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At least 163 records · Page 9Linked to original sources

Bone-conducted stimulation in electrocochleography.

The mechanical vibration patterns close to the cochlea in intact skulls of human cadavers have been studied by means of a miniature accelerometer. A Radioear B70A vibrator and a Brüel & Kjaer Mini Shaker have been used, fed with filtered clicks and with short tone bursts. The tone bursts were found to be superior to the clicks with regard to the vibration spectrum. At 500 Hz a considerable distortion was observed in the accelerometer signal, also when using tone bursts. This distortion was presumably due to resonant vibrations in the skull itself, and may be a source of error not only when using stimuli of short duration as in bone-conduction ECoG but also in conventional bone-conduction audiometry. When the vibrations were applied to the exposed bone surface of the mastoid, vibration levels increased by 10-25 dB compared with when soft tissues covered the point of application. This could be of advantage in bone-conduction ECoG performed at ear surgery.

Acoustic Impedance Tests↗

The output characteristics of an implanted bone conduction prosthesis.

So far, the published guidelines for patient selection for the Audiant implanted bone conduction device have been derived from clinical trial rather than experimental study. Theoretical considerations suggest that the guidelines should be frequency specific; the need for this was investigated in a laboratory study. Two independent measures of the maximum output of the Audiant device using both the body-worn and ear-level amplifiers have been performed on two subjects. These lead to maximum output figures for the device ranging from 15 dB HL at 250 Hz to 60 dB HL at 6000 Hz for the body-worn amplifier, and from 6 dB HL at 250 Hz to 42 dB HL at 6000 Hz for the ear-level amplifier. These results suggest that the ear-level amplifier is suitable only for candidates with essentially normal bone conduction thresholds at frequencies of 1000 Hz and below.

Adult↗

Ocular vestibular evoked myogenic potentials (OVEMPs) produced by air- and bone-conducted sound.

OBJECTIVE: To determine the origin and properties of short latency extraocular potentials produced by activation of the vestibular apparatus using two modes of acoustic stimulation. METHODS: Extraocular potentials were measured in 10 normal subjects using a bipolar montage to increase selectivity. Three dimensional eye movements were also recorded in five subjects. The subjects were stimulated with both air-conducted (AC) and bone-conducted (BC) sound using a single cycle of a 500Hz sine wave. RESULTS: Short latency positive and negative potentials that peaked at 8.1-12.7ms for AC and 7.5-13.9ms for BC stimulation were recorded, which were distinct for the two eyes and for the two modes of stimulation. The extraocular potentials began prior to the onset of eye movements, which peaked at 16.5-20.1ms for AC, 17.8-25.0ms for BC stimulation. CONCLUSIONS: The pattern of short latency eye movements and extraocular potentials induced by AC and BC vestibular stimulation are distinct. As the potentials preceded the eye movements and were not correlated morphologically with them, the source of the observed potentials is not an eye movement and thus we refer to them as ocular vestibular evoked myogenic potentials (OVEMPs). SIGNIFICANCE: The potentials had properties consistent with modulation of the electromyogenic activity of the extraocular muscles and if interpreted as originating from displacement of the eye will give misleading results. AC and BC acoustic stimulation are likely to activate differing profiles of vestibular end organs.

Acoustic Stimulation↗

Vestibular neuritis in a child with otitis media with effusion; clinical application of vestibular evoked myogenic potential by bone-conducted sound.

Vestibular evoked myogenic potential (VEMP) has been applied for patients with vestibulo-cochlear disorders. The impairment of the sound transmission due to middle ear pathology affects VEMP results. In children, otitis media with effusion (OME) is well documented and it is difficult to apply conventional VEMP in such cases. To overcome the attenuation of stimulation due to middle ear pathology, VEMP by bone-conducted sound has been developed. We report a 3-year-old girl with vestibular neuritis and OME as a representative case of clinical application of VEMP by bone-conducted sound. VEMP by bone-conducted sound can be an alternative method to elicit vestibular-dependent potential.

Bone Conduction↗

A brief communication on bone conduction artefacts.

The various factors which may be involved in the incorrect measurement of bone-conduction threshold are outlined. One of these factors, airborne radiation from the vibrator, has been investigated for three Radioear vibrators, the B70A, B71 and B72. The results indicate that false bone-conduction threshold values could arise, due to the airborne radiation component, mainly with the B72 vibrator.

Audiometry↗

Binaural interaction of bone-conducted auditory brainstem responses in children with congenital atresia of the external auditory canal.

Bilateral bone-conducted auditory brainstem responses (BC-ABRs) were recorded in children with atresia of the external auditory canal bilaterally (AECB) in order to compare the response characteristics to normal hearing adults. The binaural interaction component (BIC) of the ABR occurs when the sum of the monaural-evoked ABR amplitudes are different in amplitude when compared to the binaural-evoked ABR amplitude. Previous electrophysiological work from our lab has shown that children with AECB lateralize bone-conducted (BC) sound. Furthermore, we have found in normal-hearing adults that BICs exist using BC clicks. In adults, BC-BIC occurred in the latency region corresponding to waves IV-VI, whereas for children with AECB corresponding peak latencies occurred earlier. Same as normal-hearing adults, BC-ABR IV-V complex peak amplitudes for sum of the BC-monaural right and BC-monaural left ears were different from binaural response amplitude. Individual peak latencies were similar in children with AECB when compared to normal-hearing adults except for shorter latencies for BIC. These results indicate that: (1) BC-BI is present in children with AECB as well as normal-hearing adults; (2) the gross response properties of BIC are similar in children with AECB and normal-hearing adults; (3) fitting of a bilateral BC hearing aid might be a feasible method to optimize binaural hearing and sound lateralization.

Adolescent↗

First clinical experiences with an implantable bone conduction hearing aid at the University of Amsterdam.

A transcutaneous bone-conduction hearing aid was implanted in 11 patients who were not suitable for transcranial sound amplification. Audiological and surgical selection criteria were followed strictly. One device had to be explanted and minor revision surgery was needed in two cases for skin irritation and scarring. In general the aids were well tolerated but the amplification power of the external device proved to be insufficient in some patients, in whom bone conduction levels were on the borderline of the selection limits.

Adolescent↗

Modification of the traditional bone conduction hearing aid.

The purpose of this technical note is to describe a modification of the traditional bone conduction hearing aid used for the treatment of hearing impairment associated with atresia, microtia, or auditory canal anomalies. This modified unit offers a viable alternative to patients wanting an alternative to the traditional model or an implantable bone conduction aid.

Bone Conduction↗

Measurement of bone conduction levels for high frequencies.

For assessment of safety, it is necessary to measure the maximum possible force exerted by a bone conduction device coupled to the human head. Calibration of bone conduction hearing aids and vibrators in the audiometric range is based on measurement of acceleration and force using an artificial mastoid. Extending the measurement to the high audio range was accomplished using a live head. To assess safety of the UltraQuiet tinnitus treatment system, as an example, acceleration was measured from 5 to 20 kHz on a live human head as compared with calibrated levels at 6 kHz on an artificial mastoid and the live head. Using head acceleration and anchoring it to established calibration levels is a means of establishing clinical safety. Stimulation in the high audio frequencies at low levels was found to be safe. In contrast, stimulation with ultrasound requires more energy (approximately 75-90 dB re 6 kHz), which may increase the risk of damage to the car.

Auditory Threshold↗

Bone conduction thresholds in patients with otosclerosis.

PURPOSE: Sensorineural hearing loss in patients with otosclerosis is commonly encountered. This study was conducted to determine if surgery on the otosclerotic ear had an effect on the sensorineural hearing. METHODS: A cohort of 262 patients subjected to operation in 311 ears were evaluated. All patients had a minimum of 5 years follow-up and patients over 60 years of age were excluded. Audiograms obtained 1 day before surgery were compared with those obtained 1 year postoperatively and at the last follow-up examination in the study. Results were evaluated using the Student's t test for statistical analysis of hearing results. RESULTS: The mean follow-up was 9.6 years. Deterioration of bone conduction scores occurred in 6.4% of 311 operated ears. Deterioration of bone conduction threshold occurred in the speech frequency in 6 ears (1.9%). CONCLUSIONS: Bone conduction scores of operated ears remained quite stable compared with the otosclerotic ears not subjected to operation. Patients with bilateral otosclerosis may benefit from surgery performed on both ears when indicated.

Adult↗

Changes in bone conduction thresholds with vibrator contact area.

An experimental bone conduction vibrator was used to measure force and acceleration directly at the point of contact, the subject's forehead. Force and acceleration at threshold were measured for six subjects over a frequency range of 250 to 6000 Hz and over a contact area range of five to one. These measurements suggest that for any test subject, the variation in force of threshold with contact area is much smaller than the corresponding variation in acceleration at threshold.

Audiology↗

Bone conduction speech audiometry in normal subjects.

The present study was designed to investigate: (1) the relationship among bone conduction (BC) pure tone averages, BC speech reception thresholds (SRTs), and BC speech detection thresholds for normal subjects; (2) short term reliability of BC SRTs; and (3) characteristics of the articulation functions for spondees obtained by bone conduction. Twenty-five normal-hearing young adults participated. The data revealed that BC SRT-pure tone average and SRT-speech detection threshold relationships are essentially the same as for air conduction. A comparison of the articulation functions for air conduction and BC revealed no practical difference between the two modes of stimulus presentation.

Adult↗

Clinical applications of transcranial bone conduction attenuation in children.

It is a common belief that there is no significant transcranial attenuation across the skull by bone conduction (BC). In 32 children with proven unilateral sensorineural hearing loss the unmasked bone thresholds were measured on each side. There was a significant attenuation of BC at 4 kHz. Transcranial attenuation of BC at 4 kHz may explain the difference in sound perception between the two ears when bone conduction amplification is used. Further research should be undertaken to identify the better cochlea in mixed hearing losses.

Adolescent↗

The effect of coupling force on bone conduction audiometry.

The present research is devoted to the study of the effect of coupling force on bone conduction threshold determination. The following characteristics of this investigation are listed: A systematic range of coupling forces from 250 to 750 grams (in 100-gram intervals) is used by means of some adopted mechanical devices; A Brüel & Kjaer mechanical impedance head type 8000 (with a mini-shaker) is employed for testing; Test-retest variabilities of bone conduction thresholds are analysed under different coupling forces; Variation of hearing levels under the effect of coupling force is studied.

Adult↗

Bone conduction errors at high frequencies: implications for clinical and medico-legal practice.

The magnitude and origin of audiometric air-bone gaps in the range 3 kHz to 8 kHz was investigated in 20 normal subjects. The average gap ranged from a minimum of about 3 dB at 3 kHz to a maximum of about 19 dB at 6 kHz. Approximately 5 dB of the gap at high frequencies is caused by excess air-radiated sound from the bone vibrator. A larger error appears to result from discrepancies between the air and bone conduction standards to which audiometers are calibrated. These errors may influence diagnosis and we recommend that bone conduction tests at frequencies greater than 4 kHz are avoided. These findings have implications for medico-legal work where small air-bone gaps have diagnostic significance.

Audiometry, Pure-Tone↗

Transmission properties of bone conducted sound: measurements in cadaver heads.

In the past, only a few investigations have measured vibration at the cochlea with bone conduction stimulation: dry skulls were used in those investigations. In this paper, the transmission properties of bone conducted sound in human head are presented, measured as the three-dimensional vibration at the cochlear promontory in six intact cadaver heads. The stimulation was provided at 27 positions on the skull surface and two close to the cochlea; mechanical point impedance was measured at all positions. Cochlear promontory vibration levels in the three perpendicular directions were normally within 5 dB. With the stimulation applied on the ipsilateral side, the response decreased, and the accumulated phase increased, with distance between the cochlea and the excitation position. No significant changes were obtained when the excitations were on the contralateral side. In terms of vibration level, the best stimulation position is on the mastoid close to the cochlea; the worst is at the midline of the skull. The transcranial transmission was close to 0 dB for frequencies up to 700 Hz; above it decreased at 12 dB/decade. Wave transmission at the skull-base was found to be nondispersive at frequencies above 2 kHz whereas it altered with frequency at the cranial vault.

Acoustic Stimulation↗

Clinical application of an implantable bone conduction hearing device.

For some patients, the transcutaneous bone-conduction implant offers a viable alternative to conventional amplification. However, this option should be employed only after considering the relative advantages and disadvantages of conventional medical management and, when feasible, the fitting of air-conduction amplification. The cases presented here illustrate some important factors to consider in the selection and fitting of bone-implant candidates.

Adult↗