ORIGINAL RESEARCH article
Front. Audiol. Otol.
Sec. Technology and Innovation in Auditory Implants and Hearing Aids
This article is part of the Research TopicAdvances in Technologies for Fitting Bone Conduction Hearing DevicesView all 4 articles
Equivalent Threshold Force Levels for Skin Drive Bone Conduction Hearing Devices
Provisionally accepted
- Western University, London, Canada
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Introduction: Bone conduction hearing devices (BCDs) are essential for individuals with conductive or mixed hearing loss who cannot use traditional air conduction devices. Prescriptive methods for skin drive BCDs have recently been developed, taking into account skin and soft tissue transmission loss. Equivalent Threshold Force Levels (ETFLs) are needed to define normative references and enable accurate prescription and verification yet are not well established for skin drive BCDs. Methods: In this study, in-situ thresholds were measured in 20 normal-hearing young adults using three commercially available skin drive BCDs, and corresponding force level outputs were recorded with a skull simulator to derive ETFLs. Results: In-situ thresholds were significantly higher than audiometric bone conduction thresholds and varied by 2.7–15 dB across devices. After conversion to force levels, variability in measured thresholds between devices decreased but remained significant at select frequencies, with discrepancies of up to 17 dB. Discussion: These results indicate that ETFLs can be defined for skin drive BCDs, although device-specific differences are observed. Establishing ETFLs provides a foundation for standardized prescription and verification methods, but may need to incorporate device-specific properties.
Keywords: Bone Conduction, force level output, hearing aid fittings, Hearing Aids, in-situ thresholds, Reference Equivalent Threshold Force Levels, transcutaneous
Received: 27 Sep 2025; Accepted: 04 Dec 2025.
Copyright: © 2025 El-Naji, Bagatto and Scollie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marlene Bagatto
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