There are many different types of hearing loss, and while traditional hearing aids are a great option for many types and degrees of hearing loss, they’re not always the right option. In some cases — especially those where hearing loss is just in one ear or if there is a blockage in the middle ear — a different option is needed. In these cases, bone-anchored hearing aids may be a better fit.
In this post, we’ll explore the differences between these two types of hearing aids, the pros and cons of each, and who is best served by each type.
Hearing aids, in today’s context, are high-tech amplification devices designed to help people with hearing loss hear more clearly. Modern hearing aids have extensive built-in technology that makes them easy to use and adaptable in different sound environments, helping wearers re-engage with the world around them.
All hearing aids contain three main components: the microphone, amplifier and speaker (sometimes called the receiver).
The microphone picks up the sound around you and then converts it into a digital signal, which the amplifier intensifies and sends it through to the speaker, helping the hearing aid wearer better hear the sounds in their environment. But each hearing aid type does this slightly differently, due to unique designs.
There are three main types of hearing aids, outlined below.
● Behind-the-ear (BTE) hearing aids: this is the type of device most people picture when thinking of hearing aids. They’re larger than other hearing aid types, but this means they’re able to offer more powerful amplification, making them suitable for those with severe and profound hearing loss.
● Receiver-in-canal (RIC) hearing aids: these hearing aids offer the most natural sound quality, due to the receiver sitting directly in the ear canal. RIC hearing aids can treat the widest range of hearing losses, and that factor, along with their discreet design, makes them the most popular style of hearing aids.
● In-the-ear (ITE) hearing aids: these hearing aids are the smallest and most discreet hearing aid style, and there are no components that loop behind the ear. The entire device sits within the bowl or canal of the ear, with the earpiece custom molded for a secure and comfortable fit. Sub-categories of ITE hearing aids include completely-in-canal (CIC) and invisible-in-canal (IIC), the two smallest styles of hearing aids that are nearly invisible.
There are two main types of surgically implantable BAHAs: BAHAs with abutments and BAHA magnetic hearing aids. Both feature an implant attached to the skull, but one utilizes a BAHA abutment to connect the implant to the sound processor that sits on the outside of the head while the other uses a magnet. But overall, the way they transfer sound via bone conduction is the same.
Nonsurgical bone conduction hearing aids (BCHA) are an alternative to BAHAS, typically used as an option for children who are not ready for a BAHA surgery, or for people who simply don’t want the surgery. BCHAs still transfer sound via bone conduction, but rather than a surgical implant, the BCHA either attaches directly to the skin by an adhesive or is attached to a headband which is worn as needed.
Bone-anchored hearing aid surgery is typically an outpatient procedure, with the surgery itself lasting about 30-60 minutes.
The surgery involves an otolaryngologist making an incision in the skin behind the ear, then drilling a small hole in the mastoid bone of the skull, where a titanium implant is placed.
If a BAHA abutment is being used (rather than a magnetic connector) the abutment will also be placed during surgery, and the skin will heal around it.
Below, we’ll outline the pros and cons of hearing aids, from who they work best for to how cost and built-in technology can affect your decision-making process.
Pros:
Cons:
Below, we’ll outline the advantages and disadvantages of bone-anchored hearing aids to help you assess if this might be the right option for addressing your hearing loss needs.
Pros:
Cons:
Use the table below to help guide you in which type of hearing aid is best for your situation. But, of course, always talk to your doctor or hearing care professional for their insights and advice on your unique situation.
How it works: Amplifies sound and transmits it through the ear canal
Type of hearing loss: Sensorineural hearing loss (mild to severe) and some cases of mixed hearing loss
Aesthetic appearance: Generally small and discreet; some are nearly invisible
Comfort: May cause a plugged-ear sensation, depending on the style of the hearing aid
Sound quality: Depends on the severity of hearing loss and device technology
Maintenance: Requires cleaning and regular battery replacement or recharging, as well as annual check-ups and adjustments as necessary
Surgical requirement: No
Cost: Varies, from moderate to high
Best for: People with mild-to-profound sensorineural or mixed hearing loss (different types of hearing aids are better suited to different levels of hearing loss)
How it works: Transmits sound via bone vibrations directly to the inner ear
Type of hearing loss: Conductive, unilateral or mixed hearing loss, or single-sided deafness (SSD)
Aesthetic appearance: Requires a visible sound processor that is attached to the skull behind the ear
Comfort: Since no part of the device sits inside the ear, its generally more comfortable; however, the surgery and healing process require can cause discomfort
Sound quality: Clearer for those with middle or outer ear issues
Maintenance: Requires care of the implant area and regular check-ups following the implant surgery
Surgical requirement: Yes
Cost: Higher cost; includes surgery and device expenses, though these may be covered by insurance
Best for: People with conductive hearing loss, severe mixed hearing loss or single-sided deafness
