Twenty-six patients with severe mixed hearing loss (PTA range 57 to 108 dB HL) were fitted with the “super-bass” bone-anchored hearing aid (BAHA) HC220 and divided into two groups. Group I contained 19 patients who previously used a conventional bone conduction hearing aid that had resulted in serious complaints. Group II contained 7 patients who had previously used an air conduction hearing aid that could no longer be used because of recurrent otorrhoea. Sound field speech audiometry for the patients in Group I revealed that for 7 patients the maximum phoneme score did not change, but that it improved for 12 patients with the HC220, compared with their conventional bone conduction hearing aid. In Group 11, the maximum phoneme score improved for 3 patients, worsened for 3 patients and did not change for 1 patient with the HC220, compared with their air conduction hearing aid. Speech recognition in noise was difficult for most of the patients regardless of group. However, results were obtained from 10 patients, and 7 improved significantly with the HC220 compared with their previous aid. Overall, speech recognition with the HC220 was comparable with or better than a conventional bone conduction hearing aid; however, compared with an air conduction hearing aid the results were ambiguous.