Human ultrasonic hearing is induced by a direct ultrasonic stimulation of the cochlea.

Ultrasound can be perceived by bone-conduction. The cochlear basal turn is involved in processing bone-conducted ultrasound (BCU) information. Previous studies have suggested that ultrasonic perception is induced by ultrasound itself. In contrast, it has also been suggested that a lower frequency sound is generated in non-linear process during the transmission pathway to the cochlea to induce an auditory sensations. To address this issue, we assessed cisplatin-induced changes in BCU sensitivity at 27, 30 and 33kHz in 20 participants (40 ears) who were scheduled to undergo cisplatin chemoradiation therapy. Following the treatment, 62.5% ears were diagnosed with hearing loss according to the criteria of the American Speech-Language-Hearing Association. As expected, significant increases in sensitivity threshold were observed for air-conducted sounds ranging from 8 to 14kHz. In contrast, the BCU threshold significantly decreased after the treatment. Considering that both air-conducted high-frequency sound and BCU are perceived in the cochlear basal turn, these findings indicate that ultrasonic perception is independent of hearing a lower frequency sound generated in non-linear process. In addition, our findings support the hypothesis that ultrasound itself induces ultrasonic perception in the cochlea. The observed cisplatin-induced increase in BCU sensitivity may be explained by hypersensitivity associated with outer hair cells' disorder.