Effect of transducer placements on thresholds in ears with an abnormal ear canal and severe conductive hearing loss

Nishimura, Tadashi; Hosoi, Hiroshi; Saito, Osamu; Shimokura, Ryota; Morimoto, Chihiro; Okayasu, Tadao; Kitahara, Tadashi

doi:10.1002/lio2.697

Cited by 6 publications

(7 citation statements)

References 32 publications

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“…In cases with fibrotic aural atresia, fibrotic tissue may be connected to the ossicles. Sound can travel to the cochlea via these fibrotic tissues and ossicles (fibrotic tissue pathway) without skull bone vibration, which achieves excellent benefits from CC hearing devices [27,28]. In this study, there was no fibrotic tissue pathway in four ears.…”

Section: Discussionmentioning

confidence: 62%

“…CC hearing devices have better aided hearing levels than ADHEAR [19], which may result from the difference not only in the transducer output, but also place of fixation, thickness of the fixation tape, and mass of the transducer. Regarding the fixation place, the thresholds for cartilage stimulation are better than those for mastoid stimulation at low frequencies when the simple-type transducer is used [28]. In ADHEAR and CC hearing devices with simple-type transducers, the surface of the transducer in contact with the body is regular.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Cartilage Conduction Hearing Devices Designed by Ear Impression and Computed Tomography

et al. 2023

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The ear molds and shells of hearing devices are generally designed using ear impressions. Computed tomography (CT) can provide information concerning ear structure, which can be utilized in computer-aided design to create hearing devices. This study aimed to compare the differences in hearing devices designed using either ear impressions or CT images. The ear chip of a cartilage conduction (CC) hearing device was designed based on the ear impression and CT images of patients with aural atresia. Three patients with bilateral (n = 1) or unilateral (n = 2) aural atresia participated in this study. The aided thresholds and subjective evaluations were compared. There were no serious problems with the use of either device, and no remarkable differences were observed regarding their respective audiological and subjective benefits. Regarding the subjective patient preferences, the hearing aid with the device designed via CT imaging was better in three ears of two patients, whereas the wearing comfort of the transducer was better for the device designed via the ear impression. The subjective evaluation of appearance varied among the cases. Finally, a device that was designed using CT findings was purchased for one patient. CT images can be utilized in computer-aided design to create CC hearing devices.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Comparison of Cartilage Conduction Hearing Devices Designed by Ear Impression and Computed Tomography

et al. 2023

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“…Compared with the vibrator placed on the mastoid, the delivered vibrations could deteriorate because they are delivered to the skull bone via the cartilaginous tissues. A previous study compared the thresholds of a vibrator on the aural cartilage and those on the mastoid (cartilage and mastoid stimulation conditions) [ 32 ]. A previous study demonstrated the thresholds at low frequencies to be significantly better in the cartilage stimulation condition, and that no difference was present in the thresholds at high frequencies, implying that the fixation placement had no negative effect.…”

Section: Signal Transmission Pathway To the Cochlea In Atretic Earsmentioning

confidence: 99%

“…The findings demonstrated an improvement in the thresholds of the fibrotic pathway, and the benefits became more significant as the frequency decreased. In another study, the thresholds in atretic ears with a fibrotic pathway significantly improved by approximately 20 dB at frequencies below 1000 Hz when the transducer was placed on the aural cartilage [ 32 ]. No differences were observed in the thresholds at frequencies above 2000 Hz.…”

Section: Benefits Of CC In Atretic Ears With Fibrotic Pathwaysmentioning

confidence: 99%

Cartilage Conduction Hearing Aids in Clinical Practice

et al. 2023

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A relatively loud sound is audible when a vibrator is attached to the aural cartilage. This form of conduction is referred to as cartilage conduction (CC). In Japan, a new type of hearing aid has been developed using CC and has been available in clinical practice since 2017. A clinical study conducted prior to its launch demonstrated its benefits, particularly in patients with aural atresia who were unable to use air conduction hearing aids. Several studies have been published on the benefits of CC hearing aids since their introduction into clinical practice. Most of the patients included in these studies had canal stenosis or aural atresia, and the purchase rates of CC hearing aids in these patients were relatively high. However, the number of patients with canal-open ears was small, with overall poor results in the trials, with the exception of patients with continuous otorrhea. CC hearing aids are considered a good option for compensating for hearing loss in ears with canal stenosis or atresia in both bilateral and unilateral cases. However, CC hearing aids are not currently considered the first choice for patients with a canal-open ear.

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“…This means that the BC sensitivity from the contribution of skull bone vibrations alone is nearly the same at the two positions, which is also suggested by the cochlear promontory simulations in Figure 5. This finding is corroborated by the results in Nishimura et al (2021) where ears suffering from aural atresia had a similar threshold independent of whether the transducer was applied at the mastoid or at the ear canal opening.…”

Section: Skull Bone Vibrationsmentioning

confidence: 99%

Hearing Through Bone Conduction Headsets

2023

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Bone conduction (BC) stimulation has mainly been used for clinical hearing assessment and hearing aids where stimulation is applied at the mastoid behind the ear. Recently, BC has become popular for communication headsets where the stimulation position often is close to the anterior part of the ear canal opening. The BC sound transmission for this stimulation position is here investigated in 21 participants by ear canal sound pressure measurements and hearing threshold assessment as well as simulations in the LiUHead. The results indicated that a stimulation position close to the ear canal opening improves the sensitivity for BC sound by around 20 dB but by up to 40 dB at some frequencies. The transcranial transmission ranges typically between −40 and −25 dB. This decreased transcranial transmission facilitates saliency of binaural cues and implies that BC headsets are suitable for virtual and augmented reality applications. The findings suggest that with BC stimulation close to the ear canal opening, the sound pressure in the ear canal dominates the perception of BC sound. With this stimulation, the ear canal pathway was estimated to be around 25 dB greater than other contributors, like skull bone vibrations, for hearing BC sound in a healthy ear. This increased contribution from the ear canal sound pressure to BC hearing means that a position close to the ear canal is not appropriate for clinical use since, in such case, a conductive hearing loss affects BC and air conduction thresholds by a similar amount.

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Effect of transducer placements on thresholds in ears with an abnormal ear canal and severe conductive hearing loss

Cited by 6 publications

References 32 publications

Comparison of Cartilage Conduction Hearing Devices Designed by Ear Impression and Computed Tomography

Comparison of Cartilage Conduction Hearing Devices Designed by Ear Impression and Computed Tomography

Cartilage Conduction Hearing Aids in Clinical Practice

Hearing Through Bone Conduction Headsets

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