Background:
Conductive hearing loss (CHL) and single -sided deafness (SSD) pose challenges when surgical correction is not feasible, non-surgical options, such as percutaneous abutment-fixed devices (BAHA), adhesive bone conduction systems (ADHEAR), and contralateral routing of signal (BICROSS), provide varying benefits. However, osseointegrated implants offer a more stable and effective alternative. Sidra Medicine, the first hospital in Qatar to implement the OSIA300 implant, has evaluated its clinical outcomes.
Methods:
Patients with long-standing CHL, unsuitable for surgery and SSD patients struggling with. Comparative analysis including audiometric evaluation and speech perception tests, and patient reported outcomes before and after intervention with non-surgical solutions or OSIA300

Results:
Non-surgical devices improved hearing but had limitations in sound quality and localization. OSIA300 recipients showed enhanced speech perception, particularly in noise, with greater patient satisfaction. No major complications were reported during follow-up.

Conclusion:
While non-surgical options remain viable, osseointegrated implants provide superior outcomes in clarity, spatial hearing, and comfort. As the first institution in Qatar to adopt this technology, Sidra Medicine experience highlights its clinical benefits. Further research is needed to refine patient selection criteria and optimize outcome

Background:
Conductive hearing loss (CHL) in children, whether congenital or acquired, can significantly hinder speech, communication, and social development—yet it is often under-recognized. Early intervention is crucial. Non-surgical solutions like BAHA softbands and surgical devices such as active transcutaneous bone conduction implants (BCIs) are currently available. Among BCIs, the OSIA system allows direct bone stimulation while avoiding skin complications common to percutaneous systems.

Methods:
This prospective study evaluated the audiological and subjective outcomes of 18 pediatric patients implanted with OSIA 2 or OSIA 3 devices. All participants had previously used a BAHA softband (aBCD), enabling intra-individual comparison. Assessments were conducted at 1, 6, and 12 months post-activation and included pure-tone audiometry (PTA), speech recognition in noise (Matrix Test), and the Speech, Spatial, and Qualities of Hearing Scale (SSQ) for subjective evaluation.

Results:
The mean age at surgery was 12,3 years. Ten children had single-sided deafness (SSD) due to congenital malformations, and six had bilateral CHL. The unaided four-frequency PTA averaged 54 dB HL. Hearing thresholds improved to 34 dB HL (37% gain) with the softband and to 27 dB HL (51% gain) with OSIA. Matrix Test results improved by 23.4% with the softband and 44.6% with the OSIA. Subjective satisfaction, as measured by SSQ, was higher with the implanted system.

Conclusion:
While softband devices are useful alternatives when surgery is not feasible, the OSIA implant demonstrated superior audiological performance and user satisfaction within three months. For children with SSD or CHL, BCIs represent a more effective long-term solution, particularly in noisy environments.

Background: Hearing loss can significantly impact speech, learning and social development, especially in childhood. Although conventional hearing aids are effective for many children with conductive or mixed hearing loss (CHL/MHL), they may be insufficient in some cases. The Bonebridge implant offers an effective bone conduction alternative for children over the age of five.
Methods: This study involved 80 paediatric patients (M=13.2 years) aged 5–17 years, including 60 with CHL and 20 with MHL, who underwent Bonebridge implantation. To evaluate the efficacy of the Bonebridge implant, audiological outcomes were assessed before implantation and again 3-6 months after activation. These included pure-tone and speech audiometry in a free field, the Polish Matrix Sentence Test and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire.
Results: Post-implantation average hearing thresholds (500–4000 Hz) were 25.2–34.1 dB HL (CHL) and 29.3–38.8 dB HL (MHL). Word recognition improved from 5% to 92% (CHL) and from 0.6% to 88% (MHL). Matrix test scores improved from +3.11 to –4 dB SNR (CHL) and from +5.4 to –3.5 dB SNR (MHL). APHAB scores showed reductions in perceived difficulties by 15.4 points (pre M=39.2; post M=23.8) (CHL) and 16.9 points (pre M=46.3; post M=29.4) (MHL).
Conclusion: Bonebridge implantation led to significant improvements in hearing thresholds and speech understanding in quiet and noisy environments. Although children with MHL initially performed worse, they achieved comparable improvements and reported greater subjective reductions in hearing-related difficulties than those with CHL.

Background
BC aids are an alternative to surgery for OME. They are also an excellent stop gap whilst patients are waiting for surgery. We wanted to audit the outcomes.
Method
The medical notes of 50 consecutive otherwise fit and well children with persistent OME who elected for treatment with BC aids +/- grommet insertion later were analysed for their outcome 3 months after fitting.
Results
Average age 6 years (range 2-15). All patients had a Starkey Contact mini on a soft band or Alice band. Outcomes: 20 still using, 12 stopped wearing as got better, 6 stopped wearing as had grommet insertions, 12 stopped as uncomfortable. Those that stopped for discomfort were a mixture of soft band and Alice band users.
Conclusions
BC aids are a viable alternative to grommet insertion in our practice. No patient stopped wearing because they didn’t work. 24% got better and thus potentially avoided an operation. Newer more comfortable/cosmetic BC designs could improve compliance.

Background
Bone conduction devices (BCDs) are critical interventions for children with conductive or mixed hearing loss who are not candidates for traditional hearing aids. Early amplification with non-surgical BCDs (e.g., softband or adhesive systems) aligns with Joint Committee on Infant Hearing (JCIH) recommendations for intervention before 6 months of age. Surgical BCDs, typically introduced after age 5, offer improved sound transmission and stability. However, real-world data on device adoption, long-term adherence, and transition patterns from non-surgical to surgical systems remain limited.

Methods
A retrospective chart review was conducted at a tertiary care center, evaluating pediatric patients (<18 years) who underwent bone-conduction hearing evaluations and received either non-surgical or surgical BCDs. Data collected included device type, age at fitting, follow-up adherence, duration of use, and transition rates between device types.

Results
Analysis of 360 subjects reveals higher long-term adherence in children receiving surgical BCDs compared to non-surgical systems. The transition rate from non-surgical to surgical BCDs was 11%. Despite surgical eligibility beginning at age 5, most transitions occurred later indicating a delay in surgical intervention . Data logging indicated lower average daily use among soft band users compared to those with surgical implants. Higher rates of discontinuation and loss to follow-up were more common among patients using non-surgical devices.

Conclusion
Surgical BCDs are associated with improved long-term use and follow-up adherence compared to non-surgical solutions. Understanding the timeline and influencing factors for device adoption and transition can inform clinical counseling, promote early intervention, and optimize hearing outcomes in pediatric patients with hearing loss.

Background:
Improving communication for children and adolescents with single-sided deafness (SSD) is a significant challenge. If hearing cannot be primarily restored, the only alternative is to transfer the acoustic signal to the contralateral hearing ear (CROS).
Here, we report on our experience of treating children and adolescents with SSD using an active bone conduction (BC) hearing implant (BoneBridge®) as CROS device.

Methods:
Olgahospital Stuttgart has been treating patients with BB implants since 2012. To date, 92 BB implants have been fitted for various conditions and in patients of various ages. Nine children and adolescents have received an implant for SSD.
In our experience, subjective benefit is best measured by processor wearing time. Psychoacoustic test procedures can also be used, but these tests are not standardisable in practice. The implant fitting was individually adapted to the subjective hearing threshold of the better ear.

Results:
The wearing time of the implant was very variable, ranging from 4 to 13 hours.

Conclusion:
The BoneBridge® BC implant for SSD enables a practical improvement in everyday communication and is well accepted by the wearer. The amplification must be adjusted according to the wearer's subjective perception of loudness. As a result, it can be worn for long periods of time over many years.

Background:
Children with unilateral aural atresia (UAA) might benefit from unilateral bone conduction amplification. There are few prospective studies comparing the outcome of implantation using active middle ear implants (AMEI) or active transcutaneous bone conduction devices (atBCD) on sound localization ability (SLA) and speech recognition thresholds (SRT).

Methods:
Children with UAA aged 4-18 eligible for AMEI or atBCD were included in a repeated measurements prospective observational study. Unaided hearing thresholds, SRT and SLA were measured at baseline (just before surgery), and aided post-operatively. The SRT was estimated in spatially separated and co-located competing speech. SLA was measured using corneal eye-tracking and quantified as an error index (EI) ranging from 0 (perfect) to 1 (random performance).

Results:
Fourteen individuals have been included (AMEI n=10, atBCD n=4). Ten individuals completed postoperative measurement on average 1.1 years after implantation. Postoperative data presented are preliminary results from the last measurement conducted.

Aided postop in situ pure tone average was 22 dB HL (n=14).

Median spatially separate SRT improved by of 2.5 dB (preop: -10.2 dB (n=9), postop: -12.7 dB (n=8)) whereas co-located SRT improved by a median of 3.2 dB (preop: -3.5 dB (n=7), postop: -6.7 dB (n=8)).

The median difference in EI was 0.183 (preop: EI=0.505 (n=14), postop: EI=0.322 (n=10)) corresponding to improved SLA. Significant intra-individual change (>0.054) was found in 6 individuals (5 improved and 1 deteriorated).

Conclusion:
On a group level our preliminary results show that SRT and SLA might improve after implantation with AMEIs or atBCDs. However, intra-individual results vary.

Background: While one-stage bone-anchored hearing surgery (BAHI) has long been the standard in adult patients, the approach has been more cautious in children where the use of two-stage procedures and later loading of the sound processor remains common. Nevertheless, some clinics have implemented on-stage procedures in paediatric patients with good results.
The objective of this study was to evaluate the clinical safety, stability, and functional outcomes of early sound processor loading following one-stage BAHI surgery using the Oticon
Medical Ponto BHX system in a paediatric population.
Methods: The study was a prospective single-centre, single-arm observational study with 24-month follow-up conducted at The James Cook University Hospital, Middlesbrough, United Kingdom. The patient cohort consisted of fifteen children (ages 7–14 years) with conductive or mixed hearing loss who received 16 Ponto BHX implants via a one-stage surgical approach, followed by early sound processor loading.
The primary outcome was Implant survival at 24 months. Secondary outcomes included implant stability (ISQ), audiological performance, soft tissue tolerance (Holgers score), and patient-reported outcomes (PEACH, GCBI).

Results: All 16 implants remained stable at 24 months with no losses. ISQ values were high at baseline and showed statistically significant increases over time (p<0.05). Skin reactions were minimal, with only one transient adverse reaction (Holgers 2). Audiological thresholds improved across frequencies, and patient-reported outcomes indicated increased quality of life and hearing satisfaction.

Conclusion: Early loading of the Ponto BHX system following one-stage BAHI surgery is clinically safe and feasible in children, offering reliable osseointegration and improved auditory and quality-of-life outcomes.