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Introduction Bone conduction hearing devices (BCDs) are an established intervention for pediatric conductive hearing loss (CHL), including congenital conditions such as aural atresia. Early fitting on a softband provides auditory access before surgical eligibility, making it a critical early hearing intervention. Recent guidelines have broadened BCD indications to include persistent CHL from otitis media with effusion (OME). With increasing clinical use, evidence on softband BCD outcomes remains limited, particularly for non-congenital etiologies. This study aimed to (I) characterize the demographic and clinical profiles of children fitted with a BCD through a national pediatric hearing care program (Study A) and (II) evaluate clinical outcomes during routine follow-up in a subset of these children with long-term BCD use on a softband (Study B). Methods Study A involved a retrospective review of 5,490 clinical records (1998–2025) from a nationwide Australian pediatric hearing service, extracting etiology, hearing loss laterality and degree, device type, and fitting parameters. Study B involved case file reviews of 200 children, capturing etiology, device use, and outcomes from the parents' evaluation of aural/oral performance of children (PEACH) questionnaire and routine speech perception testing; reported outcomes are limited to the non-surgical softband phase in children with long-term BCD use. Results Children with CHL associated with microtia/atresia represented 12% of all BCD fittings, while other causes—including canal stenosis, OME, craniofacial anomalies, cleft palate, and unknown etiologies—accounted for 88%. Median age at fitting was 3.6 months for children with microtia/atresia and bilateral hearing loss and 7.2 months for children with microtia/atresia and unilateral hearing loss, with later fitting (approximately 5 years of age) in other etiologic groups. In study B, most children were consistent daily users of their devices. For bilateral CHL, PEACH scores improved significantly with BCD vs. unaided listening ( p = 0.003), while differences for unilateral CHL were not significant ( p = 0.87). Across children with unilateral and bilateral CHL, routine aided speech scores typically exceeded 80%. Conclusion Among children with documented longer-term softband BCD use across diverse pediatric etiologies, outcomes showed robust aided speech performance and functional listening ability, particularly in children with bilateral CHL, supporting their clinical effectiveness.
Gavrilis et al. (Fri,) studied this question.