For the majority of the population of individuals with hearing loss, amplification with the use of traditional hearing aids is a common treatment option, which relies on air conduction and the presence of a functioning outer and middle ear system. There is a smaller, perhaps underserved, population of patients who do not receive benefit from these air-conducted signals, but would benefit from a bone-conducted one.
Bone, like air, can conduct sound vibrations, and for children who have a damaged, blocked, or occluded middle ear system, an osseointegrated device bypasses the outer and middle ear systems altogether. The BAHA (bone anchored hearing aid) processor attaches to the osseointegrated titanium implant and can provide a bone conducted signal to the auditory nerve.
This population of patients has previously relied on traditional bone conduction hearing aids, which can be
- Uncomfortable due to the pressure needed to maintain contact between conductor and mastoid
- Have poor sound quality due to soft tissue attenuation
- Are aesthetically unappealing due to the large size of the aid.
These considerations make it difficult to use conventional, headband-mounted bone conduction aids successfully with the pediatric population.
The BAHA is a widely accepted hearing solution for children with conductive or mixed hearing loss, as well as single-sided deafness (SSD).
Common causes for conductive hearing loss include
- Suppurative otitis media
Some of these children may have conductive hearing loss attributable to craniofacial abnormalities in which the conductive mechanism (outer or middle ear) is not functioning properly.
Children with a mixed hearing loss with bone conduction scores of at least 45dB or better can also benefit from the use of a BAHA processor.
Patients with SSD have often stated they hear well in quiet, one-on-one situations, but will report that they have great difficulty listening in noise and localizing sound sources.
In this population, the BAHA stimulates both cochleae through bone conduction, so the normally-functioning cochlea picks up the sounds from the contralateral, impaired side via the bone-conducted signal. Patients have reported better speech understanding and discrimination in the presence of background noise and improved sound localization with the use of the BAHA.
The osseointegrated/BAHA system is composed of three parts:
- A titanium implant
- An external abutment
- A sound processor
The titanium implant is surgically placed, but attachment of the external abutment can often be three to four months post-surgery. This allows time for the implant to fuse with the bone, allowing direct structural conduction of sound through bone.
Once this osseointegration has taken place, the external abutment is attached to the implant. The processor is then programmed specifically for the individual patient and couples directly to the attached abutment for use. The FDA has approved this surgery for children five years and older.
Children under the age of five may still benefit from the use of a BAHA processor coupled for use on a soft band. Tension and pressure from the soft band must remain high to insure appropriate contact between the processor and the mastoid, much like the conventional bone conduction aid, but the level of technology offered by the BAHA processor far surpasses that of the traditional bone conduction aid.
There are two commercially available osseointegrated devices on the market:
PENTA currently implants and dispenses both devices for patients.
For more details about these manufacturers and their processors, please consult their websites. For more questions regarding BAHA or to determine if your child could be a candidate for BAHA, contact your audiologist at 404-851-1884.