Bone-anchored hearing aids (BAHAs) provide a unique hearing solution for individuals with specific types of hearing loss or conditions that make traditional hearing aids unsuitable. By utilizing bone conduction technology, these devices bypass the outer and middle ear to deliver sound directly to the inner ear. With a combination of surgically implanted and external components, BAHAs offer improved sound clarity and accessibility for those facing challenges with conventional hearing aids.
Bone-anchored hearing aids (BAHAs) are specialized devices designed to assist individuals with certain types of hearing loss, particularly conductive or mixed hearing loss, and those who cannot use conventional hearing aids due to chronic ear conditions or anatomical challenges. A BAHA hearing system is surgically implanted and has both internal and external components, allowing sound waves to travel to the inner ear bones via bone conduction.1
A BAHA hearing device uses a titanium implant anchored in the skull to transmit sound vibrations through the bones of the skull directly to the inner ear, bypassing the outer and middle ear. This method is particularly beneficial for individuals with conditions like aural atresia (absence of an ear canal) or chronic ear drainage, where traditional air-conduction hearing aids are not suitable.
A bone-anchored hearing aid and cochlear implant are both surgical devices, but differ in design, function, and suitability for patients.
BAHAs are used to treat mild to moderate hearing loss. This hearing device introduces sound into the mastoid bone directly and bypasses the skin and subcutaneous tissues in the outer and middle ear. BAHAs do not restore perfect hearing but help patients better discern speech and sounds.
Cochlear implants partially restore hearing and are used to treat severe hearing loss from inner-ear damage. These small electronic devices consist of an external portion that sits behind the ear, and a second portion surgically placed under the skin. Cochlear implants bypass damaged portions of the ear, but rather than amplify sound, they directly stimulate the auditory nerve.
There are two main bone-anchored hearing aid types.
The Percutaneous (Abutment) System involves a titanium implant that is surgically placed in the bone behind the ear. A small connector (abutment) comes through the skin, and a sound processor attaches to it. This sends sound vibrations directly to the skull and inner ear.
The Transcutaneous (Magnetic) System also uses a titanium implant, but instead of an external abutment, it employs two magnetic discs. One disc is attached to the implant and buried under the skin, while the other is external and connected to the sound processor. With magnetic bone-anchored hearing aids, sound vibrations pass through the skin to the skull and cochlea.
There is also a nonsurgical alternative called a bone conduction hearing aid (BCHA). Rather than involving a surgical procedure, BCHAs are instead worn externally using headbands, softbands, adhesive systems, or other wearable configurations. This is often a great alternative to a BAHA for children who aren’t ready for a surgical device or for adults who want to try a BAHA system ahead of surgery.
Bone-anchored hearing aid surgery involves two steps: surgically placing the titanium implant and attaching the external sound processor. It is typically an outpatient procedure done in one stage for adults under local anesthesia2 and takes about an hour to perform.
Post-surgery, it’s important to keep the surgical site clean and dry. You may be given a healing cap to wear over the site for a week or more, to promote healing. Your doctor will tell you when you are cleared to shower and wash your hair, as the surgical site can’t immediately be exposed to water.
All that being said, recovery from bone-anchored hearing aid surgery is usually straightforward, and patients can usually get back to their regular activities quickly. However, it is important to consult with your provider for full recovery details.
Bone-anchored hearing aids sit outside the ear canal, offering greater comfort and reducing the risk of skin irritation. They offer a solution for individuals who cannot use traditional hearing aids due to the shape or size of their ear canals.
Although they are a great option for many, there are some disadvantages of bone-anchored hearing aids to keep in mind. Surgical implantation can carry the risk of infection, inflammation, or implant failure. Additionally, BAHAs may not be suitable for individuals with certain medical conditions or anatomical challenges that complicate implantation.
Bone-anchored hearing aid complications include losing the implant and skin problems, which occur due to irritation around the abutment.2
The cost of BAHAs can vary greatly, ranging from roughly $9,000 to around $25,000 with the devices and surgery combined. Costs vary based on factors like the hearing system type, clinic location, specialist expertise, follow-up care, maintenance, and surgical expenses. Fortunately, BAHAs are typically covered under health insurance.
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Accessories for bone-anchored hearing aids include:
BAHA wearers often report improved hearing clarity, especially in noisy environments. Many find BAHAs more comfortable than traditional hearing aids, since they don’t sit in the ear canal, though some users experience challenges with skin irritation around the implant site.
1Hagr, Abdulrahman. “BAHA: Bone-Anchored Hearing Aid.” International journal of health sciences vol. 1,2 (2007): 265-76. https://pmc.ncbi.nlm.nih.gov/articles/PMC3068630/
2Science Direct. “Practice guidelines for bone-anchored hearing aids in children." Science Direct, www.sciencedirect.com/science/article/pii/S1879729611000834.
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