V latencies to 500-Hz BC tones are significantly shorter than those of adults, whereas infant and adult responses to 2000-Hz BC tones are similar in latency, suggesting that the effective intensity of the BC tones may be 9-17 dB greater for infants than for adults. A marked asymmetry between the ipsilaterally and contralaterally recorded wave V is seen for infant responses to 500- and 2000-Hz tones at all intensities; this asymmetry is not as evident in adults, except near threshold.

Acoustic Stimulation↗

Application of an implantable bone conduction hearing device to patients with unilateral sensorineural hearing loss.

This investigation, comprised of five studies, was undertaken to determine if individuals with newly acquired profound unilateral hearing losses would benefit from an implantable bone-conduction hearing device. The bone conductor was implanted on the side of the deaf ear at the time of translabyrinthine acoustic tumor resection. Two areas greatly affected by unilateral hearing loss, speech recognition in noise and sound localization, were examined. No improvement in aided performance could be documented in either area.

Adult↗

Air-radiated sound from bone vibration transducers and its implications for bone conduction audiometry.

The effect of air-borne sound radiated from transducers used in bone conduction audiometry has been known for many years. This paper seeks to quantify this effect for the vibrator types (B70A, B71, and B72. Using three examples of each vibrator sound pressure levels were measured at the entrance to the external ear canal on four human heads. Values obtained have been related to hearing theshold levels for otologically normal young persons using two different methods: firstly using international standard values of open-ear free-field theshold with corrections for monaural listening and for diffraction, and secondly by direct measurement of the subjects' monaural open-ear thresholds. None of the vibrators tested meets international standard requirements for air-borne sound radiation at all frequencies, but in practics, provided a high quality ear plug is fitted to the test ear at 3 and 4 kHz large errors are unlikely to be recorded for any of the vibrator types tested.

Audiometry↗

Influence of contralateral masking on bone-conduction thresholds.

Two studies were conducted using normal-hearing listeners. In study 1, bone-conduction (BC) thresholds were obtained with contralateral masking at an effective level (EL) of 30 and 35 dB. In study 2, the EL of the contralateral masking equaled the magnitude of the occlusion effect (OE) plus a safety factor of 10 and 20 dB. Within each study, BC threshold shifts were evident at the higher compared with the lower ELs. Between studies, the highest BC thresholds were always obtained in the presence of the highest SPL of the masker which occurred in the 35 dB EL condition, whereas the lowest BC thresholds were always obtained in the presence of the lowest SPL of the masker which occurred in the OE + 10 dB condition. Even though the BC thresholds were influenced by the amount of contralateral masking, the BC thresholds obtained in each study were in good agreement with the new ANSI S3.26-1981 BC reference thresholds.

Adult↗

Normal pure tone thresholds for hearing by bone conduction.

Reference equivalent thresholds on a Brüel and Kjaer artificial mastoid have been obtained from bone conduction measurements made on a group of otologically normal listeners. The results are compared with other recent work. Various methods of presenting reference thresholds are discussed. A new method for masking the non-test ear is described.

Audiometry, Pure-Tone↗