Critical issues in bone anchored hearing aids

Eur Arch Otorhinolaryngol. 2025 Oct 24. doi: 10.1007/s00405-025-09757-3. Online ahead of print.

Abstract

Purpose: This study investigates the audiological performance and user satisfaction of bone-anchored hearing aids (BAHA). It addresses four key aspects: comparison with conventional hearing aids, differences between percutaneous and transcutaneous devices, benefits in unilateral hearing loss, and the patient adaptation process.

Methods: Between January 2023 and June 2024, 40 patients with conductive and mixed hearing loss received BAHA implants. Audiological evaluations included pure-tone and free-field audiometry, the Italian Matrix Sentence Test, and satisfaction questionnaires.

Results: BAHA significantly improved hearing thresholds, speech recognition, and signal-to-noise ratios compared to the unaided situation and to the conventional hearing aid use, with sustained benefits over 3 months. Questionnaire scores confirmed enhanced patient-reported outcomes.

Conclusion: Significant improvements were noted in audiometric and subjective outcomes, with BAHA outperforming conventional hearing aids in noise. Percutaneous devices showed better high-frequency performance, but both systems provided similar speech-in-noise benefits. BAHA also enhanced binaural hearing in unilateral loss. Audiologic results at 3 and 6 months are similar: after 3 months BAHA use, adaptation is complete.

Keywords: Adaptation; Bone anchored hearing aids; Conventional hearing aids; Matrix sentence test; Monolateral device; Percutaneous; Transcutaneous.