Single-sided deafness (SSD) significantly affects speech understanding and spatial hearing in noisy environments, reducing overall quality of life. Traditional hearing solutions such as contralateral routing of sound (CROS) hearing aids or cochlear implants may not be suitable for some patients due to anatomical constraints or intolerance.
This study evaluates the audiological and subjective benefits of active transcutaneous bone conduction implants in SSD patients.
A prospective study included 35 participants aged 13 to 51 years who were diagnosed with SSD. The leading causes of SSD were congenital deafness and mumps-related deafness. All participants were unsuitable for CROS hearing aids or cochlear implants due to anatomical limitations or intolerance. Patients underwent surgical implantation of a device on the deaf side. Speech recognition in noise was assessed using the Polish Sentence Matrix Test. Patient satisfaction and quality of life were evaluated before and after implantation using the Abbreviated Profile of Hearing Aid Benefit questionnaire.
Patients demonstrated a significant improvement in speech recognition in noisy environments. The mean Polish Sentence Matrix Test scores improved from +0.5 dB SNR at the initial assessment to -3.6 dB SNR six months after activation. The APHAB questionnaire results indicated enhanced communication abilities, with a mean benefit score of 21.5 points.
Bone conduction implants provide an effective and safe rehabilitation option for SSD patients, significantly enhancing speech understanding in noisy environments and overall quality of life. Early intervention with this technology may improve hearing outcomes in individuals with SSD who are not candidates for traditional hearing solutions. F

Background:

This study aims to compares the outcomes of cochlear implantation (CI) and active piezoelectric transcutaneous bone conduction implantation (OSI) in children with unilateral sensorineural hearing loss (UHL).

Methods:

A cross-sectional study of patients diagnosed with UHL who received CI or OSI between 2019 and 2025. Data collection included demographics, surgical details, pre- and post-implant hearing thresholds, speech discrimination scores (SDS), device usage, and the frequency of audiology programming and speech therapy sessions. Finally, hearing aids satisfaction survey was completed by the participant (or their parents).

Results:

Sixteen children were included: 7 OSI and 9 CI. Among CI recipients, 7 had prelingual congenital deafness (median age: 2.9 years), and 2 had postlingual UHL. In contrast, all OSI recipients (median age: 6 years) had aplastic/hypoplastic cochlear nerves. Preoperative hearing thresholds and SDS were similar between both groups. Postoperatively median aided pure-tone average was 32.5 dB for CI and 30 dB for OSI (p > 0.05). SDS was significantly higher in the OSI group (88% vs. 72%, p = 0.01), while CI provided better sound localization. CI recipients required more rehabilitation, with a median of 8 programming sessions and weekly speech therapy in the first year, compared to 2 programming sessions and minimal speech therapy for OSI recipients. Satisfaction scores were higher in the OSI group (92% vs. 84%, p = 0.01).

Conclusion:

CI and OSI effectively improved hearing in participants with UHL. OSI is a viable alternative, particularly for children with cochlear nerve deficiency and requires less rehabilitation.

BACKGROUND:Active transcutaneous bone conduction devices have an external microphone and processor that send electrical signals to the vibrating implant that is in contact with the bone.
METHODS:We evaluated the improvement of social and emotional aspects in 10 adults implanted with active transcutaneous bone conduction devices (8 implanted with BonebridgeTMBCI602 and 2 with Osia®2System), 3 men and 7 women (20-64 years old) who underwent surgery between July2023 and January2025, with unilateral deafness on the right ear. About the etiologies, 2 were diagnosed with enlarged vestibular aqueduct, 2 with deafness secondary to chronic cholesteatomatous otitis after mastoidectomy, 3 with idiopathic congenital deafness and 3 with a idiopathic sudden deafness. We used the Hearing Handicap Inventory for Adults(HHIA), a questionnaire that evaluates the social and emotional effects of hearing loss in individuals under 65 years before the surgery. After at least 2 months of device’s activation, patients were asked about the improvement in social and emotional aspects present in the HHIA.
RESULTS:Among the 10 patients evaluated, the average HHIA was 60.2% before the rehabilitation (above 42% represents a severe perception of the effects of hearing loss on daily life). After the device’s activation, 70% reported that are using more the telephone; 80% felt less embarrassed when introduced to strangers; 70% feel less irritated; 70% have less difficulty at parties and social events; 90% feel less sad and 80% have a better perception of the sound’s location source.
CONCLUSION:Bone conduction devices have an important role in improving the quality of life of patients with single sided hearing loss.

Background:
Single-sided deafness (SSD) significantly impairs spatial hearing, speech understanding in noisy environments, and overall quality of life. The Bonebridge (BB), an active transcutaneous bone conduction implant, has emerged as a promising less invasive solution, yet its subjective benefits in SSD remain undercharacterized.
Objectives:
To synthesize current evidence regarding the self-perceived auditory outcomes of Bonebridge in SSD patients, based on standardized Patient-Reported Outcome Measures (PROMs).
Methods:
A systematic review was conducted in accordance with PRISMA guidelines. PubMed, EMBASE, Cochrane Library, and Web of Science were searched for studies reporting PROMs after BB implantation in SSD. Ten studies met inclusion criteria. Data from three validated instruments—Abbreviated Profile of Hearing Aid Benefit (APHAB), Bern Benefit in Single-Sided Deafness (BBSS), and Speech, Spatial and Qualities of Hearing Scale (SSQ-B)—were extracted and pooled for analysis.
Results
The APHAB (n = 115) revealed significant post-implant improvement in Background Noise (-21.3), Ease of Communication (-18.9), and Reverberation (-18.9) (all p < 0.001), with no significant change in Aversiveness (p = 0.72). The BBSS (n = 85) showed high global satisfaction (mean: 3.19), with modest improvement in sound localization. SSQ-B results (n = 22) demonstrated gains in speech (+1.81), spatial (+0.66), and quality (+1.17) domains.
Conclusion:
Bonebridge offers robust subjective benefits for SSD patients, particularly in communication and speech-in-noise perception. Despite limited localization improvements, overall satisfaction is high, reinforcing the clinical value of PROMs in implant candidacy and counseling.

Introduction
Single-sided deafness (SSD) presents a substantial audiological challenge, impairing sound localization, speech understanding in noise, and spatial hearing. Bone conduction implants (BCIs) have emerged as an effective intervention for auditory rehabilitation in this population. However, the success of implantation largely depends on managing patient expectations. Realistic preoperative counseling is critical to ensure satisfaction and perceived benefit.
Objective
To describe surgical, audiological, and subjective outcomes in patients with SSD implanted with the Osia®2 system.
Methods
This was a multicenter, retrospective, descriptive study. Patients with SSD who received the Osia®2 device were included. Functional gain (FG) was assessed by comparing unaided preoperative thresholds to aided free-field thresholds with contralateral masking. Subjective benefit was evaluated using the Client Oriented Scale of Improvement (COSI) questionnaire before activation and 12 months post-activation.
Results
A total of 105 patients (mean age 35 years, range 6–79; 28% under 18) were included. Most surgeries (54%) were on the right ear; 10 involved conversion from a prior percutaneous implant. Mean surgical time was 51 minutes; 82% used a 4-mm implant. Mean skin thickness was 5.7 mm; flap reduction was required in only 3.8%. Preoperative PTA4 was 109.2 dB HL; aided PTA4 was 27.6 dB HL, yielding a mean FG of 81.6 dB. “Speech in noise” was the most common COSI priority (59%; mean improvement score: 3.8/5), followed by “speech in quiet” (24%; 4.6/5).
Conclusion
Osia®2 implantation in SSD is surgically feasible and provides excellent audiological outcomes. Proper expectation alignment remains essential to optimize patient satisfaction, especially in noisy environments.

Background:
Osseointegrated hearing devices have been used to treat conductive and mixed hearing loss along with single sided deafness since 1977. FDA approval for treatment of conductive and mixed hearing loss came through in 1996. Subsequent approval for treatment of unilateral sensorineural hearing loss wasn't until 2002. Multiple studies have indicated a high degree of satisfaction in various listening conditions in both patient populations. However, long term device usage and hearing satisfaction for patients with single sided deafness compared to conductive or mixed hearing loss has not been explored. The purpose of this study is to compare Long term outcomes between the two groups.

Methods:
This is a survey-based, case-control comparative analysis of subpopulations with single sided deafness and conductive/ mixed hearing loss who have been implanted for three to eighteen years. Type of osseointegrated device, hours per day of device use, upgrade status of device, and routine follow up status are the primary endpoints. Subjective patient satisfaction is the secondary endpoint.

Results:
Eight hundred eighty six patients met inclusion criteria. Seven hundred sixty eight patients had mixed/conductive loss and one hundred eighteen patients had single sided deafness. Outcomes on the type of osseointegrated device, hours per day of device use, upgrade status of device, routine follow up status, and subjective long term patient satisfaction will be reported.

Conclusion:
Early outcomes suggest patients with conductive or mixed hearing loss have higher hearing satisfaction, longer wear times and device use, more upgrades, and routine follow up as compared to the patients with single sided deafness.

Background: Bone conduction device can be a treatment option for the patients with single sided deafness (SSD). In the pilot study we compared the speech understanding in noise with active and percutaneous bone conduction device.
Methods: Patients with the SSD and normal hearing on the other side, the speech in noise comming from the frontal and deaf side was measured. We estimated the noise threshold for the 50 and 100% word understanding.
Results: We tested 10 OSIA and 10 Baha Connect patients. In OSIA, the average 50% words recognition in noise was at -9.1 dB at 0 degrees and - 9.3 dB on the deaf side. In the Baha patients it was at -7.7 dB at 0 degrees and - 8.5 dB on the deaf side. We noticed improvement in 100% words recognition with the bone conduction
Conclusions: Both devices provide better speech understanding in noise and are suitable for the patients with SSD. In our series younger patients achieved better results.

Background:
Single-sided deafness (SSD) significantly impairs spatial hearing and speech understanding in noise. Rehabilitation options include Contralateral Routing of Signal (CROS) hearing aids and bone conduction systems like ADHEAR. While both aim to overcome the head shadow effect, direct comparisons of their effectiveness and user satisfaction are limited.
Methods:
Thirty adults with SSD participated in a crossover study, each fitted with both a CROS hearing aid and the ADHEAR bone conduction device. Speech discrimination was assessed in quiet and noisy conditions using free-field testing, with noise presented to the better-hearing ear and speech stimuli directed to the poorer ear. Subjective hearing experiences, including spatial perception and sound quality, were evaluated using the Speech, Spatial and Qualities of Hearing Scale (SSQ).
Results:
The ADHEAR device demonstrated significantly better speech discrimination scores in both quiet and noisy settings (p < 0.005). Participants reported improved spatial hearing and overall sound quality with ADHEAR. Additionally, 90% of users preferred the ADHEAR, citing enhanced hearing benefit and the convenience of wearing a single, non-occluding device on the mastoid. CROS hearing aids were less favored due to the requirement for bilateral devices.
Conclusion:
The ADHEAR bone conduction system offers superior speech understanding, spatial hearing, and user satisfaction compared to CROS hearing aids in adults with SSD. It is a practical and effective non-surgical option for auditory rehabilitation.