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Bone conduction hearing refers to the transmission of sound vibrations through the bones of the skull, directly stimulating the cochlea and bypassing the outer and middle ear structures. Multiple physiological mechanisms contribute to this process, including cochlear fluid inertia, in-phase and out-of-phase motion of the cochlear walls, and ossicle inertia. Bone conduction is clinically relevant for patients who cannot use conventional air conduction hearing aids due to ear canal pathology, chronic infection, anatomical abnormalities, or single-sided deafness. Bone conduction hearing aids and bone-anchored devices utilize this pathway for rehabilitation of conductive and mixed hearing loss, offering sound amplification by vibrating the skull or mastoid bone. The process is assessed by audiological tests and is not targeted by pharmaceuticals but rather by medical devices.
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