Soft Tissue Conduction: Review, Mechanisms, and Implications.

Soft tissue conduction (STC) is a recently explored mode of auditory stimulation, complementing air (AC) and bone (BC) conduction stimulation. STC can be defined as the hearing induced when vibratory stimuli reach skin and soft tissue sites not directly overlying skull bone such as the head, neck, thorax, and body. Examples of STC include the delivery of vibrations to the skin of parts of the body by a clinical bone vibrator, hearing underwater sounds and free field air sounds, while AC hearing is attenuated by earplugs. The vibrations induced in the soft tissues are apparently transmitted along soft tissues, reaching, and exciting the ear. Further research is required to determine whether the mechanism of the final stage of STC hearing involves the excitation of the ear by eliciting inner ear fluid pressures that activate the hair cells directly, by the induction of skull bone vibrations, or by a combination of both mechanisms, depending on the magnitude of each mechanism.