HypothesisThe transcranial attenuation of bone-conducted (BC) sound depends on the stimulation position and the stimulation frequency.BackgroundSubjective transcranial attenuation of BC sound has previously only been measured at a few audiometric frequencies and with the stimulation at the mastoid.

Transcranial Attenuation of Bone-Conducted Sound When Stimulation Is at the Mastoid and at the Bone Conduction Hearing Aid Position

Pure-tone audiometry was done on 1475 persons on two occasions 6 years apart by the same audiologist in the same facility. The age of the subjects ranged from 58 to 88 years at the initial testing and 63 to 95 at the second. The average 6-year threshold change ranged from 1 to 8 dB at 250-6 kHz and 10-15 dB at 8 kHz. The differences in thresholds fell into two patterns, one for low frequencies (250-1 kHz) and the other for high frequencies (4-8 kHz). For the lows, thresholds worsened at an increasing rate with increasing age independent of the initial hearing level, and women's thresholds worsened more than men's. For the highs, the rate of threshold change decreased with age and with the initial threshold at rates that did not differ between genders. Using a change in PTA (0.5, 1, 2 kHz) of greater than 10 dB as a criterion, significant worsening occurred in the right ear in 8.5%, in the left ear in 13.5%, and in both ears of 4.1% of the subjects over the 6 year period. The rate of significant worsening increased with age. Although hearing loss increased with age, age alone accounted for less than 10% of the variance. Therefore, factors that co-vary with age may be responsible. The difference in phenomena between the low frequencies and the highs suggests that two different processes are occurring. Hair-cell degeneration is the most likely cause for the change in the high frequencies. Strial atrophy or other intracochlear processes may be the cause of the low frequency changes.

Incidence of Hearing Decline in the Elderly

The Bonebridge: preclinical evaluation of a new transcutaneously-activated bone anchored hearing device.

Transcranial attenuation for bone conduction as a function of frequency (0.25 to 4 kHz.) was measured on a group of unilaterally deaf (n 15) and a group of normal (n = 35) ears. The results indicate a positive mean attenuation for all frequencies with a peak value of 13 db. for both groups at 2 kHz. Inter-subject variability was extremely large. This is considered to be a result of variability in skull bone thickness.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0022215100091155

Transcranial attenuation in bone conduction audiometry.

The ability to use binaural cues when stimulation was by bilaterally applied bone conduction (BC) transducers was investigated in 20 normal hearing participants. The results with BC stimulation were compared with normal air conduction (AC) stimulation through earphones. The binaural hearing ability was tested by spatial release from masking, binaural intelligibility level difference (BILD), binaural masking level difference (BMLD) using chirp stimulation, and test of the precedence effect. In all tests, the participants revealed a benefit of bilateral BC stimulation indicating use of binaural cues. In the speech based tests, the binaural benefit for BC stimulation was approximately half that with AC stimulation. For the BC BMLD test with chirp stimulation, there were indications of superposition of the ipsilateral and contralateral pathways at the cochlear level affecting the results. The precedence effect test indicated significantly worse results for BC stimulation than for AC stimulation with low-frequency stimulation while they were close for high-frequency stimulation; broad-band stimulation gave results that were slightly worse than the high-frequency results.

/pdf/binaural-hearing-ability-with-mastoid-applied-bilateral-bone-56mvgis3gy.pdf

Binaural hearing ability with mastoid applied bilateral bone conduction stimulation in normal hearing subjects.

Clinical masking of air- and bone-conducted stimuli.

Clinical masking of the nontest ear.

Intertest Variability and the Air-Bone Gap

The standardization of bone-conduction thresholds.

About 5 percent of school children do not hear well. This may retard them educationally and stunt their vocabulary. Yet hearing losses often go undetected. This article defines types of hearing losses, tells how to screen for them, and discusses hearing testing programs.

Hearing Problems in Schoolchildren

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