Simulation of soft tissue stimulation-Indication of a skull bone vibration mechanism in bone conduction hearing.

Soft tissue conduction has been proposed as an alternative to bone conduction (BC) for hearing vibrations applied at soft tissue positions at the human head. Arguments for soft tissue conduction originate primarily from experimental studies with stimulation applied to different positions such as the neck, the eye, and directly to the dura. To investigate the mechanism for hearing when stimulations are at soft tissue positions, experimental studies were replicated using the finite element model for BC research, the LiUHead. The vibrations at the cochlear promontory and the sound pressure in the cerebrospinal fluid (CSF) close to the inner ear were extracted from simulations in the LiUHead. The LiUHead simulations were able to replicate data in the literature of cochlear promontory vibration levels and CSF sound pressures with stimulation applied at the soft tissue positions and at the skin covered mastoid. It was shown that the mechanical point impedance of the soft tissue positions affected the output of the BC transducer at frequencies below 1 kHz. The LiUHead simulated cochlear promontory velocities predicted the soft tissue position's hearing thresholds reported in the literature within the inter-study range. This indicates that the hearing mechanism for stimulation at soft tissue positions equals the hearing mechanism for conventional BC hearing, and that soft tissue conduction is not an alternative hearing mechanism. Moreover, the simulations indicated that the CSF sound pressure is not an important pathway for BC hearing and that the CSF pressure is generated by the local skull bone vibrations.