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Bone Anchored Hearing Implants - Technology Marches On

Hearing loss is different for different people. Some experience mild hearing loss that can be remedied with a discrete pair of hearing aids. Others experience more severe hearing loss caused by genetics, disease or ear trauma to name a few.

The most common form of hearing loss is sensorineural hearing loss and can range from mild to profound. For persons with mild to severe hearing loss hearing aids are the most common treatment and there are plenty of options for this segment of the population – a segment growing larger every day as more Boomers realize that all that head banging back in the 60s and 70s really did cause permanent hearing loss.

Many people with profound hearing loss have enjoyed improved quality of life through the use of cochlear implant technology. Cochlear implants are devices that circumvent nerve damage deep within the inner ear. These implants are hard wired to deliver sound directly to the nerves that hook up to the hearing centers of the brain, by electrically stimulating the auditory nerve within the cochlea.

And while cochlear implants are, indeed, an excellent, medically proven solution for persons with severe to profound hearing loss who can’t benefit from traditional hearing aids, these miracles of modern hearing technology aren’t the solution for another population of hearing loss that can’t always benefit from traditional hearing aids.

Conductive Hearing Loss and Mixed Hearing Loss

Not only is there a wide range of causes of hearing loss and different degrees of hearing loss, there are also different types of hearing loss. Two other forms of hearing loss are conductive hearing loss and mixed hearing loss.

In the case of conductive hearing loss, the conduction of sound through the outer ear and/or middle ear is disrupted. The outer ear begins at our pinna (the visible part of our ear) and sound is funneled down the ear canal to the eardrum. The middle ear begins at the eardrum (also called the tympanic membrane). Behind the eardrum is the middle ear space containing three tiny bones. The eardrum vibrations cause the three middle ear bones to vibrate, which then transfer sound vibration to the inner ear. When conductive hearing loss occurs there is an issue with one of these mentioned parts.

Conductive hearing loss can often be treated medically; however, there are cases due to deformity or damage from surgery and/or chronic disease that results in a permanent conductive hearing loss. In some patients due to various reasons, traditional hearing aids are often not successful in treating the conductive hearing loss.

Mixed hearing loss occurs when there is both conductive hearing loss and sensorineural (nerve) hearing loss. Sensor neural hearing loss is most often treated with hearing aids and/or cochlear implants; however, for cases of mixed hearing loss where there is a conductive component, hearing aids are not always successful.

Hearing professionals have long sought successful solutions for persons with chronic outer/middle ear issues who have not had success with traditional hearing aids.

Until now. Thanks to ongoing research and the dedication of hearing device manufacturers there are now solutions.

Bone Anchored Hearing Systems

Oticon Medical's Ponto
Oticon Medical's Ponto

Today, those who experience conductive and mixed hearing loss, and who have had little success with traditional hearing aids, now have new options as technology marches on.

In August, 2009, Oticon Medical, received FDA approval to begin using Ponto – an innovative, bone-anchored hearing system. Oticon’s Ponto and Ponto Pro use Oticon’s highly-sophisticated RISE hearing circuitry. The Ponto and Ponto Pro mark Oticon’s first foray into bone-anchored hearing systems.

“The Ponto System will move bone anchored hearing solutions to the next level,” says Jes Olsen, GM of Oticon’s Medical division. “Ponto offers physicians and hearing care professionals unprecedented choice in an arena of growing patient demand. The new system combines exceptional sound quality, improved aesthetics, user friendliness and reliability. In an industry in which only a few companies have the technical skill to act, Oticon medical brings freedom to choose that will benefit new and existing patients.”

Another bone anchored hearing system is Cochlear America’s Baha implant which has been on the market for quite some time. The Baha was one of the first hearing systems based on direct bone conduction and has been fit on thousands of patients around the world. Since being purchased by Cochlear Americas in 2005, the Baha system has gone through extensive improvements.

Bone anchored hearing systems are gaining popularity among hearing health professionals and studies have shown positive results thus far for the use of this technology.

But just what IS a bone anchored hearing system?

Cochlear America's Baha
Cochlear America's Baha

A bone anchored system consists of: a sound processor, an abutment and a small titanium implant that is implanted into the boney portion of the skull behind the ear. The sound processor picks up the sound waves around you (similar to a hearing aid) and transfers the sound to the abutment and the bone anchored implant. The sound is then transferred via bone vibration directly to the healthy inner ear (the cochlea) and bypasses the damaged outer and/or middle ear.

So similar to a hearing aid in that it picks up sound around you to amplify, but instead of sending the signal through the ear canal, it sends it via vibrations through the skull – pretty cool huh?

Is a Bone Anchored Hearing Implant the Solution you’ve been looking for?

May well be.

If the cause of your hearing loss is nerve damage (sensorineural hearing loss), a bone anchored implant like Cochlear America’s Baha or Oticon’s Ponto series isn’t going to solve your hearing loss problem. Traditional hearing aids or cochlear implants are designed for your type of hearing loss.

However, if the source of your hearing loss isn’t entirely nerve hearing loss but conductive hearing loss and you have had little success with traditional hearing aids, then you should talk to a hearing professional about bone anchored implant candidacy.

In addition to conductive hearing loss and mixed hearing loss, persons with Single Sided Deafness (SSD) are also considered potential candidates. SSD occurs when a person has one normal hearing ear and one completely deaf ear. Although the person has functional hearing in one ear, they often have difficulty with localization – the ability to recognize where the sound is coming from. This type of hearing loss can also cause difficulties understanding speech in background noise.

Studies have shown that bone anchored hearing implants are a viable option for persons with SSD. A study in 2005 using the Baha system for persons with SSD, demonstrated the Baha system improved the speech-in-noise measurements and that patients were satisfied with the device after one year of use (Hol, Bosman, Snik, Mylanus & Cremers, 2005).

The bone anchored implant is implanted on the deaf side and via bone vibrations, sound picked up on the deaf side of the head will stimulate the normal hearing ear. The ability to hear 360 degrees is regained.

For any potential candidates they must keep in mind these devices do require surgery so it’s not a simple yes or no choice. In fact, as an advocate for your own hearing health, it’s well-worth your time to make an appointment with an audiologist or ear, nose and throat (ENT) specialist to discuss whether your type of hearing loss and the quality of your life would benefit from this leading edge hearing gear.

Benefits of Bone Anchored Hearing Implants

Today’s bone anchored hearing systems have come a long way in the area of design, sound quality and comfort. Sophisticated sound processing is being utilized to ensure you are receiving a quality, undistorted signal. Some of the benefits listed for today’s bone anchored technology consist of:

  • Direct bone conduction allows clearer and more natural sound quality for persons with conductive and mixed hearing loss, as well as persons with SSD
  • Recipients can test the technology prior to surgery to experience the benefits to help in their decision • Improved wearing comfort and design
  • The procedure to implant the devices is reversible and does not cause any permanent damage to the inner ear or nerve hearing abilities.
  • Can be programmed specially for the nerve hearing loss persons with mixed hearing loss
  • Allows users to maintain natural hearing while receiving the “boost” in volume they need via direct bone vibration

The first step is to determine if you are a candidate is to visit an audiologist for a full hearing evaluation, who will then refer you to a physician specializing in bone anchored hearing implants, such as an ENT.

Technology marches on. Don’t you want to join the parade?

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