Download PDF
Semin Hear 2003; 24(4): 333-344
DOI: 10.1055/s-2004-815549
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

The Occlusion Effect and Ampclusion Effect

Robert W. Sweetow1 , Chester Z. Pirzanski2
  • 1Director of Audiology, Professor of Otolaryngology, University of California, San Francisco; San Francisco, California
  • 2Starkey Labs Canada, Mississauga; Mississauga, Ontario, Canada
Further Information

Publication History

Publication Date:
15 January 2004 (online)

   Buy Article Permissions and Reprints

ABSTRACT

When an individual speaks, laryngeal vocalizations are generated in the ear canal. Normally, these vibrations escape from the external auditory meatus. When the ear canal is blocked by an earmold or hearing aid shell, these vibrations translate into increased low frequency SPL reaching the tympanic membrane. This bone-conducted phenomenon is called the occlusion effect. Hearing aid users also may experience altered perception of their voices due to air conduction of the sound amplified by the hearing instrument. Because this second phenomenon is related to amplification it is termed ampclusion. The origin of the problems can be determined through a systematic approach. Once determined, the effects can be relieved via changes in otoplastics, electroacoustics, and/or counseling.

KEYWORDS

Occlusion - ampclusion - bone conduction - otoplastics - electroacoustics

REFERENCES

  • 1 Lazenby B, Logan S. Ahlstrom J, Bess F. Self-assessment questionnaire for the elderly: hearing aid dispensary use. Paper presented at the American Speech and Hearing Association Convention, 1985
    Google Scholar
  • 2 Dillon H, Birtles G, Lovegrove R. Measuring the outcomes of a national rehabilitation program: normative data for the Client Oriented Scale of Improvement (COSI) and the Hearing Aid Users Questionnaire (HAUQ).  J Am Acad Audiol . 1999;  10 67-79
    PubMedGoogle Scholar
  • 3 Killion M, Wilber L, Gudmundsen G. Zwislocki was right: a potential solution to the “hollow voice” problem (amplified occlusion effect) with deeply sealed earmolds.  Hear Instrum . 1988;  39 14-18
    PubMedGoogle Scholar
  • 4 Pirzanski C. Diminishing the occlusion effect: clinician/manufacturer factors.  Hear J . 1998;  51 66-78
    PubMedGoogle Scholar
  • 5 Kampe S, Wynne M. The influence of venting on the occlusion effect.  Hear J . 1996;  49 59-66
    PubMedGoogle Scholar
  • 6 Sweetow R, Valla A. Effect of electroacoustic parameters on ampclusion in CIC hearing instruments.  Hear Rev . 1997;  4 8-22
    PubMedGoogle Scholar
  • 7 Bryant M, Mueller G, Northern J. Minimal contact long canal ITE hearing instruments.  Hear Instrum . 1991;  42 12-50
    PubMedGoogle Scholar
  • 8 Fagelson M, Martin F. The occlusion effect and ear canal sound pressure level.  Audiology. J Am Acad Audiol . 1994;  5 379-383
    PubMedGoogle Scholar
  • 9 Allen G, Fernandez C. The mechanism of bone conduction.  Ann Otol Rhinol Laryngol . 1960;  69 5-28
    PubMedGoogle Scholar
  • 10 Von Bekesy G. Experiments in Hearing New York: McGraw-Hill; 1960
  • 11 Zwislocki J. Acoustic attenuation between the ears.  J Acoust Soc Am . 1953;  25 752-759
    PubMedGoogle Scholar
  • 12 Von Bekesy G. The structure of the middle ear and the hearing of one's own voice by bone conduction.  J Acoust Soc Am . 1949;  21 217-232
    PubMedGoogle Scholar
  • 13 Painton S. Objective measure of low frequency reduction in canal hearing aids with adaptive circuitry.  J Am Acad Audiol . 1993;  4 152-156
    PubMedGoogle Scholar
  • 14 Dunn H, Farnsworth D. Objective measure of low-frequency amplification reduction in canal hearing aids with adaptive circuitry.  J Acoust Soc Am . 1993;  10 184-199
    PubMedGoogle Scholar
  • 15 Stone M A, Moore B C. Tolerable hearing aid delays. I. Estimation of limits imposed by the auditory path alone using simulated hearing losses.  Ear Hear . 1999;  20 182-92
    CrossrefPubMedGoogle Scholar
  • 16 Revit L. Two techniques for dealing with the occlusion effect.  Hear Instrum . 1992;  43 16-18
    PubMedGoogle Scholar
  • 17 Wimmer. The occlusion effect from earmolds.  Hear Instrum . 1986;  19 57-58
    PubMedGoogle Scholar
  • 18 Dempsey J. The occlusion effect created by custom canal hearing aids.  Am J Otol . 1990;  11 44-46
    CrossrefPubMedGoogle Scholar
  • 19 Biering-Sorensen M, Pedersen F, Parving A. Is there a relationship between the acoustic occlusion effect and the sensation of occlusion?.  Scan Audiol . 1994;  23 111-116
    PubMedGoogle Scholar
  • 20 Oliveira R, Hammer B, Stillman A. et al . A look at ear canal changes with jaw motion.  Ear Hear . 1992;  13 464-466
    PubMedGoogle Scholar
  • 21 Carle R, Laugesen S, Nielsen C. Observations on the relations among occlusion effect, compliance, and vent size.  J Am Acad Audiol . 2002;  13 25-37
    PubMedGoogle Scholar
  • 22 Kuk F, Plager A, Pape N. Hollowness perception with noise reduction hearing aids.  J Am Acad Audiol . 1992;  3 39-45
    PubMedGoogle Scholar
  • 23 Lybarger S. Earmold venting as an acoustic control factor. In: Studebaker G, Hochberg J, eds. Acoustic Factors Affecting Hearing Aid Performance, 1st ed Baltimore: University Park Press; 197-217
    Google Scholar
  • 24 Staab W, Finlay B. A fitting rationale for deep fitting canal hearing instruments.  Hear Instrum 1991;42:8-10, 50.
    PubMedGoogle Scholar
  • 25 Westermann S. The occlusion effect.  Hear Instrum . 1987;  38 43
    PubMedGoogle Scholar
  • 26 Pogash R, Williams C. Occlusion and own-voice issues: protocols and strategies. http://www.hearingreview.com/articles.ASP?Article ID=H0103F03
    Google Scholar
  • 27 Chasin M, Pirzanski C, Hayes D, Mueller G. Real ear occluded gain as a clinical predictor.  Hear Rev . 1997;  4 22-26
    PubMedGoogle Scholar
  • 28 Bongiovanni R, Auriemmo J, Kuk F. Is a longer canal length always better when fitting CIC hearing instruments?.  Hear Rev . 2001;  8 44-77
    PubMedGoogle Scholar
  • 29 Mims Voll L, Lyons P. Frequency and effectiveness of in-office modifications with CIC hearing instrument fittings.  Hear Rev . 1995;  2 38-50
    PubMedGoogle Scholar
  • 30 Pirzanski C, Berge B. Distant learning course ACD 602. Research assignments submitted by doctoral students. Pennsylvania College of Optometry, School of Audiology; 2000-2002
    Google Scholar
  • 31 Ricketts T. Directional hearing aids.  Trends Amplf . 2001;  5 139-176
    PubMedGoogle Scholar
  • 32 Fortune T. Real ear compression ratios: the effects of venting and adaptive release time.  Am J Audiol . 1997;  6 55-63
    PubMedGoogle Scholar
  • 33 Studebaker G, Cox R. Sidebranch and parallel vent effects in real ears and in acoustical and electrical models.  J Am Audiol Soc . 1977;  3 108-116
    PubMedGoogle Scholar
  • 34 Mueller G. CIC hearing aids: what is their impact on the occlusion effect?.  Hear J . 1994;  47 29-34
    PubMedGoogle Scholar
  • 35 Kuk F, Ludvigsen C. Occlusion management I: understanding variables (in press).  2002.
    PubMedGoogle Scholar
  • 36 Punch J, Beck E. Low frequency response of hearing aids and judgments of aided speech quality.  J Speech Hear Dis . 1980;  45 325-335
    PubMedGoogle Scholar
      >