The Merits of Bilateral Application of Bone-Conduction Devices in Children With Bilateral Conductive Hearing Loss.
Chrisje A den Besten, Katharina Vogt, Arjan J Bosman and 3 others
PMID 32032221WHAT IT FOUND
Children with bilateral conductive hearing loss who wear two bone conduction devices can tell if a sound is on the left or right.
However, they mostly lateralize rather than truly localize the exact source. Using one device instead of two significantly worsened this ability.
Key findings
01Listening with two bone conduction devices resulted in significantly better lateralization (minimum audible angle) compared to listening with just one device.
02While bilateral fitting allowed children to distinguish left from right, their responses showed a bimodal pattern indicating lateralization rather than true sound localization.
03When using only one bone conduction device, 92% of stimuli were perceived toward the aided side, demonstrating a strong bias that does not occur with bilateral use.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study included a small number of participants (11 children). The unilateral condition was acute (temporary), so children were not accustomed to using just one device for a long period, which might affect real-world performance. There was potential selection bias, as children who were less satisfied or had difficulty cooperating were excluded. The study population was unique, with varied hearing loss etiologies (mostly congenital) and ages. The study did not determine if training could improve true localization abilities over time.
Declared interests
The funding source is listed as 'Research Support, Non-U.S. Gov't' in the publication types. No specific conflicts of interest statement from the authors is provided in the text.
The easy way to misread this
Do not assume that bilateral bone conduction devices provide normal hearing or true sound localization. The study shows that while these devices allow children to tell left from right, they mostly lateralize sounds rather than pinpointing exact locations. Additionally, do not assume that a child who struggles with bilateral use will perform better with one; the unilateral condition resulted in a strong bias to the aided side and worse lateralization.