{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:28Z","timestamp":1778803228316,"version":"3.51.4"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T00:00:00Z","timestamp":1622332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>It is generally believed that ultrasound cannot be heard. However, ultrasound is audible when it is presented through bone conduction. Bone-conducted ultrasound (BCU) has unique characteristics; the most interesting is its perception in patients with profound deafness. Some patients can perceive it and discriminate speech-modulated BCU. Previous reports have suggested that BCU can be used for a hearing aid or tinnitus sound therapy. In this review, the perception of BCU at both the peripheral and central levels was investigated based on previous studies, although some of them remain controversial. We also investigated the clinical use of BCU. To develop hearing aids utilizing BCU, the encoding of speech signals into BCU has to be established. The outcomes of the reported speech modulations were evaluated. Furthermore, the suppression of tinnitus by BCU was reviewed, and the feasibility of the application of BCU to tinnitus treatment was investigated.<\/jats:p>","DOI":"10.3390\/audiolres11020022","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:22:15Z","timestamp":1622420535000},"page":"244-253","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Perception Mechanism of Bone-Conducted Ultrasound and Its Clinical Use"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0000-1041","authenticated-orcid":false,"given":"Tadashi","family":"Nishimura","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadao","family":"Okayasu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Hosoi","sequence":"additional","affiliation":[{"name":"MBT (Medicine-Based Town) Institute, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1177\/000348943204100306","article-title":"Physical data and physiology of excitation of the auditory nerve","volume":"41","author":"Wegel","year":"1932","journal-title":"Anns. Otol. Rhinol. Lar."},{"key":"ref_2","first-page":"2053","article-title":"Audibillite de sons de frequence elevee","volume":"226","author":"Gavreau","year":"1948","journal-title":"Compt. Rendu."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1038\/166571b0","article-title":"Upper limit of frequency for human hearing","volume":"166","author":"Pumphrey","year":"1950","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/BF00456548","article-title":"Some thoughts on the perception of ultrasonics by man","volume":"209","author":"Dieroff","year":"1975","journal-title":"Arch. Otorhinolaryngol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1121\/1.1918804","article-title":"Bone-conduction thresholds for sonic and ultrasonic frequencies","volume":"35","author":"Corso","year":"1963","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1126\/science.139.3555.590","article-title":"Perception of ultrasound","volume":"139","author":"Haeff","year":"1963","journal-title":"Science"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0378-5955(02)00735-9","article-title":"Ultrasonic masker clarifies ultrasonic perception in man","volume":"175","author":"Nishimura","year":"2003","journal-title":"Hear. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1126\/science.2063208","article-title":"Human ultrasonic speech perception","volume":"253","author":"Lenhardt","year":"1991","journal-title":"Science"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/S0140-6736(05)78683-9","article-title":"Activation of the auditory cortex by ultrasound","volume":"351","author":"Hosoi","year":"1998","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1097\/00001756-200103050-00030","article-title":"Ultrasound activates the auditory cortex of profound deaf subjects","volume":"12","author":"Imaizumi","year":"2001","journal-title":"NeuroReport"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1056\/NEJMra1904407","article-title":"Cochlear Implantation in Adults","volume":"382","author":"Carlson","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.1001\/jama.2020.17647","article-title":"Hearing Loss in Children: A Review","volume":"324","author":"Lieu","year":"2020","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"7629","DOI":"10.1073\/pnas.1015291108","article-title":"Pitch perception beyond the traditional existence region of pitch","volume":"108","author":"Oxenham","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_14","first-page":"5962","article-title":"Mechanisms of Bone-conducted Ultrasonic Perception Assessed by Measurements of Acoustic Fields in the Outer Ear Canal and Vibrations of the Tympanic Membrane","volume":"2018","author":"Nakagawa","year":"2018","journal-title":"Annu. Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_15","unstructured":"Von B\u00e9k\u00e9sy, G. (1960). Experiments in Hearing, McGraw-Hill."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1177\/000348946207100312","article-title":"Some observations on ultrasonic perception in man","volume":"71","author":"Bellucci","year":"1962","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.heares.2011.01.004","article-title":"Peripheral perception mechanism of ultrasonic hearing","volume":"277","author":"Nishimura","year":"2011","journal-title":"Hear. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.neulet.2013.01.040","article-title":"Human ultrasonic hearing is induced by a direct ultrasonic stimulation of the cochlea","volume":"539","author":"Okayasu","year":"2013","journal-title":"Neurosci. Lett."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e2921","DOI":"10.1038\/cddis.2017.314","article-title":"Epigallocatechin-3-gallate, a prototypic chemopreventative agent for protection against cisplatin-based ototoxicity","volume":"8","author":"Borse","year":"2017","journal-title":"Cell Death Dis."},{"key":"ref_20","unstructured":"Sakaguchi, T., Hirano, T., Nishimura, T., Nakagawa, S., Watanabe, Y., Hosoi, H., Imaizumi, S., and Tonoike, M. (2001). Cerebral neuromagnetic responses evoked by two-channel bone-conducted ultrasound stimuli. Proceedings of the 12th International Conference on Biomagnetism, Helsinki University of Technology."},{"key":"ref_21","unstructured":"Nishimura, T., Sakaguchi, T., Nakagawa, S., Hosoi, H., Watanabe, Y., Tonoike, M., and Imaizumi, S. (2001). Dynamic range for bone conduction ultrasound. Proceedings of the 12th International Conference on Biomagnetism, Helsinki University of Technology."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0304-3940(02)00409-3","article-title":"Effect of stimulus duration for bone-conducted ultrasound on N1m in man","volume":"327","author":"Nishimura","year":"2002","journal-title":"Neurosci. Lett."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.neulet.2008.03.086","article-title":"Assessment of ability to discriminate frequency of bone-conducted ultrasound by mismatch fields","volume":"438","author":"Yamashita","year":"2008","journal-title":"Neurosci. Lett."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/00016480902915707","article-title":"N1m amplitude growth function for bone-conducted ultrasound","volume":"562","author":"Nishimura","year":"2009","journal-title":"Acta Otolaryngol. Suppl."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neulet.2018.11.035","article-title":"Temporal window of integration estimated by omission in bone-conducted ultrasound","volume":"696","author":"Okayasu","year":"2019","journal-title":"Neurosci. Lett."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.heares.2017.10.005","article-title":"An Overview of Cochlear Implant Electrode Array Designs","volume":"356","author":"Dhanasingh","year":"2017","journal-title":"Hear. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1002\/lary.26738","article-title":"Meta-Analysis of Quality-of-Life Improvement after Cochlear Implantation and Associations with Speech Recognition Abilities","volume":"128","author":"McRackan","year":"2018","journal-title":"Laryngoscope"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1121\/1.5092350","article-title":"Speech recognition as a function of the number of channels in perimodiolar electrode recipients","volume":"145","author":"Berg","year":"2019","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1121\/10.0000673","article-title":"Measuring access to high-modulation-rate envelope speech cues in clinically fitted auditory prostheses","volume":"147","author":"Stone","year":"2020","journal-title":"J. Acoust. Soc. Am."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Warnecke, M., Peng, Z.E., and Litovsky, R.Y. (2020). The impact of temporal fine structure and signal envelope on auditory motion perception. PLoS ONE., 15.","DOI":"10.1371\/journal.pone.0238125"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.heares.2005.05.007","article-title":"Intelligibility of bone-conducted ultrasonic speech","volume":"208","author":"Okamoto","year":"2005","journal-title":"Hear. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1080\/00016480902926449","article-title":"Comparison between bone-conducted ultrasound and audible sound in speech recognition","volume":"562","author":"Yamashita","year":"2009","journal-title":"Acta. Otolaryngol. Suppl."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/WNR.0b013e328334f196","article-title":"The effect of visual information in speech signals by bone-conducted ultrasound","volume":"21","author":"Yamashita","year":"2009","journal-title":"NeuroReport"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1126\/science.1549785","article-title":"Ultrasonic hearing","volume":"255","author":"Dobie","year":"1992","journal-title":"Science"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.heares.2005.02.004","article-title":"Nonlinear explanation for bone-conducted ultrasonic hearing","volume":"204","author":"Fujimoto","year":"2005","journal-title":"Hear. Res."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Kagomiya, T., and Nakagawa, S. (2010). An evaluation of bone-conducted ultrasonic hearing-aid regarding transmission of Japanese prosodic phonemes, Proceedings of 20th International Congress on Acoustics.","DOI":"10.21437\/SpeechProsody.2010-105"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.neulet.2013.11.048","article-title":"Evaluation of prosodic and segmental change in speech-modulated bone-conducted ultrasound by mismatch fields","volume":"559","author":"Okayasu","year":"2014","journal-title":"Neurosci. Lett."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.neulet.2011.03.044","article-title":"Duration-dependent growth of N1m for speech-modulated bone-conducted ultrasound","volume":"495","author":"Okayasu","year":"2011","journal-title":"Neurosci. Lett."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.heares.2014.09.012","article-title":"An examination of the effects of broadband air-conduction masker on the speech intelligibility of speech-modulated bone-conduction ultrasound","volume":"317","author":"Nishimura","year":"2014","journal-title":"Hear. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.heares.2016.05.009","article-title":"A systematic review of the reporting of tinnitus prevalence and severity","volume":"337","author":"McCormack","year":"2016","journal-title":"Hear. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"222","DOI":"10.4081\/audiores.2019.222","article-title":"Tinnitus and suicide: An unresolved relation","volume":"9","author":"Szibor","year":"2019","journal-title":"Audiol. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"68","DOI":"10.5935\/0946-5448.20170013","article-title":"Tinnitus patients suffering from anxiety and depression: A review","volume":"21","author":"Ziai","year":"2017","journal-title":"Int. Tinnitus J."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Tinnitus Retraining Therapy Trial Research Group, Scherer, R.W., and Formby, C. (2019). Effect of Tinnitus Retraining Therapy vs Standard of Care on Tinnitus-Related Quality of Life: A Randomized Clinical Trial. JAMA Otolaryngol. Head Neck Surg., 145, 597\u2013608.","DOI":"10.1001\/jamaoto.2019.0821"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.anl.2019.09.007","article-title":"Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan","volume":"47","author":"Ogawa","year":"2020","journal-title":"Auris Nasus Larynx"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00405-019-05743-8","article-title":"Internet\/smartphone-based applications for the treatment of tinnitus: A systematic review","volume":"277","author":"Nagaraj","year":"2020","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/03655230600895358","article-title":"Residual inhibition functions in relation to tinnitus spectra auditory threshold shift","volume":"556","author":"Roberts","year":"2006","journal-title":"Acta Otolaryngol. Suppl."},{"key":"ref_47","first-page":"14","article-title":"Tinnitus improvement with ultra high frequency vibration therapy","volume":"11","author":"Goldstein","year":"2005","journal-title":"Int. Tinnitus J."},{"key":"ref_48","first-page":"111","article-title":"Ultra-high frequency ultrasonic external acoustic stimulation for tinnitus relief: A method for patient selection","volume":"11","author":"Goldstein","year":"2005","journal-title":"Int. Tinnitus J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.heares.2014.01.011","article-title":"Residual inhibition of tinnitus induced by 30-kHz bone-conducted ultrasound","volume":"310","author":"Koizumi","year":"2014","journal-title":"Hear. Res."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/11\/2\/22\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:09:08Z","timestamp":1760162948000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/11\/2\/22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,30]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["audiolres11020022"],"URL":"https:\/\/doi.org\/10.3390\/audiolres11020022","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,30]]}}}