A comparative study between audiological and speech outcomes of non-implantable wearing options for BAHA in the pediatric population


  • Mohammad Garrada Department of Otorhinolaryngology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
  • Ziad Faisal Zimmo Department of Otorhinolaryngology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
  • Meaad Alsulami Department of Otorhinolaryngology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
  • Talal Alkhatib Department of Otorhinolaryngology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia




Comparative, Audiological, Speech, Non-implantable, Wearing, BAHA


Background: The aim of the study was to determine the audiological benefit of the current BAHAs sound processor worn on a SoundArc and to compare it to the known Softband in terms of soundField hearing thresholds and speech understanding in patients who have purely conductive, mixed, or SSD hearing loss.

Methods: A cross-sectional study looking at children with conductive, mixed, or SSD hearing loss who are not candidates for middle ear surgery, canalplasty, or standard hearing aids. At the baseline visit, pure-tone audiograms were obtained, including masked/unmasked air- and bone conduction thresholds with speech recognition scores.  

Results: After two weeks of using programmed processors with Softband and SoundArc, all children were examined. The threshold for aided pure-tone audiometry was tested twice through each of the two transmission paths. The aided pure-tone audiometry threshold demonstrated a statistically significant improvement in PTA. The mean air-conduction thresholds for frequencies (0.5 to 4 kHz) were 63 dB, while the aided mean thresholds with the device (with Softband and SoundArc) was 35 dB. When compared to the unaided scenario, a statistically significant improvement of 98 percent (SoundArc) to 96 percent (Softband) was found at 65 dBSPL. There were no statistically significant differences between any of the ensembles (p=0.261).

Conclusions: The results of our study suggest that subjects with conductive, mixed, or single-sided deafness hearing loss aided with BAHA sound processor worn on SoundArc or on a Softband can cause a significant improvement in terms of soundfield hearing threshold and speech understanding when compared to unaided conditions.


McLeod RWJ, Culling JF, Jiang D. Advances in the Field of Bone Conduction Hearing Implants. Adv Otorhinolaryngol. 2018;81:24-31.

Willenborg K, Avallone E, Maier H, Lenarz T, Busch S. A New Active Osseointegrated Implant System in Patients with Single-Sided Deafness. Audiol Neurotol; 2021.

Hakansson B, Liden G, Tjellstrom A. Ten years of experience with the Swedish bone-anchored hearing system. Te Annals Otology Rhinology Laryngol. 1990;151:1-16.

Edmiston RC, Aggarwal R, Green KMJ. Bone conduction implants - A rapidly developing feld. Te J Laryngol Otology. 2015;129:936-40.

Hol MKS, Kunst SJW, Snik AFM, Cremers AFM. Pilot study on the efectiveness of the conventional CROS, the transcranial CROS and the BAHA transcranial CROS in adults with unilateral inner ear deafness. European Archives Oto-Rhino-Laryngol. 2010;267(6):889-96.

Snapp HA, Hofer ME, Liu X, Rajguru SM. Efectiveness in rehabilitation of current wireless CROS technology in experienced bone-anchored implant users. Otology Neurotology. 2017;38(10):1397-404.

Wazen JJ, Wycherly B, Daugherty J. Complications of bone-anchored hearing devices. Advances in Oto-Rhino Laryngology. 2011;71:63-72.

Candreia C, Birrer R, Fistarol S. Predisposing factors for adverse skin reactions with percutaneous bone anchored hearing devices implanted with skin reduction techniques. European Archives Oto-Rhino-Laryngol. 2016;273(12):4185-92.

Pffner F, Kompis M, Stieger C. Bone-anchored hearing aids: correlation between pure-tone thresholds and outcome in three user groups. Otology Neurotology. 2009;30(7):884-90.

Cox RM, Johnson JA, Xu J. Impact of Hearing Aid Technology on Outcomes in Daily Life I: The Patients' Perspective. Ear Hear. 2016;37(4):e224-37.

American Academy of Audiology. Clinical Practice Guidelines: Remote Microphone Hearing Assistance Technologies for Children and Youth from Birth to 21 Years. Includes Supplement A, 2011. Available at: https://audiology-web.s3.amazonaws.com/migrated/HAT_Guideli00. Accessed on 02 June 2022.

Kurz A, Flynn M, Caversaccio M, Kompis M. Speech understanding with a new implant technology: A comparative study with a new nonskin penetrating BAHA system. BioMed Res Int. 2014;9.

Riss D, Arnoldner C, Baumgartner WD. Indication criteria and outcomes with the bonebridge transcutaneous bone-conduction implant. Te Laryngoscope. 2014;124(12):2802-6.

Mclean T, Pai I, Philipatos A, Gordon M. Te Sophono bone-conduction system: Surgical, audiologic, and quality-oflife outcomes. Ear Nose Throat J. 2017;96(7):E28-E33.

Reinfeldt S, Hakansson B, Taghavi H, Fred´en Jansson KJ, Eeg-Olofsson M. Te bone conduction implant: Clinical results of the first six patients. Int J Audiology. 2015;54(6):408-16.

Zarowski AJ, Verstraeten N, Somers T, Rif D, Ofeciers EF. Headbands, testbands and sofbands in preoperative testing and application of bone-anchored devices in adults and children. Advances in Oto-Rhino-Laryngology. 2011;71:124-31.

Medical Advisory Secretariat. Bone anchored hearing aid: an evidence-based analysis. Ont Health Technol Assess Ser. 2002;2(3):1-47.

Wimmer GT, Munzinger W, Caversaccio F, Kompis M, Martin. Speech Understanding and Sound Localization with a New Nonimplantable Wearing Option for BAHA. BioMed Research Int. 2018;1-8.






Original Research Articles