How does bone conduction allow sound to reach the inner ear?
Bone conduction is the process by which sound reaches the inner ear through vibrations of the skull bones, bypassing the outer and middle ear. This occurs through two primary mechanisms:21
Compressional Bone Conduction
Used for high-pitched sounds, this process involves the skull vibrating in segments. These vibrations directly compress the otic capsule—the bony case enclosing the inner ear—which transmits the energy to the cochlear fluids. Because the round window membrane is more mobile than the stapes footplate, these vibrations stimulate the organ of Corti.21
Inertial Bone Conduction
At lower frequencies (1,500 Hz and below), the skull moves as a rigid body. Due to their inertia and suspension within the middle-ear cavity, the ossicles move less freely than the cochlea. This creates relative motion between the oval window and the stapes footplate, effectively stimulating the inner ear as if the stapes were vibrating normally.21
These mechanisms are clinically significant for distinguishing between conductive and sensorineural hearing loss during audiology testing.13