Comparison of 2 Implantable Bone Conduction Devices in Patients With Single-Sided Deafness Using a Daily Alternating Method

OBJECTIVE: Comparison of the auditory and subjective capabilities of 2 implantable bone conduction devices BAHA Divino sound processor (Divino) and the BAHA BP100 sound processor (BP100) using a daily alternating method. STUDY DESIGN: Open prospective comparative trial. SETTING: Tertiary referral otology and neurotology center. PATIENTS: Ten patients with single-sided deafness (SSD) using a Divino for more than 1 year. INTERVENTIONS: The patients with SSD changed to the BP100 for 1 week, and then underwent an evaluation period of 18 days switching between BP100 and Divino on a daily alternating basis. On a scale from 0 to 10, patients rated their quality of hearing daily with both devices concerning overall satisfaction, clearness of sound, and effort of listening in background noise. For the total duration of the trial, the spatial hearing questionnaire (SHQ) and the abbreviated profile of hearing aid benefit (APHAB) were administered. In the unaided condition and with Divino at baseline and aided with BP100 after the evaluation period, adaptive speech in quiet and in noise testing was performed with speech and noise coming from different azimuth angles. MAIN OUTCOME MEASURES: Subjective rating in a diary, APHAB, SHQ, and aided speech in quiet and speech in noise. RESULTS: The diary shows significant improvement on all subscales with BP100 in comparison with Divino. These differences did not change significantly during 18 days. On the APHAB, listening in background noise and in reverberant conditions was rated significantly better with the BP100. The SHQ shows a significant difference between both devices on all subscales except for source localization and speech understanding in quiet. Speech audiometry showed a significant head shadow benefit with both implantable bone conduction devices (median Q1, Q3: Divino = 2.67 dB 0.33, 1.51, BP100 = 2.83 dB 4.08, 3.83). There was no significant difference found between both devices. CONCLUSION: Both the Divino and the BP100 reduce the handicap experienced by patients with SSD. Subjective assessment using a daily alternating method shows higher overall hearing capabilities with BP100. Results of the questionnaires are similar. Speech audiometry in noise does not reveal a statistically significant difference between both devices. A daily alternating method can provide useful information for both the patient and the audiologist because objective measurements do not show any statistically significant differences between patients. In our opinion, daily alternation of devices is a useful method to compare different devices.