Learning Objectives: The Bonebridge is viable and popular alternative to conventional hearing aids and other implantable devices in suitable patients.

Introduction: The Bonebridge is a semi-implantable transcutaneous bone conducting device that was introduced in 2012. The device consists of an internal Bone Conducting Implant device, consisting of a magnet, receiver coil, demodulator and Bone Conducting – Floating Mass Transducer (BC-FMT), and the external Samba sound processor. It is suitable for conductive and mixed hearing losses or for single-sided deafness (SSD). The manufacturers recommend BC thresholds no greater than 45 dB in conductive or mixed hearing loss.

Methods: Since the first surgery was carried out in Tayside in 2012 we have now carried out 16 implantations on 15 patients for a range of indications including ear canal atresia and stenosis, SSD and following CSOM surgery. The procedure requires pre-operative planning on CT due to the size of the BC-FMT, as the dura, ear canal and sigmoid sinus must be avoided or managed. Due to the amount of drilling required and the length of the procedure all cases in Tayside have been carried out under general anaesthesia.

We are able to offer suitable patients the choice between Bone Anchored Hearing Aids (BAHAs) from both manufacturers, BAHA Attract and Bonebridge. The majority choose Bonebridge. Due to the limited gain we recommend BAHA Attract rarely.

Results and Conclusions: The patients who have chosen Bonebridge generally do so because of cosmetic reasons and because of the avoidance of feedback. Hearing outcomes for BAHA and Bonebridge appear similar. Local patient satisfaction surveys have demonstrated a high level of satisfaction with Bonebridge.