A bone conduction device is a well-established treatment indicated for patients with unilateral microtia and canal atresia. There are a variety of nonsurgical bone conduction hearing aids (BCHAs) with different coupling methods (softbands/adhesive adapter/spectacles). There appears to be uncertainty of the true benefit of different coupling methods with issues surrounding skin irritation/aesthetic/audiological outcomes. The authors have evaluated the audiological characteristics of the different wearing modes in the same BCHA (ADHEARtm). Eighteen patients were assessed (range 5-24) audiologically with warble tones at frequencies 0.5, 1, 2, and 4kHz to determine functional hearing gain (FHG) of hearing thresholds (in dB HL). In addition, speech perception abilities were assessed by speech discrimination score (SDS in %) in Mandarin Chinese. Hearing outcomes were evaluated with the BCHA worn on either a softband or adhesive adapter. Results indicated the mean FHG was 20.63 dBHL with the adhesive adapter, and 26.39 dBHL with the softband. Similarly, the softband provided higher aided SDS than adhesive adapter. The authors suggest the significant benefit of BCHAs in microtia patients - both coupling methods are significantly better for audiological outcomes. It is useful to consider the patient individually when utilising BCHAs. With lower BMI/smaller hearing loss/sensitive skin/aesthetic favouring adhesive adapter and vice versa.