Bone conduction hearing in the blockage of oval and/or round windows in cats

Bone-conduction hearing aid is effective in congenital oval window atresia

BACKGROUND

Implantable bone-conduction hearing aids (BCHA) are effective in patients with congenital ear malformations.However, there is no large sample study to verify the efficacy of Bonebridge in patients with congenital oval window atresia.

OBJECTIVES

To investigate efficiency of implantable bone-conduction hearing aids in Mandarin-speaking patients with congenital oval window atresia.

MATERIAL AND METHODS

We retrospectively analyzed 15 patients, who were confirmed with either unilateral or bilateral congenital oval window atresia by temporal bone CT. All patients were implanted with a bone-conduction hearing device between July 2016 and July 2019 at Beijing Tongren Hospital, Capital Medical University. Pure tone audiometry (PTA), air-bone gap (ABG), speech discrimination scores (SDSs), and hearing thresholds were performed.

RESULTS

Postoperative complications including facial paralysis were particularly rare. Unaided mean sound field threshold was 62.2 ± 10.5 dBHL and that with implantable bone-conduction hearing aids was 39.1 ± 13.2 dBHL (p < 0.01). The mean speech discrimination scores improved greatly (p < 0.01), specifically with regard to sentence and disyllabic words.

CONCLUSIONS

Patients with congenital oval window atresia often show moderate to severe conductive hearing loss. Implantable bone-conduction hearing aids are considerably safe and stable for hearing rehabilitation. It is a novel treatment modality for Mandarin-speaking patients with congenital oval window atresia.

Finite element simulation of cochlear traveling wave under air and bone conduction hearing

Besides the normal hearing pathway known as air conduction (AC), sound can also transmit to the cochlea through the skull, known as bone conduction (BC). During BC stimulation, the cochlear walls demonstrate rigid body motion (RBM) and compressional motion (CPM), both inducing the basilar membrane traveling wave (TW). Despite numerous measuring and modeling efforts for the TW phenomenon, the mechanism remains unclear, especially in the case of BC. This paper proposes a 3D finite element cochlea model mimicking the TW under BC. The model uses a traditional "box model" form, but in a spiral shape, with two fluid chambers separated by the long and flexible BM. The cochlear fluid was enclosed by bony walls, the oval and round window membranes. Contingent boundary conditions and stimulations are introduced according to the physical basis of AC and BC. Particularly for BC, both RBM and CPM of the cochlea walls are simulated. Harmonic numerical solutions are obtained at multiple frequencies among the hearing range. The BM vibration amplitude ([Formula: see text]) and its relation with volume displacement difference between the oval and round windows [Formula: see text], as well as the pressure difference at the base of the cochlea ([Formula: see text]), are analyzed. The simulated BM response at 12 mm from the base is peaked at about 3 k Hz, which is consistent with published experimental data. The TW properties under AC and BC are the same and have a common mechanism. (1) [Formula: see text] is proportional to [Formula: see text] at low frequencies. (2) [Formula: see text] is also proportional to [Formula: see text], within 5 dB error at high frequencies such as 16 k Hz. This study partly reveals the common quantitative relations between the TW and related factors under AC and BC hearing.