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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451810002
DOI: 10.1055/s-0045-1810002
Original Research

Bilateral Fitting of Bone-Anchored Hearing Devices: Speech Recognition and Sound Localization

Authors

  • Cynthia Harumi Yokoyama Ueda 

    1   Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Isabela de Souza Jardim 

    1   Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Ricardo Ferreira Bento 

    1   Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

  • Renata Marcial Soares 

    1   Department of Otorhinolaryngology, Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil

Funding The authors received no financial support for the research.
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Abstract

Introduction

Bilateral fitting of bone-anchored hearing devices (BAHD) remains a contentious topic, as the use of a single device can direct sound to both cochleae. However, the interplay of interaural attenuation and time delay may result in different responses in each ear; thus, greater challenges for unilateral BAHD users.

Objective

To assess the auditory performance of BAHD users with unilateral and bilateral fitting regarding speech recognition in silence and noise and sound localization.

Methods

Cross-sectional study. Unilateral BAHD users treated at a Brazilian public hospital underwent a speech recognition test, containing a list of monosyllables at 65dBSPL in silence and noise (S/N ratio = 0dB). The sound localization test employed eight speakers arranged at 45° distance. A recorded trisyllabic word served as the stimulus. For bilateral fitting, an elastic band with a device similar to the implant was used; patients underwent the same tests under identical conditions.

Results

Sixteen patients were assessed (mean age = 24.2 years). The average monosyllable recognition in silence rate was 71.5% in unilateral fitting and 78.2% in bilateral fitting. In noise, 61% in unilateral fitting and 72.2% in bilateral fitting. The mean angular deviation for the sound localization test was 80.48° in unilateral fitting and 68.08° in bilateral fitting. The bilateral fitting outcomes were better for all tests.

Conclusion

Users with bilateral BAHD fitting had better outcomes for speech recognition and sound localization.

Keywords

bilateral hearing loss - hearing aids - bone-anchored prosthesis - bone conduction - correction of hearing impairment - speech discrimination tests

Authors' Contributions

CHYU: conceptualization, validation, formal analysis, investigation, writing; ISJ: conceptualization, methodology; RFB: supervision, RMS: investigation, validation.


Data Availability Statement

Data supporting the results of this study are available upon a reasonable request from the corresponding author.




Publication History

Received: 10 December 2023

Accepted: 24 May 2025

Article published online:
16 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Cynthia Harumi Yokoyama Ueda, Isabela de Souza Jardim, Ricardo Ferreira Bento, Renata Marcial Soares. Bilateral Fitting of Bone-Anchored Hearing Devices: Speech Recognition and Sound Localization. Int Arch Otorhinolaryngol 2025; 29: s00451810002.
DOI: 10.1055/s-0045-1810002