Mechanisms of Bone Conduction: A Review of the Literature

Abstract

Clinical bone conduction during a routine audiological evaluation is a vital tool for audiologists to differentiate a sensorineural hearing loss from a conductive hearing loss. However, the mechanisms that give rise to responses during bone conduction stimulation are poorly understood. This paper will cover the results of a review of the literature regarding the mechanisms of bone conduction to attempt to aid in the understanding of the mechanisms underlying bone conduction testing. Various proposed mechanisms of bone conduction are discussed, including mechanisms involving the outer ear, middle ear, and inner ear, along with newly proposed mechanisms such as soft tissue conduction and cerebrospinal fluid conduction. The evidence found in the literature supporting the existence of each mechanism is also reviewed.