Air Conduction, Bone Conduction, and Soft Tissue Conduction Audiograms in Normal Hearing and Simulated Hearing Losses

2015 ◽  
Vol 26 (01) ◽  
pp. 101-108 ◽  
Author(s):  
Cahtia Adelman ◽  
Adi Cohen ◽  
Adi Regev-Cohen ◽  
Shai Chordekar ◽  
Rachel Fraenkel ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Soft Tissue ◽  
Middle Ear ◽  
Bone Conduction ◽  
Auditory Stimulation ◽  
Threshold Shift ◽  
N Application ◽  
Similar Threshold ◽  
Air Conduction

Background: In order to differentiate between a conductive hearing loss (CHL) and a sensorineural hearing loss (SNHL) in the hearing-impaired individual, we compared thresholds to air conduction (AC) and bone conduction (BC) auditory stimulation. The presence of a gap between these thresholds (an air-bone gap) is taken as a sign of a CHL, whereas similar threshold elevations reflect an SNHL. This is based on the assumption that BC stimulation directly excites the inner ear, bypassing the middle ear. However, several of the classic mechanisms of BC stimulation such as ossicular chain inertia and the occlusion effect involve middle ear structures. An additional mode of auditory stimulation, called soft tissue conduction (STC; also called nonosseous BC) has been demonstrated, in which the clinical bone vibrator elicits hearing when it is applied to soft tissue sites on the head, neck, and thorax. Purpose: The purpose of this study was to assess the relative contributions of threshold determinations to stimulation by STC, in addition to AC and osseous BC, to the differential diagnosis between a CHL and an SNHL. Research Design: Baseline auditory thresholds were determined in normal participants to AC (supra-aural earphones), BC (B71 bone vibrator at the mastoid, with 5 N application force), and STC (B71 bone vibrator) to the submental area and to the submandibular triangle with 5 N application force) stimulation in response to 0.5, 1.0, 2.0, and 4.0 kHz tones. A CHL was then simulated in the participants by means of an ear plug. Separately, an SNHL was simulated in these participants with 30 dB effective masking. Study sample: Study sample consisted of 10 normal-hearing participants (4 males; 6 females, aged 20–30 yr). Data Collection and Analysis: AC, BC, and STC thresholds were determined in the initial normal state and in the presence of each of the simulations. Results: The earplug-induced CHL simulation led to a mean AC threshold elevation of 21–37 dB (depending on frequency), but not of BC and STC thresholds. The masking-induced SNHL led to a mean elevation of AC, BC, and STC thresholds (23–36 dB, depending on frequency). In each type of simulation, the BC threshold shift was similar to that of the STC threshold shift. Conclusions: These results, which show a similar threshold shift for STC and for BC as a result of these simulations, together with additional clinical and laboratory findings, provide evidence that BC thresholds likely represent the threshold of the nonosseous BC (STC) component of multicomponent BC at the BC stimulation site, and thereby succeed in clinical practice to contribute to the differential diagnosis. This also provides evidence that STC (nonosseous BC) stimulation at low intensities probably does not involve components of the middle ear, represents true cochlear function, and therefore can also contribute to a differential diagnosis (e.g., in situations where the clinical bone vibrator cannot be applied to the mastoid or forehead with a 5 N force, such as in severe skull fracture).

scholarly journals Fundamental Principles of Bone Conduction Hearing in Humans

2020 ◽  
Vol I (3) ◽  
pp. 28-32
Author(s):  
Georgios K Panagiotopoulos
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Auditory Perception ◽  
Bone Conduction ◽  
Sound Transmission ◽  
Auditory Pathway ◽  
Routine Practice ◽  
Clinical Routine ◽  
Bone Conduction Hearing ◽  
Air Conduction

Bone conduction involves sound transmission through bone oscillations of the skull or neighboring body areas, resulting in auditory perception. Its significance is not confined to differential diagnosis of hearing loss only. It represents a secondary auditory pathway supplementing air conduction process co instantaneously. Known bio-mechanical mechanisms involved in bone conduction in humans are analyzed and summarized in a most concise way including most recent updates that improve current clinical routine practice. Nevertheless, longstanding assumptions still need further research in order to establish a thorough bone and tissue conduction understanding.

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

Fluctuating hearing loss in presbyacusis

1988 ◽  
Vol 102 (1) ◽  
pp. 25-26
Author(s):  
F. W. Martin ◽  
R. W. Ruckley
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Bone Conduction ◽  
Simple Explanation ◽  
Subjective Improvement ◽  
Middle Ear Pressure ◽  
Before And After ◽  
Valsalva's Manoeuvre ◽  
Fluctuating Hearing Loss ◽  
Air Conduction

AbstractThirty-six patients with bilateral symmetrical presbyacusis who reported a temporary improvement in the hearing of one ear following a Valsalva's manoeuvre were further investigated. Bone conduction and air conduction thresholds, middle ear pressure and middle ear compliance were measured before and after Valsalva's manoeuvre in the ears which had a subjective improvement in hearing following auto-inflation. Bone conduction thresholds remained unaltered in 66 per cent of ears while average air conduction thresholds varied by less than 5 decibels. Middle ear pressure was unchanged in over half the ears tested and in 81 per cent of the ears there was no change in middle ear compliance. There appears to be no simple explanation for the temporary subjective fluctuation in hearing reported by patients with presbyacusis.

Mutual cancellation between tones presented by air conduction, by bone conduction and by non-osseous (soft tissue) bone conduction

2012 ◽  
Vol 283 (1-2) ◽  
pp. 180-184 ◽  
Author(s):  
Shai Chordekar ◽  
Leonid Kriksunov ◽  
Liat Kishon-Rabin ◽  
Cahtia Adelman ◽  
Haim Sohmer
Keyword(s):  
Soft Tissue ◽  
Bone Conduction ◽  
Air Conduction

Ataxia and Hearing Loss Secondary to Perilymphatic Fistula

PEDIATRICS ◽  
1978 ◽  
Vol 61 (2) ◽  
pp. 238-241
Author(s):  
Gerald B. Healy ◽  
Jules M. Friedman ◽  
Joseph DiTroia
Keyword(s):  
Hearing Loss ◽  
Soft Tissue ◽  
Head Trauma ◽  
Middle Ear ◽  
Vestibular System ◽  
Perilymphatic Fistula ◽  
Labyrinthine Fistula ◽  
First Case ◽  
The Absolute ◽  
Physical Findings

Ataxia is rarely attributed to lesions of the peripheral vestibular system. In 1973, the first case of ataxia and hearing loss secondary to a labyrinthine fistula was reported. Until now, this syndrome has not been reported in patients under the age of 10 years. A case is presented of a 5-year-old boy with symptoms of ataxia and hearing loss as well as vertigo and tinnitus after head trauma. Three physical findings appear to be most characterisitic of patients with perilymphatic fistulas: a positive fistula response, positive positional testing with the involved ear down, and evidence of vestibular ataxia when testing station and gait. The absolute diagnosis of perilymphatic fistula can only be established by exploration of the middle ear space. If a fistula is found, it may be sealed with soft tissue and, if this fails, actual stapedectomy may be required.

Conductive SISI Test

1974 ◽  
Vol 83 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Vincent W. Byers
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Statistical Difference ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Sensitivity Index ◽  
Index Test ◽  
Bone Conduction Threshold ◽  
Conductive Hearing

The conductive SISI (short increment sensitivity index) test is an indirect procedure to estimate bone-conduction thresholds for middle ear pathology patients. A series of SISI tests are run, beginning at 20 dB S.L. and increasing in 10 dB S.L. steps, until a 100% SISI score is obtained. The following equation predicts the bone-conduction threshold: [Formula: see text] The results of 25 conductive SISI tests on a conductive hearing loss group indicate that the equation approximates the measured B.C. threshold. There was no statistical difference between the predicated B.C. thresholds (12.4 dB) and measured B.C. thresholds (10.4 dB) for the group.

Study for the interaction between the medium in the middle ear and vibro-acoustic transmission

2021 ◽  
Vol 263 (1) ◽  
pp. 5538-5540
Author(s):  
Jeon Jonghoon ◽  
Jonghoon Jeon ◽  
Kyunglae Gu ◽  
Junhong Park
Keyword(s):  
Middle Ear ◽  
Geometric Model ◽  
Signal Transmission ◽  
Bone Conduction ◽  
Human Perception ◽  
Transmission Mechanism ◽  
Evaluation Indexes ◽  
Individual Evaluation ◽  
Priority Factor ◽  
Air Conduction

This study presented a quantitative evaluation index related to sound response for diagnosis of middle ear condition. The signal transmission paths for human perception of sound are divided into bone conduction and air conduction, respectively, depending on the path through which vibration and sound are transmitted. The components of auditory system that can affect the sound signal variability include temporal bone, ear canal, eardrum, and middle ear cavity. The specific acoustic impedances were obtained through simple geometric model of the auditory components, and the sound transmission mechanism was implemented through the outer-middle ear circuit model. The frequency range corresponding to the resonance characteristics of each components were calculated. The response difference for the medium of middle ear was confirmed by deriving frequency response function between the input sound and the output sound in the frequency domain through the transfer function method. The reliability of the algorithm was confirmed through the ROC curve, and individual evaluation indexes were derived according to the priority factor between classification accuracy and error rate.

scholarly journals Hearing gain after myringoplasty in relation to the size of tympanic membrane perforation

2020 ◽  
Vol 25 (1) ◽  
pp. 54-59
Author(s):  
Sutanu Kumar Mondal ◽  
Ashim Kumar Biswas ◽  
Md Mahmudul Huq ◽  
Md Hasan Ali ◽  
Md Kamruzzaman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Bone Conduction ◽  
Tympanic Membrane Perforation ◽  
Medium Size ◽  
Hearing Gain ◽  
Bone Conduction Threshold ◽  
Large Size ◽  
Membrane Perforation ◽  
Air Conduction

Objectives: To assess hearing gain after successful myringoplasty in relation to the size of tympanic membrane perforation. Methods: This cross-sectional study was done in the department of otolaryngology and head neck surgery, BSMMU, Sahbag, Dhaka during the period of January 2009 to December 2010.A total of 60 patients were under went myringoplasty operation after taking detailed history, clinical examination and investigation. Preoperative and postoperative hearing assessment was done. Analysed data presented by various tables, graphics and figures. Results: In case of small size perforation preoperative mean bone conduction threshold was 7.66 dB, mean air conduction threshold was 34.14 dB and mean air bone gap was 26.48 dB. In case of medium size perforation preoperative mean bone conduction threshold was 9.61 dB, mean air conduction threshold was 44.48 dB. Mean air bone gap was 34.87 dB. In case of large size perforation preoperative mean bone conduction threshold was 13.12 dB, mean air conduction threshold was 59 dB, and mean air bone gap was 45.88 dB. Hearing loss increases with increasing size of perforation. Ahmed and Rahim (1979) showed in the study that hearing loss increases with increasing the size of the perforation which was relevant in the study. After myringoplasty post-operative mean air bone gap was 21.24 dB in small size, 21.74 dB in medium sized and 24 dB in large size. From the record improvement of mean air bone gap or hearing gain was 5.24 dB in small size perforation respectively. The different of air bone gap closure between small and medium size perforation was statistically significant by unpaired’ test. Conclusion: Hearing gain after myringoplasty is better in large size perforation. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 54-59

Role of ossiculoplasty in canal wall down tympanoplasty for middle-ear cholesteatoma: hearing results

2006 ◽  
Vol 121 (4) ◽  
pp. 324-328 ◽  
Author(s):  
E De Corso ◽  
M R Marchese ◽  
B Sergi ◽  
M Rigante ◽  
G Paludetti
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Consecutive Series ◽  
Canal Wall ◽  
Hearing Results ◽  
Middle Ear Cholesteatoma ◽  
Canal Wall Down ◽  
The Mean ◽  
Air Conduction ◽  
Cholesteatoma Surgery

The aim of this study was to evaluate the hearing results of ossiculoplasty in canal wall down tympanoplasty in one stage middle-ear cholesteatoma surgery.We carried out a retrospective review of a consecutive series of 142 cases which had undergone type two or three canal wall down tympanoplasty with ossicular reconstruction, between January 1995 and December 2002, due to chronic otitis media with cholesteatoma.Pre-operative audiometric testing revealed a mean air conduction pure tone average (PTA) of 50.97 dB and a mean bone conduction PTA of 22.14 dB. The mean post-operative result for air conduction PTA was 37.62 and for bone conduction PTA was 23.37 dB. The mean pre- and post-operative air–bone gaps (ABGs) were 28.83 and 13.94 dB, respectively, with a gain of 14.89 dB. Almost 62.67 per cent of patients closed their ABGs to within 20 dB.Our functional results are comparable with those of other authors. In the present study, we show that hearing improvement is possible following cholesteatoma surgery with canal wall down tympanoplasty and ossicular chain reconstruction.

Sign in / Sign up

Export Citation Format

Share Document