scholarly journals Perception Mechanism of Bone-Conducted Ultrasound and Its Clinical Use

2021 ◽  
Vol 11 (2) ◽  
pp. 244-253
Author(s):  
Tadashi Nishimura ◽  
Tadao Okayasu ◽  
Akinori Yamashita ◽  
Hiroshi Hosoi ◽  
Tadashi Kitahara

It is generally believed that ultrasound cannot be heard. However, ultrasound is audible when it is presented through bone conduction. Bone-conducted ultrasound (BCU) has unique characteristics; the most interesting is its perception in patients with profound deafness. Some patients can perceive it and discriminate speech-modulated BCU. Previous reports have suggested that BCU can be used for a hearing aid or tinnitus sound therapy. In this review, the perception of BCU at both the peripheral and central levels was investigated based on previous studies, although some of them remain controversial. We also investigated the clinical use of BCU. To develop hearing aids utilizing BCU, the encoding of speech signals into BCU has to be established. The outcomes of the reported speech modulations were evaluated. Furthermore, the suppression of tinnitus by BCU was reviewed, and the feasibility of the application of BCU to tinnitus treatment was investigated.

1993 ◽  
Vol 102 (6) ◽  
pp. 433-437 ◽  
Author(s):  
Mark A. Frattali ◽  
Robert T. Sataloff

Profound deafness has received increasing attention in recent years, largely because of the availability of cochlear implants. Consequently, it is especially important for otolaryngologists to remember that a “blank” audiogram does not necessarily mean total or even profound deafness. Patients with far-advanced otosclerosis may have no measurable hearing with routine audiometric testing even in the presence of serviceable sensorineural hearing. Review of nine patients (10 ears) who underwent stapedectomy from 1980 to 1987 reveals that seven of the nine (78%), who had been unable to use a hearing aid preoperatively, obtained serviceable hearing with hearing aids following surgery. Otolaryngologists should depend on a good history and tuning fork examination to avoid being misled by the audiogram, and should not hesitate to offer stapes surgery to patients with far-advanced otosclerosis.


2015 ◽  
Vol 20 (01) ◽  
pp. 034-038 ◽  
Author(s):  
Maria Mondelli ◽  
Thais Mariano ◽  
Heitor Honório ◽  
Rubens Brito

Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.


1997 ◽  
Vol 76 (4) ◽  
pp. 238-247 ◽  
Author(s):  
Gösta Granström ◽  
Anders Tjellström

A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Susan Marynewich ◽  
Lorienne M. Jenstad ◽  
David R. Stapells

Slow cortical potentials (SCPs) are currently of great interest in the hearing aid fitting process for infants; however, there is conflicting evidence in the literature concerning the use of SCPs for this purpose. The current study investigated SCP amplitudes and latencies in young normal-hearing listeners in response to a 60 ms duration tonal stimulus (1000 Hz) presented at three intensities (30, 50, and 70 dB SPL) in aided and unaided conditions using three hearing aids (Analog, DigitalA, and DigitalB) with two gain settings (20 and 40 dB). Results showed that SCP amplitudes were smaller for the digital hearing aids compared with the analog hearing aid, and none of the hearing aids resulted in a reliable increase in response amplitude relative to the unaided across conditions. SCP latencies in analog conditions were not significantly different from latencies in the unaided conditions; however, both digital hearing aids resulted in significantly delayed SCP latencies. The results of the current study (as well as several previous studies) indicate that the SCP may not accurately reflect the amplified stimulus expected from the prescribed hearing aids. Thus, “aided-SCP” results must be interpreted with caution, and more research is required concerning possible clinical use of this technique.


In Today’s era health related issues are increasing day by day and one of them is hearing loss. Hearing aids have done wonders and helped people in this situation. Hearing aid is a small device that makes the sound loud and clear for the person who is unable to listen, communicate and could not participate actively in day to day activities. A hearing aid can help people to listen in different environments such as loudspeakers in the background, a loud train horn and different noisy situations etc. But the speech signals are degraded and corrupted by different types of noises such as train noise, car engine noise, loud speaker and traffic noise at different SNR levels like -2db, 5db, 10db. These speech signals need to be improved by removing the unwanted disturbances or interference called noise so that enhanced signal can be obtained with good quality for voice communication in hearing aids. This research work proposes the noise reduction technique using FIR filters for hearing aids. The approach of threshold will be applied to remove empty bands or unwanted noise from the noisy signal. The threshold based technique de-noises the input signal efficiently. The proposed approach is implemented in MATLAB and results are analyzed in terms of SNR (signal to noise ratio) and MSE (mean square error).


2013 ◽  
Vol 24 (06) ◽  
pp. 452-460 ◽  
Author(s):  
Earl E. Johnson

Background: Hearing aid prescriptive recommendations for hearing losses having a conductive component have received less clinical and research interest than for losses of a sensorineural nature; as a result, much variation remains among current prescriptive methods in their recommendations for conductive and mixed hearing losses (Johnson and Dillon, 2011). Purpose: The primary intent of this brief clinical note is to demonstrate differences between two algebraically equivalent expressions of hearing loss, which have been approaches used historically to generate a prescription for hearing losses with a conductive component. When air and bone conduction thresholds are entered into hearing aid prescriptions designed for nonlinear hearing aids, it was hypothesized that that two expressions would not yield equivalent amounts of prescribed insertion gain and output. These differences are examined for their impact on the maximum power output (MPO) requirements of the hearing aid. Subsequently, the MPO capabilities of two common behind-the-ear (BTE) receiver placement alternatives, receiver-in-aid (RIA) and receiver-in-canal (RIC), are examined. Study Samples: The two expressions of hearing losses examined were the 25% ABG + AC approach and the 75% ABG + BC approach, where ABG refers to air-bone gap, AC refers to air-conduction threshold, and BC refers to bone-conduction threshold. Example hearing loss cases with a conductive component are sampled for calculations. The MPO capabilities of the BTE receiver placements in commercially-available products were obtained from hearing aids on the U.S. federal purchasing contract. Results: Prescribed gain and the required MPO differs markedly between the two approaches. The 75% ABG + BC approach prescribes a compression ratio that is reflective of the amount of sensorineural hearing loss. Not all hearing aids will have the MPO capabilities to support the output requirements for fitting hearing losses with a large conductive component particularly when combined with significant sensorineural hearing loss. Generally, current RIA BTE products have greater output capabilities than RIC BTE products. Conclusions: The 75% ABG + BC approach is more appropriate than the 25% ABG + AC approach because the latter approach inappropriately uses AC thresholds as the basis for determining the compression ratio. That is, for hearing losses with a conductive component, the AC thresholds are not a measure of sensorineural hearing loss and cannot serve as the basis for determining the amount of desired compression. The Australian National Acoustic Laboratories has been using the 75% ABG + BC approach in lieu of the 25% ABG + AC approach since its release of the National Acoustic Laboratories—Non-linear 1 (NAL-NL1) prescriptive method in 1999. Future research may examine whether individuals with conductive hearing loss benefit or prefer more than 75% restoration of the conductive component provided adequate MPO capabilities to support such restoration.


1998 ◽  
Vol 107 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Ad F. M. Snik ◽  
Andy J. Beynon ◽  
Catharina T. M. van der Pouw ◽  
Emmanuel A. M. Mylanus ◽  
Cor W. R. J. Cremers

Most, but not all, hearing-impaired patients with air conduction hearing aids prefer binaural amplification instead of monaural amplification. The binaural application of the bone conduction hearing aid is more disputable, because the attenuation (in decibels) of sound waves across the skull is so small (10 dB) that even one bone conduction hearing aid will stimulate both cochleas approximately to the same extent. Binaural fitting of the bone-anchored hearing aid was studied in three experienced bone-anchored hearing aid users. The experiments showed that sound localization, and speech recognition in quiet and also under certain noisy conditions improved significantly with binaural listening compared to the monaural listening condition. On the average, the percentage of correct identifications (within 45°) in the sound localization experiment improved by 53% with binaural listening; the speech reception threshold in quiet improved by 4.4 dB. The binaural advantage in the speech-in-noise test was comparable to that of a control group of subjects with normal hearing listening monaurally versus binaurally. The improvements in the scores were ascribed to diotic summation (improved speech recognition in quiet) and the ability to separate sounds in the binaural listening condition (improved sound localization and improved speech recognition in noise whenever the speech and noise signals came from different directions). All three patients preferred the binaural bone-anchored hearing aids and used them all day.


2017 ◽  
Vol 96 (7) ◽  
pp. E28-E33 ◽  
Author(s):  
Timothy Mclean ◽  
Irumee Pai ◽  
Andrew Philipatos ◽  
Michael Gordon

We prospectively evaluated the surgical, audiologic, and quality-of-life outcomes in 5 patients—2 men and 3 women, aged 22 to 64 years (mean: 41.8)—who were implanted with the Sophono Alpha 2 MPO Processor. The indications for implantation of this bone-conduction device included recurrent ear canal infections with hearing aids (n = 3), single-sided deafness (n = 1), and patient preference in view of difficulty using a conventional hearing aid (n = 1). In addition to the patient with single-sided deafness, 3 patients had a bilateral mixed hearing loss and 1 had a bilateral conductive hearing loss. Outcomes measures included surgical complications, functional gain (FG), speech discrimination in quiet and noise, and patient satisfaction as determined by the Glasgow Benefit Inventory (GBI) and the Entific Medical Systems bone-anchored hearing aid questionnaire (BAQ). The only postsurgical complication noted was a minor skin reaction and pain in 1 patient that resolved with conservative management. In the 3 patients with the mixed hearing loss, the mean FG was 13.3, 20.0, 11.7, and 11.7 dB at 0.5, 1, 2, and 4 kHz, respectively; in the patient with the bilateral conductive hearing loss, the FG was 10, 25, 10, and 15 dB at the same frequencies. Speech discrimination scores with the Sophono device were comparable to those seen with conventional hearing aids. After implantation, all 5 patients experienced a positive quality-of-life outcome according to the GBI, although 1 of them had only a marginal improvement. On follow-up, all patients reported that they remained satisfied with their implant and that they used their device all day long. We conclude that the Sophono bone-conduction system is a safe and effective option that should be considered for patients with a mixed or conductive hearing loss who are unable to use a conventional hearing aid, as well as for those with single-sided deafness.


1996 ◽  
Vol 110 (21) ◽  
pp. 41-46 ◽  
Author(s):  
S. H. Hartland ◽  
D. W. Proops

AbstractBone anchored hearing aids (BAHA) have been implanted in Birmingham since 1988. Since this time confidence has grown in the fitting and rehabilitation of BAHA wearers, with a corresponding increase in the implantation and rehabilitation of more difficult and borderline candidates.This study analyses the results of 16 borderline BAHA candidates who have been assessed and fitted with a BAHA at Birmingham Children's Hospital and Queen Elizabeth Hospital, and who have had at least one post-fitting review. All of these subjects had mean bone conduction (BC) thresholds, in the better hearing ear, in excess of 45 dBHL in the frequency range 0.5–4 kHz, when initially assessed. The age range at the time of the study was 10–84 years, with a mean age of 60 years. The study demonstrates the benefits that these patients achieved with the BAHA compared to their previous aid, both audiologically and in terms of comfort and reduction in ear discharge.


Sign in / Sign up

Export Citation Format

Share Document