title: Comparison between a new implantable transcutaneous bone conductor and percutaneous bone-conduction hearing implant.
abstract: OBJECTIVE
  Despite good results on osseointegration and limited skin reactions with percutaneous bone conductors, there remains room for improvement. Especially in children, adverse events with percutaneous bone conductors might occur more frequently. Transcutaneous bone conductors, if powerful enough, can provide a solution that minimizes adverse events and implant loss. This study compares a new transcutaneous bone conduction hearing aid, the Sophono Alpha 1 (Sophono), with the percutaneous BAHA system (BAHA).
  
  
  METHODS
  In our tertiary referral center, 12 patients (age 5-12 yr) with congenital unilateral conductive hearing loss were enrolled in the study as follows: 6 patients with the Sophono and 6 with the BAHA. Both clinical results and audiologic data were gathered. For an objective audiologic comparison between both systems, we used a skull simulator.
  
  
  RESULTS
  The skin reactions were comparable between both groups, in 1 implant was lost 1 month after second phase surgery (BAHA). The users received audiologic benefits from both systems. The BAHA-based outcome was slightly better compared with Sophono-based results in sound field thresholds, speech recognition threshold, and speech comprehension at 65 dB. The skull simulator demonstrated that the BAHA device has an output that is 10 to 15 dB higher compared with the Sophono device.
  
  
  CONCLUSIONS
  The Sophono offers appealing clinical benefits of transcutaneous bone conduction hearing; however, the audiologic challenges of transcutaneous application remain, as the Sophono does not exceed percutaneous application regarding audiologic output.
authors.affiliation: Department of Otorhinolaryngology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. M.Hol@kno.umcn.nl
authors.forename: Myrthe K S
authors.initials: MK
authors.lastname: Hol
authors.forename: Rik C
authors.initials: RC
authors.lastname: Nelissen
authors.forename: Martijn J H
authors.initials: MJ
authors.lastname: Agterberg
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
mesh_terms: D000161:Acoustic Stimulation; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003054:Cochlear Implants / Q000009:adverse effects; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006310:Hearing Aids / Q000009:adverse effects; D006801:Humans; D008297:Male; D016348:Osseointegration; D013506:Otologic Surgical Procedures; D012189:Retrospective Studies; D012886:Skull / Q000502:physiology; D013063:Speech Discrimination Tests; D016896:Treatment Outcome