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PubMed2000

Systematic errors in bone conduction audiometry.

Air and bone conduction audiometry was carried out on two separate groups of 12 normal hearing volunteers. One group was tested at St Mary's hospital, the other at Charing Cross hospital. The results from both centres showed evidence of a systematic error in bone conduction resulting in a pattern of 'notching' at 2 kHz. We argue that the effect is likely to be more apparent in conductive deafness and that a significant distortion of the audiogram occurs in about 17% of such cases. Since the problem appears not to be restricted to the centres involved in the study, we strongly recommend that the issue be addressed by the appropriate professional bodies.

Adult↗
PubMed2004

[Probe to the bone-conduction phenomenon].

OBJECTIVE: To probe into the rule of bone-conduction measurement by testing a group of health young students with normal hearing and groups of case with different diseased ears, in order to provide some instructions for clinical audiometry. METHOD: Subjects included 20 health young students with normal hearing, 113 cases with different hearing loss. We tested all the subjects Weber Test and bone-conduction threshold by masking. RESULT: Weber Test lateralization dependented on the difference of binanural sensitivity when binaural had no conductive impairment. Different conductive impairment improved bone-conduction response at different frequencies. When monaural had conductive impairment and the other ear normal, there were 3-5 octaves WT lateralizated to the diseased ear. When there were binaural conductive impairments, bone-conduction response dependented on the nature and degree of the impairment, WT lost the rule. CONCLUSION: In order to avoid the negative effects of central masking and overmasking, our observations came to the conclusion that some conditions as follow need no masking: (1) There are no conductive impairment binaural, and the air-conduction pure tone threshold (PTT) gap between binaural higer than 40 dB, when we test bone-conduction PTT of better ear, we need no masking, as for the poor ear, it's bone conduction will come cross to the contralateral ear. (2) When one ear normal and the other is the conductive impairment,need no masking when testing the diseased ear. (3) There are conductive impairments binaural, bone-conduction PTT is normal, and air-conduction PTT is higher than interaural attenuation, we cannt get a true bone-conduction PTT by masking, but can determine the type of hearing loss and estimate the integrity of the sensory-neural system by other audiometry measurements.

Adolescent↗
PubMed1995

Middle ear and inner ear effects on clinical bone-conduction threshold.

The measurement of bone-conduction thresholds is an integral part of audiologic evaluation. The relationship between bone-conduction and air-conduction thresholds is the differentiating diagnostic indicator between conductive and sensorineural hearing loss. At the same time, the influence of middle ear and inner ear structures upon the bone-conduction response has been well documented. We present two cases illustrating this influence and attempt to explain the clinical bone-conduction thresholds with operative findings.

Acoustic Impedance Tests↗
PubMed1997

[Implantable bone conduction hearing aids].

Conventional extern bone conduction hearing aids often cause retroauricular pain by compression of the skin, distortion is enhanced by the vibrational pattern and feedback can be a problem and, last but not least, do not fit into cosmetic schemes. We report about experiences with 2 different systems of partly implantable bone conduction hearing aids which were designed to overcome the technical, audiological and cosmetical problems of conventional bone conduction hearing aids. There is a transcutaneous and a percutaneous system discussed. Clinical experiences demonstrate that the percutaneous system is superior in both objective hearing gain and patient acceptance.

Bone Conduction↗
PubMed1994

Extended high-frequency audiometry. Air- and bone-conduction thresholds, age and gender variations.

Air-conduction and bone-conduction thresholds have both been determined in the conventional audiometric frequency ranges and in the extended high frequencies through respectively 18 and 16 kHz for otologically healthy subjects in different age groups covering the age span 8-14 years through the eighth decade. Subjects younger than 30 years had conventional frequency air-conduction thresholds < or = 10 dB HL, whereas the corresponding thresholds of older subjects were within 0.1 and 0.9 percentiles of ISO 7029 (1984). Age- and gender-specific thresholds, medians and ranges, are presented for bone conduction in the extended high frequencies. Thresholds increase with both age and frequency in the range 8-16 kHz, and there is a largely non-significant tendency for thresholds to be higher in males. Threshold deterioration at the highest frequencies is already present at age 18-24 years compared with the youngest (8-14 year) age group.

Acoustic Stimulation↗
PubMedDate not supplied

Auditory brain stem responses of premature infants to bone-conducted stimuli: a feasibility study.

The feasibility of bone conduction auditory brain stem response (ABR) audiometry in intensive care nursery neonates was investigated. Forty premature infants were tested with both air- and bone-conducted stimuli. Bone-conducted stimuli resulted in more identifiable ABRs and a greater number of subjects passing the hearing screening. The findings of this study suggest that bone conduction ABR audiometry is a feasible technique with premature infants. Due to the lower frequency composition of the bone-conducted click, it may be more effective than an air-conducted click when the immature cochlea is being evaluated.

Air↗
PubMed2000

Improvement in bone conduction threshold after tympanoplasty.

OBJECTIVE: To investigate the causes of bone conduction threshold impairment associated with middle ear pathoses and the factors influencing improvement in bone conduction threshold after tympanoplasty. STUDY DESIGN AND SETTING: The records of 98 consecutive patients with unilateral chronic otitis media who underwent tympanoplasty were reviewed. Pre-operatively, 15 dB or more depression of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was considered to be significant. Similarly in the postoperative period, 15 dB or more improvement of bone conduction threshold at least in 2 frequencies between 500 and 6000 Hz was regarded as significant. RESULTS: Twelve (12.5%) of 98 cases were found to have depressed bone conduction threshold; 6 of 12 cases had improved bone conduction threshold after tympanoplasty. CONCLUSION: In cases with cholesteatoma and extensive middle ear disease, successful results could be achieved after tympanoplasty disregarding the air-bone gap and deteriorated bone conduction threshold. SIGNIFICANCE: Bone conduction threshold may improve after tympanoplasty.

Adolescent↗
PubMed2005

Intelligibility of bone-conducted ultrasonic speech.

Ultrasound can be perceived through bone conduction by the profoundly deaf as well as by normal-hearing subjects. Moreover, speech signals modulated onto ultrasound can be detected through bone conduction. This study explored how well listeners can understand ultrasonic speech and the confusion patterns to evaluate and improve bone-conducted ultrasonic hearing. The intelligibility of Japanese words classified by familiarity and Japanese monosyllables with bone-conducted ultrasound was investigated. Results showed that the intelligibility of familiar words was higher than that of unfamiliar words. Further, the results of a monosyllable intelligibility test with bone-conducted ultrasound and those of a test with air-conducted sound showed a similar pattern of speech recognition with regard to the errors made. The relationship between speech intelligibility and sound level showed that the increase in the intelligibility of bone-conducted ultrasonic speech did not exceed the increase in the intelligibility of air-conducted speech as the sound level rose.

Adult↗
PubMed1990

The British experience of an implantable, subcutaneous bone conduction hearing aid (Xomed Audiant).

Implantable bone conduction aids are potentially an important advance for those with a conductive hearing impairment. One system (Xomed Audiant bone conductor), which uses electromagnetic induction to vibrate a subcutaneous implanted skull magnet, has now been implanted in sufficient patients in the United Kingdom, for enough time, for its indications to be evaluated. Seventeen of the total of 18 patients that have been implanted, satisfied the average threshold criterion for suitability for implantation (average bone conduction over 0.5, 1 and 2 kHz of 25 dB HL or better) yet only 10 of the 17 (59 per cent) currently use their Audiant aid. This was not because of technical reasons but was mainly influenced by the previous type of amplification. Current usage of a body level processor was 100 per cent) (6 of 6) in those that previously could only use a conventional bone conduction aid because of bilateral congenital or acquired atresia of their external auditory canals. In comparison, usage was only 36 per cent (4 of 11) in those that could potentially use a conventional ear level aid albeit with problems such as the discharge from active chronic otitis media. This relative non-use was considered due to a lack of power of the ear level processor and the general unwillingness of patients to change from an ear level to a body level device.

Adolescent↗
PubMed2001

Frequency sensitivity range of the saccule to bone-conducted stimuli measured by vestibular evoked myogenic potentials.

Vestibular evoked myogenic potentials (VEMPs) occurring in cervical muscles after intense sound stimulation conducted by air or bone are thought to be a polysynaptic response of otolith-vestibular nerve origin. We report the results of an experiment to investigate whether acoustic stimulation of the saccule by bone conduction produces VEMPs in which response amplitudes are somewhat sensitive to stimulus frequency, as appears to be the case with air-conducted stimuli. Prior to this we investigated the effect of stimulation repetition rate on bone-conducted VEMPs (B-VEMPs) at stimulus frequencies of 200 and 400 Hz with five different repetition rates (5, 10, 20, 40, and 80 Hz). B-VEMPs were recorded from 12 normal hearing subjects in response to bone-conducted 70 dB (normal hearing level), 10-ms tone bursts (rise/fall time=1 ms and plateau time=8 ms) at frequencies of 100, 200, 400, 800, 1600 and 3200 Hz. Our study showed that B-VEMP amplitudes were highest at 10 Hz but decreased as the repetition rate increased. B-VEMP response amplitudes were found to be maximal for stimulus frequencies from 200 to 400 Hz. This response may contribute to the perception of loud sounds.

Acoustic Stimulation↗
PubMed2002

[Study on auditory brainstem response to bone conducted clicks].

OBJECTIVE: To observe how different vibrator placement and different stimulate rates affect the results of bone conduction ABRs. METHOD: Bone conduction ABRs with different vibratory placement and different stimulate rates were recorded in 20 normal hearing young adults and compared with their air conduction ABRs. RESULT: The results show that all subjects were recorded reproducible and reliable air and bone conduction ABR waveforms under higher intensities(above 40 dBnHL). The ABR thresholds from air and bone conduction were similar, they are both about 5-10 dB higher above their behavioral thresholds to clicks. The frontal placement produces significantly longer ABR wave V latencies. Bone conduction ABR wave V latencies from different stimulate rates were also observed. The results show that temporal placement ABR wave V latencies became longer significantly when the stimulate rate increased from 20/s to 52/s. CONCLUSION: Although it is affected by different vibrator placement and different stimulate rate, bone conduction ABR is a valuable and effective method to detect hearing, it plays an important role in newborn auditory screening, assessment of cochlear reserve, and identification of hearing loss.

Acoustic Stimulation↗
PubMed1976

Early bone conduction hearing aid devices.

The concept of bone conduction hearing is old. By the 16th century the conduction of sound by a rod or the staff of a spear was reported by a number of writers; however, these writers considered these phenomena as a curiosity rather than having practical value. In the 17th century, John Bulwer and George Sibscota, both interested in the deaf and their education, applied the bone conduction phenomenon as an aid to defective hearing. Soon, independent reports from Germany, France, and Italy also described bone conduction rod devices as aids to impaired hearing. In 1879, the Audiphone, a hearing fan that operated by bone conduction, was patented. The invention of the Audiphone triggered the development and sale of a number of similar devices that had considerable popularity until the invention of the carbon-electric hearing aid in the early 1900s.

Bone Conduction↗
PubMed1984

Bone conduction evaluation related to mastoid surgery.

The bone conduction threshold changes of 97 patients (100 ears) who underwent mastoid surgery were determined by comparing the last preoperative audiogram with the 1 year postoperative audiogram. Three types of mastoid surgery were evaluated: radical mastoidectomy, modified radical mastoidectomy, and intact wall atticomastoidectomy. The average three speech frequency preoperative bone conduction threshold was 17.4 dB (S.D. 11.5) in the radical mastoidectomy group, 10.1 dB (S.D. 9.6) in the modified radical mastoidectomy group, and 10.7 dB (S.D. 8) in the intact wall atticomastoidectomy group. The difference between the average three speech frequency preoperative bone conduction threshold of the radical mastoidectomy group differed significantly when compared to the modified radical mastoidectomy or intact wall atticomastoidectomy group. The postoperative average three speech frequency bone conduction threshold did not change significantly following the three surgical procedures evaluated.

Adult↗
PubMed1994

[Evaluation of bone conduction after chronic ear surgery and after stapedectomy].

The bone conduction threshold changes of 295 ears which underwent chronic ear surgery (177 ears) or stapedectomy (118 ears) were determined by comparing last preoperative with 4 to 6 weeks postoperative audiogram. Three types of middle ear operations were evaluated: radical mastoidectomy, modified radical mastoidectomy and intact wall mastoidectomy with tympanoplasty (first stage). A total stapedectomy was performed with adipose seal and tarflen prosthesis. The preoperative mean bone conduction thresholds of radical mastoidectomy at 2000-4000 Hz frequency range was significantly worse when compared to radical modified mastoidectomy and to mastoidectomy with tympanoplasty (first stage). A significant deterioration of mean bone conduction thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz was observed after open techniques and at 2000 Hz and 4000 Hz after intact wall mastoidectomy with tympanoplasty (first stage). After stapedectomy a positive change (improvement of mean bone conduction) was noted at 1000 Hz and 2000 Hz. It seems that observed changes in the bone conduction thresholds may be due to damaging risk of surgical procedure (chronic ear surgery and stapedectomy) and influence of ossicular chain mobilisation on bone conduction transmission (stapedectomy).

Acoustic Stimulation↗
PubMedDate not supplied

Implantable bone conduction hearing device: Audiant bone conductor. Update on our experiences.

An implantable hearing device has been developed and has undergone testing by animal experimentation and clinical trials in humans. Recently, the Food and Drug Administration has approved the use of this device in adults who are within the criteria of its utilization, mainly patients with conductive hearing impairments who have good inner ear reception and who are unable to benefit from surgical correction. This update describes observations and experiences we have had during the device's development and defines its limitations as well as its unique thrust into the future relief of hearing impairment. Clinical trials during the investigational period and engineering problems as well as progress are thoroughly discussed.

Adolescent↗
PubMed2005

Bone-conducted sound: physiological and clinical aspects.

OBJECTIVE: The fact that vibration of the skull causes a hearing sensation has been known since the 19th century. This mode of hearing was termed hearing by bone conduction. Although there has been more than a century of research on hearing by bone conduction, its physiology is not completely understood. Lately, new insights into the physiology of hearing by bone conduction have been reported. Knowledge of the physiology, clinical aspects, and limitations of bone conduction sound is important for clinicians dealing with hearing loss and is the purpose of this review. DATA SOURCES: The data were compiled from the published literature in the areas of clinical bone conduction hearing, bone conduction hearing aids, basic research on bone conduction physiology, and recent research on bone conduction hearing from our laboratory. CONCLUSION: Five factors contributing to bone conduction hearing have been identified: 1) sound radiated into the external ear canal, 2) middle ear ossicle inertia, 3) inertia of the cochlear fluids, 4) compression of the cochlear walls, and 5) pressure transmission from the cerebrospinal fluid. Of these five, inertia of the cochlear fluid seems most important. Bone conduction sound is believed to reflect the true cochlear function; however, certain conditions such as middle ear diseases can affect bone conduction sensitivity, but less than for air conduction. The bone conduction route can also be used for hearing aids; since the bone conduction route is less efficient than the air conduction route, bone conduction hearing aids are primarily used for hearing losses where air conduction hearing aids are contraindicated.

Basilar Membrane↗
PubMed1997

Comparison of air- and bone-conducted brain stem auditory evoked responses in young dogs and dogs with bilateral ear canal obstruction.

Brain stem responses to air- and bone-conducted stimuli were analyzed in 11 young dogs, using an in-the-ear transducer and a vibrator designed for human hearing tests, respectively. The mean thresholds were 0 to 10 dB for air-conducted stimuli and 50 to 60 dB for bone-conducted stimuli. The wave forms and inter-peak latencies of the waves of the auditory evoked responses elicited by air-conducted and bone-conducted stimuli were similar. This indicated that the signals had the same origin and thus both the air-conducted and the bone-conducted responses could be considered to be auditory responses. Measurement of air-conducted and bone-conducted brain stem-evoked responses in five dogs with bilateral chronic obstructive ear disease revealed thresholds of 50 to 60 dB for air-conducted stimuli and 60 to 70 dB for bone-conducted stimuli. By comparison of these results with those in the 11 young dogs, it could be concluded that there was hearing loss other than that caused by obstruction of the ear canals.

Aging↗