Background: The Cochlear™ Baha® 7 Sound Processor represents the latest advancement in bone conduction hearing, including enhanced connectivity, additional prescription options, verification support and fitting with Remote Assist. To evaluate the acceptance and performance of this new device with a fitting range up to 55 dB HL, a Controlled Market Release (CMR) was conducted in three European countries. The primary aim was to collect clinical experience and safety information on recipients’ fittings with the next generation Baha solutions: Baha 7 Sound Processor, Baha Fitting Software 7 and the new Cochlear Baha SoundBand™.

Methods: 33 recipients (infants to older adults) from six clinics in Denmark (Aalborg), Netherlands (Groningen, Leiden, Nijmegen, Rotterdam) and Sweden (Karlstad), were fitted with a Baha 7 Sound Processor. Over a period of two months clinicians completed detailed surveys about their own and their recipients’ experiences with the sound processors. These surveys aimed to gather feedback at the time of training, fitting, during follow-up appointments and at CMR closure.

Results: After 1-6 weeks of using the Baha 7 Sound Processor the clinicians reported that 14 of 17 recipients (82%) experienced the clarity of sound and sound quality as excellent, very good or good. In addition, at the end of the CMR, 11 of 12 recipients (92%) reported being satisfied or very satisfied with their Baha 7 Sound Processor.

Conclusion: The clinical experience recorded during this CMR indicates that the Baha 7 Sound Processor meets clinicians’ and recipients’ expectations, offering enhanced features and improved user satisfaction.

Background:
The use of smart glasses in remote surgery represents a promising technological innovation. These devices provide real-time access to information, visualization of diagnostic images, and expert remote guidance during procedures. This study evaluated the feasibility of smart glasses for remote consulting in bone-anchored hearing implant surgeries.

Methods:
This prospective observational study involved trained local surgeons and expert remote consultants. The protocol included: (I) training on smart glasses; (II) surgeries with real-time remote support; and (III) data collection via structured questionnaires. Surgeries were conducted at multiple Latin American centers, coordinated by the Hospital de Reabilitação de Anomalias Craniofaciais – University of São Paulo (HRAC-USP).

Results:
Seventeen surgeries were performed with 34 participants. Local surgeons reported a mean surgical time of 75 minutes, device comfort of 9.06, and overall satisfaction of 9.41 (on a 10-point scale). Reported issues included battery instability and internet setup difficulties. Remote consultants reported a mean consulting time of 80 minutes, with audio and video quality rated at 8.29 and 8.47, respectively. Limitations included the need for high-speed internet and possible requirement for in-person support for less experienced surgeons. High audiovisual quality and usability were key advantages.

Conclusion:
Smart glasses demonstrated high feasibility and acceptance for remote consulting in auditory implant surgery. Despite technical challenges, this approach shows potential to expand access to surgical expertise, optimize training, and support surgical procedures in geographically distant centers.

Background: Pedestrians widely use personal listening devices (PLDs), yet current systems typically rely on a single auditory modality—air conduction (AC)—which can limit environmental awareness and reduce the clarity of safety-critical alerts. Bone conduction (BC) offers an alternative that preserves open-ear awareness but is less understood in applied contexts. There is a critical gap in understanding how auditory signal modality—AC, BC, or their combination—affects detection, comprehension, and behavioral response during dynamic vehicle-to-pedestrian interactions. This work explores the potential utility of multimodal auditory systems integrating AC and BC pathways.

Methods: A multi-method research approach was used. First, naturalistic observations of over 1,200 real-world pedestrian crossings documented PLD use and behaviors. Second, immersive virtual reality simulations evaluated pedestrian response to verbal and non-verbal alerts delivered through either AC or BC PLDs during street crossings. Third, laboratory-based studies examined reaction time and perceptual differentiation between modalities. Lastly, a separate study assessed participants’ ability to distinguish simultaneous AC+BC signals as a foundation for future hybrid alert systems.

Results: Observations confirmed widespread PLD use during street crossings, primarily AC-based; BC PLDs were rare but showed signs of increasing adoption. AC led to faster detection at mid-to-high frequencies, while BC preserved environmental awareness and performed better at low frequencies. Participants reliably distinguished AC and BC signals. Although AC+BC was not tested during crossings, observers successfully differentiated combined signals in lab trials, supporting feasibility.

Conclusion: Multimodal auditory systems show strong potential to enhance pedestrian safety by leveraging the complementary strengths of AC and BC for clearer, more reliable auditory communication.

Background: Transcutaneous bone-anchored hearing implants may pose concerns for patients requiring magnetic resonance imaging (MRI). The Sentio system (Oticon Medical) is a new transcutaneous bone-anchored hearing system that received regulatory clearance in 2024. While the Sentio Ti implant is 1.5T MRI-conditional, clinical experience with MRI scans in patients with this implant remains limited. The aim of this study was to assess the patient experience of undergoing MRI with the implant in situ, as well as the occurrence of complications and adverse events (AEs).

Methods: 15 patients enrolled in a long-term safety and performance evaluation of the Sentio system volunteered to undergo a 1.5T head MRI, following manufacturer’s guidelines. After the scan patients completed a questionnaire rating their experience on an 11-point numerical rating scale (0-10). In addition, the clinician evaluated their experience and reported any complications or need for mitigating actions. Complications and AEs during and after the MRI procedure were monitored.

Results: In all 15 cases, the MRI scan was completed as planned, without complications or need for mitigating actions. Most patients reported no or mild discomfort. The median overall experience score was 2 (range: 0-7, 0=good, 10=terrible), with 80% of patients reporting a score ≤3. Median pressure and pain at implant site were 3 (range: 0-8) and 1 (range: 0-6), respectively. During the immediate follow-up period, one adverse event possibly related to the procedure was noted.

Conclusion: The results indicate that patients with a Sentio Ti implant can safely undergo a 1.5T MRI scan when adhering to the manufacturer’s guidelines.

Background: A new active transcutaneous bone conduction system has been developed and early results from the multicentre study to review the safety and performance were presented at OSSEO 2023.
Methods: N=51 patients (aged 24-77 years) with conductive, mixed or single sided sensorineural hearing losses were recruited from 6 European centres. The prospective, single-arm clinical investigation is nearing completion of the 2-year long-term review.
Results: Audiological results from all 6 centres will be presented, included aided thresholds, speech testing in quiet and adaptive noise, and patient-reported outcome measures.
Conclusion: This new system is safe, flexible to implant and gives good audiological outcomes for patients within applicable indications. Due to positive results, the system has now been launched worldwide.

The correlation between stimulation site and output efficiency has been studied for decades in the field of bone conduction, with varied results.

This submission is aimed to discuss this topic using an artificial head model called "HeadSimulator" and a comparative analysis of published studies investigating the relationship between bone conduction actuator placement and output efficiency.

A systematic review of existing literature was conducted, dividing studies into two methodological categories: those utilizing single-axis measurement and those employing a three-axis approach to assess cochlear promontory or intracochlear response.

To further validate and extend the insights from this body of work, I have developed an experimental setup with a HeadSimulator consisting of a 3D-printed plastic skull filled with artificial brain material and integrated with a tri-axial accelerometer positioned at the cochlea. The design aims to replicate mechanical impedance and vibrational transmission seen in human and cadaver models.

The comparison between published data and HeadSimulator measurements highlights a key methodological concern, studies relying solely on single-axis output measures often report falsely elevated responses, due to unaccounted-for energy distribution across all spatial directions. By contrast, three-axis data provides a more complete and accurate representation of the transmitted vibration.

Based on these findings, I would like to show and discuss
differences of bone conduction output measurement methodology, especially that studies evaluating stimulation site efficiency, requires full three-axis analysis or correct inter-cochlea pressure measurements. Without this, comparisons between stimulation sites risk being skewed, and conclusions about optimal actuator placement may be misleading.

Background
MRI-compatible active transcutaneous bone conduction implants utilize advanced magnet designs to improve imaging safety; however, concerns remain regarding potential compromises in sound processor retention. This study evaluated real-world retention outcomes in adolescents and adults using this implant system.

Methods
A prospective observational study was conducted at a tertiary referral center of patients undergoing MRI compatible piezoelectric active transcutaneous bone conduction implant (MRI-ABCD) aged 15 years and older. Coil placement was classified intraoperatively as subperiosteal, over the periosteum or over the muscle (subcutaneously) , and skin thickness at the coil site was measured. Sound processor fitting occurred three weeks postoperatively, with magnet strength assessed at activation. Patients were followed for one year to document magnet strength adjustments and any retention difficulties.

Results
A total of 10 patients were included, receiving 11 implants, with one patient undergoing bilateral simultaneous implantation. The median age was 22 years (range: 15 - 36 years). The median skin thickness was 6 mm (range: 4–8 mm), and no patients required subcutaneous tissue reduction. Coil placement was subperiosteal in 36% of cases and over the periosteum in 64%. At activation, all patients achieved satisfactory sound processor retention. Throughout the one-year follow-up, no persistent retention issues or unintended processor detachments were observed. Only one patient (9.1%) required a reduction in magnet strength due to excessive coupling force.

Conclusion
MRI-ABCD provide reliable sound processor retention in adolescents and adults. These results support the clinical effectiveness of this implant system in maintaining secure retention while ensuring MRI safety.