People who suffer from conductive or combined hearing loss and cannot be fitted with conventional hearing aids can, under certain conditions, benefit from a bone anchored hearing aid (BAHA). This device is also used for single-sided deafness to redirect sound from the deaf side to the side with normal hearing.

The BAHA consists of a titanium screw that is inserted into the skull bone behind the ear in a minor surgical procedure. A titanium anchor (abutment) is fixed to the screw, onto which a special hearing aid can then be attached.
Infants are initially fitted with a headband to which the BAHA is attached.

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Indications

Conductive hearing loss (sound transport to the middle ear impaired) or
Combined hearing loss (sound transport to the middle ear impaired AND inner ear damage)

• Cause cannot be sufficiently remedied by middle ear surgery and fitting with conventional hearing aids is not possible
• Last hearing ear: an operation would mean a high risk of deafness
• Not fit for anaesthesia
• Bone conduction component greater than 30 dB
• Hearing threshold for bone conduction not worse than 65 dB

Examples:

Ear canal/middle ear malformation, chronically recurring middle ear inflammation with ear discharge, ear canal eczema, psoriasis or allergic skin diseases of the ear canal

One-sided deafness
e.g. due to

• Vestibular schwannoma
• sudden deafness
• Meningitis
• Menière's disease
• Ear surgery
• congenital

Treatment with the BAHA system

• Prerequisite: willingness and ability to wear the device and care for the implant
• Special hearing test before the operation with a so-called test rod, which is clamped between the teeth, or via a test bracket
• Testing of a BAHA on the soft band for at least 3 weeks before an operation
• Implantation of the titanium screw into the bone, usually under general anaesthetic on an outpatient basis (in special cases, a further surgical procedure is necessary after 4 weeks)
• Healing time approx. 2-3 months
• Fitting of the BAHA by the hearing aid acoustician
• Check-ups in our university outpatient clinic or with your treating ENT specialist

Main surgical risks

• Unsatisfactory hearing success
• Loosening of the titanium screw with necessary explantation
• Recurrent inflammation of the skin/bone

The BAHA attract is a
bone conduction hearing system in which the sound processor
is coupled to the implant
via a magnetic connection. The skin therefore remains intact.

The Bonebridge is an active bone conduction implant that conducts sound directly to the inner ear via the bone. Unlike the BAHA, the implant lies completely under the skin (partially implantable hearing system). It receives its signals from a magnetically coupled audio processor that is worn on the head behind the ear.

Indications

Like other bone conduction hearing aids, the Bonebridge is used when sound transmission via the auditory canal and/or the middle ear to the inner ear does not work.

Conductive hearing loss (sound transmission to the middle ear is impaired) or
Combined hearing loss (sound transmission to the middle ear is impaired AND inner ear damage)

• Cause cannot be sufficiently remedied by middle ear surgery and fitting with conventional hearing aids is not possible
• Last hearing ear: an operation that could correct the cause of the hearing impairment would mean a high risk of deafness

Examples:

Ear canal/middle ear malformation, chronically recurring middle ear infection with ear discharge, ear canal eczema, psoriasis or allergic skin diseases of the ear canal

One-sided deafness
e.g. due to

• Vestibular schwannoma
• sudden hearing loss
• Meningitis
• Menière's disease
• Ear surgery
• congenital

The audiological results to date are comparable to those of the BAHA, although the attenuation through the skin is eliminated with the Bonebridge. The advantages of the Bonebridge are the extremely rare occurrence of skin irritation, as the implant is completely covered by skin, and the ease of handling. The cost of batteries is usually covered by health insurance companies.

Treatment with the Bonebridge

• Prerequisite: willingness and ability to handle the device
• Testing of a bone conduction hearing aid for at least 3 weeks before an operation
• Implantation of the Bonebridge in the bone behind the ear under general anaesthetic (approx. 0.5-1 hour)
• Healing time until activation 2-4 weeks
• Fitting of the Bonebridge via the hearing aid acoustician
• Check-ups in our cochlear implant consultation and/or with your ENT specialist

Main surgical risks

• Unsatisfactory hearing success
• Inflammation due to material intolerance with the need for explantation
• Shadow cast by the implant in CT/MRI with insufficient analysability of the examinations
• Haematoma in the surgical area with possible re-operation
• Device defect