Evaluation of an abutment‐level superpower sound processor for bone‐anchored hearing

Objectives Performance of an abutment‐level superpower sound processor for bone‐anchored hearing, the Ponto 3 SuperPower from Oticon Medical ( BCD 2), was compared to an earlier model from Oticon Medical ( BCD 1). Design A comparative study in which each patient serves as its own control. Setting Tertiary clinic. Participants Eighteen experienced BCD 1 users with profound mixed hearing loss. Main outcome measures Speech reception thresholds in noise; APHAB and SSQ questionnaires. Results In a group of 18 patients with severe mixed hearing loss, the performance of a recently introduced bone conduction device ( BCD 2) is evaluated relative to that of an earlier model ( BCD 1). Speech reception thresholds for the sentence‐in‐noise test in the speech and noise frontal condition are not significantly different ( P >  .05) for BCD 1 and BCD 2. Speech reception thresholds for frontal speech and three identical noise sources are 1.7 dB lower for BCD 2 than for BCD 1 ( P  <   .05). With the APHAB questionnaire, the score for background noise is significantly lower ( P  <   .01), that is more favourable, for BCD 2 than for BCD 1 with an effect size of 0.91. The APHAB domain scores for ease‐of‐communication, reverberation and aversiveness of loud sounds are not significantly different for both devices ( P  >   .05). Scores for the speech, spatial and quality of hearing domains of the SSQ questionnaire are significantly higher ( P  <   .01), that is more favourable, for BCD 2 than for BCD 1 with effect sizes of 1.22, 0.71 and 1.05, respectively. Scores for the SSQ ‐factors “speech understanding,” “spatial,” “clarity, separation and identification” and “listening effort and concentration” were all significantly higher ( P  <   .05) for BCD 2 than for BCD 1, with effect sizes of 1.28, 0.64, 0.98 and 0.78, respectively. On a proprietary questionnaire, 16 patients indicate a preference for BCD 2 over BCD 1 for conversations in a small group and two patients have no preference for either device. In a large group, one patient prefers BCD 1, six patients have no preference, and eleven patients prefer BCD 2. When listening to music, all patients prefer BCD 2 over BCD 1, with a strong preference for BCD 2 for seven patients. When asked for an overall preference, all patients prefer BCD 2 over BCD 1, with nine patients strongly preferring BCD 2. Conclusions The lower speech reception thresholds in noise with BCD 2 relative to BCD 1 can be attributed to the “speech omni” directionality mode of BCD 2. The combination of an improved directionality for primarily low‐level inputs and a higher maximum force output, relevant for mid‐ and high‐level inputs, results in a clear preference for BCD 2 over BCD 1.