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      Review of Bone Conduction Hearing Devices

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          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.

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          Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period.

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            Bone-conducted sound: physiological and clinical aspects.

            The fact that vibration of the skull causes a hearing sensation has been known since the 19th century. This mode of hearing was termed hearing by bone conduction. Although there has been more than a century of research on hearing by bone conduction, its physiology is not completely understood. Lately, new insights into the physiology of hearing by bone conduction have been reported. Knowledge of the physiology, clinical aspects, and limitations of bone conduction sound is important for clinicians dealing with hearing loss and is the purpose of this review. The data were compiled from the published literature in the areas of clinical bone conduction hearing, bone conduction hearing aids, basic research on bone conduction physiology, and recent research on bone conduction hearing from our laboratory. Five factors contributing to bone conduction hearing have been identified: 1) sound radiated into the external ear canal, 2) middle ear ossicle inertia, 3) inertia of the cochlear fluids, 4) compression of the cochlear walls, and 5) pressure transmission from the cerebrospinal fluid. Of these five, inertia of the cochlear fluid seems most important. Bone conduction sound is believed to reflect the true cochlear function; however, certain conditions such as middle ear diseases can affect bone conduction sensitivity, but less than for air conduction. The bone conduction route can also be used for hearing aids; since the bone conduction route is less efficient than the air conduction route, bone conduction hearing aids are primarily used for hearing losses where air conduction hearing aids are contraindicated.
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              Osseointegrated titanium implants in the temporal bone. A clinical study on bone-anchored hearing aids.

              The purpose of this study is to investigate the possibilities for attaching a new type of direct bone conduction hearing aid. Using a gentle surgical technique, titanium screws were inserted into the temporal bone of fourteen patients suffering from hearing impairment. The implants became integrated with the living bone tissue and have remained so for a follow-up period of, at present, two to four years. It is therefore concluded that titanium implants may be osseointegrated in the temporal bone in a similar manner to that previously described for long bones. The bone-anchored titanium screws were connected to a permanently skin-penetrating abutment, which in turn was used for attachment to a hearing aid. In this way a direct bone conduction without obstructing soft tissue layers is secured. The permanent skin penetration caused no adverse soft tissue effects. The new system has improved pure-tone hearing threshold by about 15 dB. Further research is aimed at the construction of a new hearing aid that is better adapted to the impedance situation existing in the directly bone-anchored cases.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Audiol Res
                Audiol Res
                audiolres
                Audiology Research
                MDPI
                2039-4330
                2039-4349
                18 May 2021
                June 2021
                : 11
                : 2
                : 207-219
                Affiliations
                Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor, MI 48109, USA; emnairn@ 123456med.umich.edu (E.M.N.); estucken@ 123456med.umich.edu (E.Z.S.)
                Author notes
                Article
                audiolres-11-00019
                10.3390/audiolres11020019
                8161441
                34069846
                815d2424-cc69-443b-bdd0-214405ee96b1
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 12 March 2021
                : 06 May 2021
                Categories
                Review

                bone conduction,bone-anchored hearing aid,osseointegrated implant,transcutaneous bone conduction,percutaneous bone conduction

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