PubMed HealthSearch

SEARCH · PubMed Health

Results for “Bone Conduction”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

Audiologic management of bilateral external auditory canal atresia with the bone conducting implantable hearing device.

The hearing impairment associated with congenital external auditory canal atresia has been managed with early bone conduction hearing aid placement and surgical reconstruction in selected patients. However, many patients do not wear a bone conduction hearing aid because of physical or social considerations and surgical reconstruction of the external auditory canal and middle ear may be difficult or contraindicated. This report details the use of implantable bone conducting hearing devices in five children with bilateral external auditory canal atresia. Each patient had bilateral conductive hearing impairment with normal bone conduction thresholds. Four of the five patients had associated craniofacial anomalies including three cases of microtia. The average preoperative sound field speech reception threshold improved from 63 dB to 13 dB with the implant. Patients experienced a definite preference for the implanted hearing device over the bone conduction hearing aid.

Adolescent

Alterations of bone conducted hearing in cases of modified middle ear mechanics. Conclusions from an electrical model.

In clinical diagnosis bone conduction thresholds can be used to assess impaired hearing caused by pathological function of the inner ear. The effects of changed mechanical properties of the middle ear on bone conduction are usually not considered in patients who simultaneously suffer from middle ear and inner ear diseases. This procedure is only partially correct. An exact determination of the effects of altered middle ear mechanics on bone conduction in patients with otosclerosis or after middle ear operations is rather difficult, but such determinations can improve diagnostic validity. Therefore, a special electrical model was constructed to simulate the oscillation pattern of the basilar membrane for bone conduction and variable middle ear impedance. Results from the model and possible conclusions on bone conducted hearing in vivo are discussed. Further steps to ensure measurements of inner ear function in cases with modified middle ear mechanics are proposed.

Basilar Membrane

Skull simulator for direct bone conduction hearing devices.

The Bone-Anchored Hearing Aid (BAHA) is a direct bone conduction hearing device which has given patients with various middle ear disorders a significantly improved quality of life. As the BAHA has gained acceptance as a valuable contribution to the Swedish hearing aid rehabilitation program, the need for equipment which can perform objective frequency response measurements has grown. Such equipment is indispensable for carrying out quality assurance, service, and fitting evaluation. To meet the above-mentioned demands, the skull simulator TU-1000 has been developed. The dynamic behaviour of the skull simulator TU-1000 can be characterized as that of a rigid mass body with a weight significantly exceeding the weight corresponding to the dynamic mass of the transducer incorporated in the BAHA. The motions of the mass body are measured by an accelerometer the output signal of which is amplified by a precalibrated amplifier. The output signal is proportional to the output force level from the BAHA. The skull simulator TU-1000 is capable of measuring the output force level from the BAHA with high reliability for frequencies ranging from 100 Hz to 10 kHz.

Biomechanical Phenomena

Reproducibility of hearing threshold measurements. Supplementary data on bone-conduction and speech audiometry.

The reproducibility of bone-conduction pure-tone audiometry and speech recognition thresholds has been tested in groups of normal-hearing subjects. Each person was tested twice during the same day, and the test-retest difference was calculated. The reproducibility is presented as the standard deviation of this difference. Bone-conduction threshold measurements have a high degree of test-retest precision, whereas air-bone gaps show a large range of distribution in these normal-hearing subjects. This makes the interpretation of such gaps spurious when values are below 20-30 dB. Speech recognition threshold has the highest degree of test-retest precision of all audiometric tests, and this is probably due to the steep slope of the psychometric function at 50% intelligibility. A more detailed graphic presentation of the 50% point of intersection will bring the reproducibility down to less than 2.5 dB.

Adult

Bone conduction calibration: current status.

Attempts to specify normal threshold sensitivity by bone conduction have been unsuccessful because of problems in obtaining reliable measurements from commercially available artificial mastoids. Recent design modifications incorporated in the Bruel and Kjaer 4930 artificial mastoids have resulted in greater uniformity among these units. However, the new design has resulted in impedances that are higher than those recommended in current standards. Bone-conduction thresholds referenced to measurements made on B & K 4930 artificial mastoids with the new design were performed on 60 normal listeners by three participating laboratories. The results are reported for consideration in the development of a reference threshold for hearing by bone conduction.

Acoustic Impedance Tests

Comments on the acoustic-reflex response for bone-conducted signals.

Previous studies which have measured acoustic-reflex responses to bone-conducted signals have not effectively differentiated reflex responses from artifacts. A convenient method for identifying such artifacts was developed and employed on some acoustic-reflex measures for bone-conducted signals. The findings indicated that artifacts result when a frequently-used acoustic admittance meter (Grason-Stadler 1720B) and a conventional bone vibrator were used to measure reflex responses for tonal and noise-activating signals. It was suggested that the method be employed in future studies which investigate the acoustic reflex in response to bone-conducted signals.

Acoustic Impedance Tests

Effect of vibrator to head coupling force on the auditory brain stem response to bone conducted clicks in newborn infants.

The effect of vibrator to head coupling force on the auditory brain stem response (ABR) to bone conducted clicks in newborn infants was investigated. Twenty full term newborn infants were tested. ABRs to bone conducted clicks were obtained with four different coupling forces (225, 325, 425, and 525 g) at stimulus intensities of 15 and 30 dB nHL. ABRs to air conducted clicks were also obtained at 30 dB nHL. The results of this study indicated that ABR wave V latencies to bone conducted clicks in newborn infants were affected significantly when the vibrator to head coupling force shift exceeded 200 g. It is recommended that the coupling force be controlled and remain consistent when implementing ABR to bone conducted stimuli in newborn infants.

Audiometry, Evoked Response

Effects of contralateral masking on high-frequency bone-conduction thresholds.

The present study reports effects of contralateral masking on high-frequency threshold force levels in 28 normal-hearing subjects. High-frequency air- and bone-conduction thresholds were measured with a high-frequency auditory evaluation system using matched Koss HV/1A earphones and the Pracitronic KH 70/5 bone vibrator. Measurements were made for both unmasked and masked bone-conduction thresholds at the ipsilateral mastoid of the better ear. The contralateral masked condition was performed using 30-dB-SL 400-Hz narrow-band masking noise centered at frequency of test tone. The results demonstrated that masked high-frequency bone-conduction thresholds were 1.5 to 3.4 dB poorer than the unmasked thresholds and that these differences were statistically significant at 0.01 level of confidence except at 12 kHz. ANSI and ISO standards for bone-conduction threshold force levels for frequencies below 8.0 kHz have been established with contralateral masking stimuli. This study supports the need to use effective contralateral masking to eliminate cross hearing in investigations of high-frequency bone-conduction threshold measurements.

Adult

Clinical implications in calibration requirements in bone conduction standardisation.

Although international agreement has long been reached on a standard threshold for air conduction audiometry, no similar standard exists for bone conduction autiometry. It is argued that the techniques applied to the determination of the air conduction thresholds are not applicable to those for bone conduction which should instead be brought into line with ISO 1964 and not established independently. A pilot study has been carried out which shows that by adopting the new approach now advocated international agreement could be attained with the expenditure of minimal time and effort.

Acoustic Stimulation

Labyrinthine fistulae caused by cholesteatoma. Improved bone conduction by treatment.

In five cases of labyrinthine fistulae caused by extensive cholesteatoma, more than 30-dB improvement in bone conduction was observed in four postoperative cases and in one case after preoperative administration of antibiotics. In each case, a fistula of more than 2 mm in length was present at the lateral semicircular canal, and membranous labyrinthine wall was exposed when the cholesteatoma membrane was removed. These five cases were considered to be in the stage of serous labyrinthitis. The experience with these cases shows that emergent antibiotic treatment and surgery are appropriate for cases with reduced bone conduction in which labyrinthine fistula caused by cholesteatoma is suspected. In addition, as the reduction of bone conduction does not necessarily preclude the possibility of good postoperative hearing, tympanoplasty may be appropriate even for cases with markedly reduced bone conduction due to labyrinthine fistulae.

Adolescent

The limited accuracy of bone-conduction audiometry: its significance in medicolegal assessments.

Accurate bone-conduction testing with masking is always difficult, but for clinical purposes limited accuracy suffices. However, when assessing claimants for compensation, extreme care is needed since even small apparent air-bone gaps are sometimes translated into financial abatement. This paper sets out the stringent test conditions required to achieve adequate precision. It also indicates the inaccuracies inherent in such tests, and recommends procedures for interpreting the significance of bone-conduction thresholds.

Audiometry

Occlusion effect: bone conduction speech audiometry using forehead and mastoid placement.

The occlusion effect (OE) was determined for bone conduction speech reception thresholds (SRTs) in 24 normally hearing subjects using forehead and mastoid placement. Results indicated that the OE was about 3 dB greater using forehead as opposed to mastoid placement. The intersubject variability of the OE is similar for the forehead and mastoid positions. The formula for effective masking for bone conduction speech should be equal to the minimum masking level for bone conduction speech plus the air-bone gap of the nontest ear plus 18 dB to account for the OE when using mastoid placement.

Acoustic Stimulation

A developmental study of bone conduction auditory brain stem response in infants.

Two studies, vibrator placement and masking, were performed to evaluate the developmental aspect of bone conduction auditory brain stem response (ABR) in human infants. Subject groups included newborns, 1-yr-olds, and adults. In the vibrator studies, ABRs were obtained from placements of the bone conduction vibrator on the frontal, occipital, and temporal bones. Results showed that temporal placements in neonates and 1-yr-olds produce significantly shorter wave V latencies of ABR than frontal or occipital placements. In adults, differences of wave V latencies from various vibrator placements were comparatively small. In the masking studies, ABRs were acquired from vibrator placements at the temporal bone in the presence of ipsilateral air conducted masking noise from the experimental groups. Results showed that interaural attenuations of bone conduction click stimuli are the largest in neonates, somewhat smaller from 1-yr-olds, and the smallest in adults. The findings of this research strongly suggest that temporal placements for bone conduction ABR should be used, in some instances, when testing infants and 1-yr-olds. The results of this study support the proposition that bone conduction ABR is a feasible and reliable diagnostic tool in testing infants.

Adult

[Masking in bone-conduction testing--proposal of ABC method].

A new strategic masking technique, namely the ABC method, has been developed. In performing this method of measuring thresholds of bone-conduction, the vibrator is placed at the forehead with both ears occluded by air-conduction earphones. One of the earphones is for masking noise and the other is a dummy which balances out the occlusive effect of the test ear against the nontest ear. The ABC method is based on the ABC rule that, in bone-conduction testing, the effective masking noise level necessary to block out the nontest ear can be calculated by a simple equation: right AC (A) + left AC (B)--unmasked BCu (C) under the assumption that the BCu belongs to the nontest ear. In some cases of hearing loss, the above noise level might produce overmasking, then an additive safety noise level, BCu + Interaural Attenuation, is employed. This method offers testers step by step directions which consist of indications of the noise level and a criterion for determining whether the measured bone-conduction is free from cross hearing and overmasking for the given configuration of air-conduction of both ears, BCu, and the masking noise level. Compared to the well known Plato method, in which measurements of thresholds are repeated at several masking noise levels in order to find a single bone-conduction threshold, the ABC method can essentially find the threshold at only one masking noise level. Therefore the ABC method makes it possible to save a great deal of time in performing bone conduction testing.

Audiometry

Reliability of bone-conducted electrocochleography. A clinical study.

The correlation between pure-tone bone conduction thresholds (BC) and thresholds obtained by electrocochleography with bone conducted stimulation (BC-ECoG) for 1, 2, 4 and 8 kHz was studied in 26 ears due for ear surgery. The correlations proved to be statistically highly significant and the results lend support to the conclusion that BC-ECoG can be considered to be well adapted for clinical use in cases where conventional audiometry has failed to reveal the capacity of the cochlea.

Audiometry

[Bone conduction changes in secretory otitis media (author's transl)].

In serous and secretory otitis media a reduction of bone conduction frequently exists besides the loss of air conduction. In 304 audiograms of ears with serous and viscous fluid in the middle ear there was a depression of the bone conduction between 15 and 40 dB in 40%. This bone conduction loss was reversible after the aeration of the tympanic cavity. That means that we deal with a false nerve deafness in many of these cases.

Bone Conduction

High-frequency audiometry. Masking in electric bone-conduction audiometry.

Recently, the 'electric bone-conduction' (EBC) audiometer (Audimax 500) has been used to measure high-frequency (HF) hearing. With this audiometer stimulation is binaural. No commercial masking method was available. In this study, white noise from a Madsen OB822 audiometer and presented via Sony MDR-V4 dynamic earphones, was used for masking. The masking and cross-hearing effect was measured in 8 unilaterally deaf subjects and the masking procedure was tested with 104 young normal-hearing subjects. The results showed that the EBC signals can be masked with air-conduction signals, and thus, the EBC measurements reflect monaural thresholds. The minimum masking level was 50-60 dB SPL in the HF range. There were no cross-hearing problems in the HF range with the earphones used. At the frequencies 0.5-14 kHz, the better ear's masked EBC thresholds were on the average 2.6 dB (range 0-4.5 dB) poorer, compared with the binaural EBC thresholds, indicating a binaural summation effect.

Acoustic Stimulation

Validity of bone conduction stimulated ABR, MLR and otoacoustic emissions.

The present study considers the validity of objective auditory investigation via bone conduction. Auditory Brainstem Responses (ABR) and Middle Latency Responses (MLR) were recorded in response to a bone vibrator stimulation with or without continuous bilateral air white noise masking. In all cases, such masking was found to result in an absence of recorded evoked potentials. It shows that under bone-conducted stimulation the evoked potential recorded is purely auditory, with no additional mechanical somatosensory component. In a further study, the feasibility of oto-acoustic emissions (OAEs) via bone conduction is demonstrated. These OAEs are, for a given subject, comparable to those found for air-transmission stimulation.

Adolescent