Patients with large conductive hearing loss do not always tolerate con
ventional air conduction or bone conduction hearing aids. They can be
helped sometimes with an implantable bone conductor device. The so-cal
led bone-anchored hearing aid consists of an implantable titanium skul
l screw and an external sound processor unit. In this study, we report
our experiences with 10 subjects who have been implanted with the rec
ently improved Audiant screw-type XA-II and their experience with the
newly developed behind-the-ear (BTE) external processor, the at-the-ea
r processor and the body-level device with a new transducer with varia
ble magnetic strength. Evaluation shows that the Audiant XA-II system
is well accepted and does not show any tissue reaction. The BTE proces
sor is an important new complement to the Audiant system. Furthermore,
the system is effective in compensating the air-bone gap almost compl
etely at the higher frequencies but only partially at the lower ones.
The maximum output appears to limit its feasibility for perceptive los
ses beyond 20 dB (PTA). When this system is utilized for proper hearin
g loss, however, the system usually improves speech intelligibility bo
th in quiet and in background noise. When the system is prescribed for
hearing losses with a moderate or large perceptive component, the sys
tem is ineffective and leads to negative evaluations.