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A special issue of Audiology Research (ISSN 2039-4349).

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 49531

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Dr. Tadashi Nishimura

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Guest Editor

Department of Otolaryngology-Head & Neck Surgery, Nara Medical University, Nara 634-8521, Japan
Interests: otology; neurotology; audiology; hearing aid; hearing; implantation; bone conduction, cartilage conduction
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Special Issue Information

Dear Colleagues,

Signal is transmitted to the cochlea not only via air-conduction (AC) but also by vibrating the body, particularly mastoid. This conduction is referred as bone conduction (BC), and considered an important pathway in the patients with severe conduction hearing loss, such as aural atresia.

Traditionally, BC hearing aids have been used as hearing devices. Implantable devices such BAHA, Bonebridge, and Vibrant Soundbridge have been developed and become a great option in these patients. In addition, a novel hearing aids utilizing cartilage-conduction (CC) (vibrating aural cartilage for signal transmission) has been devised. This novel device improves the demerits of conventional BC hearing aids, and can be used without any surgical operation. Therefore, their use has quickly popular among the patients with aural atresia in Japan.

Recently, the medical use of this field is remarkable. Compared to AC, there are many things that remain unexplained. This special issue of BC and CC is an attempt to further our understating of sound transmission and develop its medical use. We especially encourage submissions concerning basic research on them and clinical devices utilizing these conductions.

Dr. Tadashi Nishimura
Guest Editor

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Keywords

Bone conducition
Cartilage conduction
Hearing aid
BAHA
Bonebridge
Vibrant Soundbridge
Implant
Aural Atresia
Conductive hearing loss
Single side deafness

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Published Papers (12 papers)

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Editorial

Jump to: Research, Review

2 pages, 160 KiB

Open AccessEditorial

Bone and Cartilage Conduction

by Tadashi Nishimura

Audiol. Res. 2022, 12(1), 77-78; https://doi.org/10.3390/audiolres12010007 - 18 Jan 2022

Cited by 1 | Viewed by 2254

Abstract

Auditory sensation is an important sensation for human beings [...] Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

Research

Jump to: Editorial, Review

10 pages, 1069 KiB

Open AccessArticle

Audiological Performance of ADHEAR Systems in Simulated Conductive Hearing Loss: A Case Series with a Review of the Existing Literature

by Enrico Muzzi, Valeria Gambacorta, Ruggero Lapenna, Giulia Pizzamiglio, Sara Ghiselli, Igor Caregnato, Raffaella Marchi, Giampietro Ricci and Eva Orzan

Audiol. Res. 2021, 11(4), 537-546; https://doi.org/10.3390/audiolres11040048 - 13 Oct 2021

Cited by 4 | Viewed by 4553

Abstract

A new non-invasive adhesive bone conduction hearing device (ABCD) has been proposed as an alternative solution for reversible bilateral conductive hearing loss in recurrent or long-lasting forms of otitis media with effusion (OME) in children that cannot undergo surgical treatment. Our aim was to assess the effectiveness of ABCD in children with OME. Twelve normal-hearing Italian-speaking volunteers, in whom a conductive hearing loss was simulated, participated in the study. The free-field average hearing threshold was determined and, to evaluate binaural hearing skills, loudness summation and the squelch effect were assessed. Five conditions were tested: (1) unaided without earplugs, (2) unaided with bilateral earplugs, (3) aided right ear with bilateral earplugs, (4) aided left ear with bilateral earplugs, and (5) bilateral aid with bilateral earplugs. Post-hoc analysis showed a significant statistical difference between plugged, unplugged, and each aided condition. The main results were a better loudness summation and a substantial improvement of the squelch effect in the bilaterally aided. Our results suggest that ABCD is a valid treatment for patients with conductive hearing loss that cannot undergo bone conduction implant surgery. It is also important to consider bilateral aids in order to deal with situations in which binaural hearing is fundamental. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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8 pages, 465 KiB

Open AccessArticle

Clinical Trial for Cartilage Conduction Hearing Aid in Indonesia

by Ronny Suwento, Dini Widiarni Widodo, Tri Juda Airlangga, Widayat Alviandi, Keisuke Watanuki, Naoko Nakanowatari, Hiroshi Hosoi and Tadashi Nishimura

Audiol. Res. 2021, 11(3), 410-417; https://doi.org/10.3390/audiolres11030038 - 13 Aug 2021

Cited by 10 | Viewed by 3365

Abstract

Hearing improvement represents one of the may valuable outcomes in microtia and aural atresia reconstruction surgery. Most patients with poor development in their hearing function have had a severe microtia. Conventional methods to improve hearing function are bone conduction and bone anchored hearing aids. Cartilage conduction hearing aids (CCHA) represents a new amplification method. This study assessed the outcomes and evaluated the impact and its safety in the patients with microtia and aural atresia whose hearing dysfunction did not improve after surgery for ear reconstruction in our hospital. Hearing functions were evaluated with pure tone audiometry or sound field testing by behavioral audiometry and speech audiometry before and after CCHA fitting. As a result, there was a significant difference between unaided and aided thresholds (p < 0.001). Speech recognition threshold and speech discrimination level also significantly improved with CCHA. The average functional gains of 14 ears were 26.9 ± 2.3 dB. Almost all parents of the patients reported satisfaction with the performance of CCHA, and daily communication in children with hearing loss also became better than usual. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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8 pages, 3307 KiB

Open AccessArticle

Word Categorization of Vowel Durational Changes in Speech-Modulated Bone-Conducted Ultrasound

by Tadao Okayasu, Tadashi Nishimura, Akinori Yamashita, Yoshiki Nagatani, Takashi Inoue, Yuka Uratani, Toshiaki Yamanaka, Hiroshi Hosoi and Tadashi Kitahara

Audiol. Res. 2021, 11(3), 357-364; https://doi.org/10.3390/audiolres11030033 - 14 Jul 2021

Cited by 1 | Viewed by 2197

Abstract

Ultrasound can deliver speech information when it is amplitude-modulated with speech and presented via bone conduction. This speech-modulated bone-conducted ultrasound (SM-BCU) can also transmit prosodic information. However, there is insufficient research on the recognition of vowel duration in SM-BCU. The aim of this study was to investigate the categorization of vowel durational changes in SM-BCU using a behavioral test. Eight Japanese-speaking participants with normal hearing participated in a forced-choice behavioral task to discriminate between “hato” (pigeon) and “haato” (heart). Speech signal stimuli were presented in seven duration grades from 220 ms to 340 ms. The threshold at which 50% of responses were “haato” was calculated and compared for air-conducted audible sound (ACAS) and SM-BCU. The boundary width was also evaluated. Although the SM-BCU threshold (mean: 274.6 ms) was significantly longer than the ACAS threshold (mean: 269.6 ms), there were no differences in boundary width. These results suggest that SM-BCU can deliver prosodic information about vowel duration with a similar difference limen to that of ACAS in normal hearing. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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8 pages, 1923 KiB

Open AccessFeature PaperArticle

Vibrational and Acoustical Characteristics of Ear Pinna Simulators That Differ in Hardness

by Ryota Shimokura, Tadashi Nishimura and Hiroshi Hosoi

Audiol. Res. 2021, 11(3), 327-334; https://doi.org/10.3390/audiolres11030030 - 1 Jul 2021

Cited by 9 | Viewed by 3682

Abstract

Because cartilage conduction—the transmission of sound via the aural cartilage—has different auditory pathways from well-known air and bone conduction, how the output volume in the external auditory canal is stimulated remains unknown. To develop a simulator approximating the conduction of sound in ear cartilage, the vibrations of the pinna and sound in the external auditory canal were measured using pinna simulators made of silicon rubbers of different hardness (A40, A20, A10, A5, A0) as measured by a durometer. The same procedure, as well as a current calibration method for air conduction devices, was applied to an existing pinna simulator, the Head and Torso Simulator (hardness A5). The levels for vibration acceleration and sound pressure from these pinna simulators show spectral peaks at dominant frequencies (below 1.5 kHz) for the conduction of sound in cartilage. These peaks were likely to move to lower frequencies as hardness decreases. On approaching the hardness of actual aural cartilage (A10 to A20), the simulated levels for vibration acceleration and sound pressure approximated the measurements of human ears. The adjustment of the hardness used in pinna simulators is an important factor in simulating accurately the conduction of sound in cartilage. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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7 pages, 872 KiB

Open AccessArticle

Benefits of Cartilage Conduction Hearing Aids for Speech Perception in Unilateral Aural Atresia

by Sakie Akasaka, Tadashi Nishimura, Hiroshi Hosoi, Osamu Saito, Ryota Shimokura, Chihiro Morimoto and Tadashi Kitahara

Audiol. Res. 2021, 11(2), 284-290; https://doi.org/10.3390/audiolres11020026 - 17 Jun 2021

Cited by 10 | Viewed by 2482

Abstract

Severe conductive hearing loss due to unilateral aural atresia leads to auditory and developmental disorders, such as difficulty in hearing in challenging situations. Bone conduction devices compensate for the disability but unfortunately have several disadvantages. The aim of this study was to evaluate the benefits of cartilage conduction (CC) hearing aids for speech perception in unilateral aural atresia. Eleven patients with unilateral aural atresia were included. Each participant used a CC hearing aid in the atretic ear. Speech recognition scores in the binaural hearing condition were obtained at low speech levels to evaluate the contribution of aided atretic ears to speech perception. Speech recognition scores were also obtained with and without presentation of noise. These assessments were compared between the unaided and aided atretic ear conditions. Speech recognition scores at low speech levels were significantly improved under the aided atretic ear condition (p < 0.05). A CC hearing aid in the unilateral atretic ear did not significantly improve the speech recognition score in a symmetrical noise presentation condition. The binaural hearing benefits of CC hearing aids in unilateral aural atresia were predominantly considered a diotic summation. Other benefits of binaural hearing remain to be investigated. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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12 pages, 3301 KiB

Open AccessArticle

Management of Residual Hearing with Cartilage Conduction Hearing Aid after Lateral Temporal Bone Resection: Our Institutional Experience

by Noritaka Komune, Yoshie Higashino, Kazuha Ishikawa, Tomoko Tabuki, Shogo Masuda, Kensuke Koike, Takahiro Hongo, Kuniaki Sato, Ryutaro Uchi, Masaru Miyazaki, Ryo Shimamoto, Nana Akagi Tsuchihashi, Ryunosuke Kogo, Teppei Noda, Nozomu Matsumoto and Takashi Nakagawa

Audiol. Res. 2021, 11(2), 263-274; https://doi.org/10.3390/audiolres11020024 - 9 Jun 2021

Cited by 5 | Viewed by 2916

Abstract

Background: There is no guideline for hearing compensation after temporal bone resection. This study aimed to retrospectively analyze surgical cases with reconstruction for hearing preservation after temporal bone malignancy resection and propose a new alternative to compensate for hearing loss. Methods: We retrospectively reviewed the medical records of 30 patients who underwent lateral temporal bone surgery for temporal bone malignancy at our institution and examined their hearing abilities after surgery. Result: The hearing outcomes of patients with an external auditory meatus reconstruction varied widely. The mean postoperative air–bone gap at 0.5, 1, 2, and 4 kHz ranged from 22.5 dB to 71.25 dB. On the other hand, the average difference between the aided sound field thresholds with cartilage conduction hearing aid and bone conduction thresholds at 0.5, 1, 2, and 4 kHz ranged from −3.75 to 41.25. More closely located auricular cartilage and temporal bone resulted in smaller differences between the aided sound field and bone conduction thresholds. Conclusions: There is still room for improvement of surgical techniques for reconstruction of the auditory meatus to preserve hearing after temporal bone resection. The cartilage conduction hearing aid may provide non-invasive postoperative hearing compensation after lateral temporal bone resection. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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Review

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16 pages, 533 KiB

Open AccessReview

Sound Localization and Lateralization by Bilateral Bone Conduction Devices, Middle Ear Implants, and Cartilage Conduction Hearing Aids

by Kimio Shiraishi

Audiol. Res. 2021, 11(4), 508-523; https://doi.org/10.3390/audiolres11040046 - 30 Sep 2021

Cited by 6 | Viewed by 5432

Abstract

Sound localization in daily life is one of the important functions of binaural hearing. Bilateral bone conduction devices (BCDs), middle ear implants, and cartilage conduction hearing aids have been often applied for patients with conductive hearing loss (CHL) or mixed hearing loss, for example, resulting from bilateral microtia and aural atresia. In this review, factors affecting the accuracy of sound localization with bilateral BCDs, middle ear implants, and cartilage conduction hearing aids were classified into four categories: (1) types of device, (2) experimental conditions, (3) participants, and (4) pathways from the stimulus sound to both cochleae. Recent studies within the past 10 years on sound localization and lateralization by BCDs, middle ear implants, and cartilage conduction hearing aids were discussed. Most studies showed benefits for sound localization or lateralization with bilateral devices. However, the judgment accuracy was generally lower than that for normal hearing, and the localization errors tended to be larger than for normal hearing. Moreover, it should be noted that the degree of accuracy in sound localization by bilateral BCDs varied considerably among patients. Further research on sound localization is necessary to analyze the complicated mechanism of bone conduction, including suprathreshold air conduction with bilateral devices. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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7 pages, 367 KiB

Open AccessEditor’s ChoiceReview

How Is the Cochlea Activated in Response to Soft Tissue Auditory Stimulation in the Occluded Ear?

by Miriam Geal-Dor and Haim Sohmer

Audiol. Res. 2021, 11(3), 335-341; https://doi.org/10.3390/audiolres11030031 - 9 Jul 2021

Cited by 2 | Viewed by 2463

Abstract

Soft tissue conduction is an additional mode of auditory stimulation which can be initiated either by applying an external vibrator to skin sites not overlying skull bone such as the neck (so it is not bone conduction) or by intrinsic body vibrations resulting, for example, from the heartbeat and vocalization. The soft tissue vibrations thereby induced are conducted by the soft tissues to all parts of the body, including the walls of the external auditory canal. In order for soft tissue conduction to elicit hearing, the soft tissue vibrations which are induced must penetrate into the cochlea in order to excite the inner ear hair cells and auditory nerve fibers. This final stage can be achieved either by an osseous bone conduction mechanism, or, more likely, by the occlusion effect: the vibrations of the walls of the occluded canal induce air pressures in the canal which drive the tympanic membrane and middle ear ossicles and activate the inner ear, acting by means of a more air conduction-like mechanism. In fact, when the clinician applies his stethoscope to the body surface of his patient in order to detect heart sounds or pulmonary air flow, he is detecting soft tissue vibrations. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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9 pages, 1278 KiB

Open AccessReview

Cartilage Conduction Hearing and Its Clinical Application

by Tadashi Nishimura, Hiroshi Hosoi, Ryota Shimokura, Chihiro Morimoto and Tadashi Kitahara

Audiol. Res. 2021, 11(2), 254-262; https://doi.org/10.3390/audiolres11020023 - 3 Jun 2021

Cited by 13 | Viewed by 4197

Abstract

Cartilage conduction (CC) is a form of conduction that allows a relatively loud sound to be audible when a transducer is placed on the aural cartilage. The CC transmission mechanism has gradually been elucidated, allowing for the development of CC hearing aids (CC-HAs), which are clinically available in Japan. However, CC is still not fully understood. This review summarizes previous CC reports to facilitate its understanding. Concerning the transmission mechanism, the sound pressure level in the ear canal was found to increase when the transducer was attached to the aural cartilage, compared to an unattached condition. Further, inserting an earplug and injecting water into the ear canal shifted the CC threshold, indicating the considerable influence of cartilage–air conduction on the transmission. In CC, the aural cartilage resembles the movable plate of a vibration speaker. This unique transduction mechanism is responsible for the CC characteristics. In terms of clinical applications, CC-HAs are a good option for patients with aural atresia, despite inferior signal transmission compared to bone conduction in bony atretic ears. The advantages of CC, namely comfort, stable fixation, esthetics, and non-invasiveness, facilitate its clinical use. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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10 pages, 1337 KiB

Open AccessFeature PaperReview

Perception Mechanism of Bone-Conducted Ultrasound and Its Clinical Use

by Tadashi Nishimura, Tadao Okayasu, Akinori Yamashita, Hiroshi Hosoi and Tadashi Kitahara

Audiol. Res. 2021, 11(2), 244-253; https://doi.org/10.3390/audiolres11020022 - 30 May 2021

Cited by 3 | Viewed by 3216

Abstract

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. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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13 pages, 882 KiB

Open AccessEditor’s ChoiceReview

Review of Bone Conduction Hearing Devices

by Susan E. Ellsperman, Emily M. Nairn and Emily Z. Stucken

Audiol. Res. 2021, 11(2), 207-219; https://doi.org/10.3390/audiolres11020019 - 18 May 2021

Cited by 52 | Viewed by 10062

Abstract

Bone conduction is an efficient pathway of sound transmission which can be harnessed to provide hearing amplification. Bone conduction hearing devices may be indicated when ear canal pathology precludes the use of a conventional hearing aid, as well as in cases of single-sided deafness. Several different technologies exist which transmit sound via bone conduction. Here, we will review the physiology of bone conduction, the indications for bone conduction amplification, and the specifics of currently available devices. Full article

(This article belongs to the Special Issue Bone and Cartilage Conduction)

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