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Osseointegrated Options for Successful Hearing Outcomes

By Hannah Prather, Au.D., CCC-A, F/AAA


While traditional hearing aid styles help improve the hearing of millions of individuals, sometimes they are not always the most suitable. Bone anchored hearing aids or osseointegrated implants are sometimes a more appropriate solution for patients who suffer from conductive hearing loss or single sided deafness. In a traditional style hearing aid, the sound travels through the entire auditory system via air conduction from the programmed hearing aid. With a bone conduction hearing aid, a small implant is surgically placed into the skull and connects to an external sound processor. The sound then bypasses the middle ear system and utilizes sound vibration to stimulate the auditory nerve directly. A bone-conduction hearing aid is not to be confused with a cochlear implant. The criterion for the two types of hearing devices are completely different. Typically, an Audiologist and an Otolaryngologist (ENT)/Otologist can best determine patient candidacy for these types of implants.

In individuals who have conductive hearing loss from malformation of the outer ear (microtia, anotia, and atresia), chronic middle ear infections, middle ear pathologies & malformations (such as ossicular discontinuity, otosclerosis, history of cholesteatoma), or a surgical history in which the hearing is not expected to get better, a bone anchored hearing aid or osseointegrated implant may be the best option. The benefits of a bone conducted hearing aid in these types of losses are that there is no earmold in the ear, there is nothing placed in the ear canal, which reduces the need for antibiotics to clear infections, and it allows the patient to have consistent hearing through the implant. The implant would be surgically placed on the poorer ear and programmed accordingly by an audiologist.


In individuals who have single sided deafness (complete hearing loss in one ear with usable hearing in the better ear), the osseointegrated implant would be surgically placed on the poorer ear. Single sided deafness can be a result of a sudden hearing loss, an acoustic neuroma (benign growth on the auditory nerve), or Meniere’s disease. In doing this, this placement will allow the patient to localize sound better, help distinguish speech in noisy environments, and provide consistent hearing through the implant.


Currently, there are 3 manufacturers who make osseointegrated implants. The three main manufacturers are Cochlear Americas, Oticon Medical, and MED-EL. Cochlear Americas currently has a BAHA 5 processor and the Cochlear OSIA implant. The BAHA system is available to patients 5 years and older who have single sided deafness or conductive hearing loss. The BAHA system can be both a surgical and non-surgical option. The non-surgical options allow the patient to wear a soft headband or a hard headband to secure the processor to the head. With the BAHA 5 system, there is a small abutment surgically placed into the skull bone that attaches to an external sound processor. The OSIA is available to patients 12 years and older who have single sided deafness or conductive hearing loss and is only a surgical option at this time. With the OSIA implant, the implant utilizes bone conduction and electrostimulation to send the signal to the auditory nerve. The implant is surgically placed under the skin on the scalp and an external processor is placed on the outside of the skull and is held on by a magnet. Additionally, most manufacturers of bone conduction devices or osseointegrated implants now offer products that can be connected to Bluetooth cell phone devices. There are other accessory options available to help improve listening situations. An audiologist can best determine candidacy for both of these products from audiological testing in office.










Oticon Medical’s osseointegrated option is called the Ponto. This device is very similar to the Cochlear BAHA device. Typically, this device is surgically implanted but can be trialed on a soft-band.


MED-EL’s osseointegrated option is called the bonebridge implant and the SAMBA audio processor. This is a surgical option. MED-EL also has a non-surgical option called the ADHEAR. This device can be used in order to avoid a surgical procedure but still obtain clear crisp sound through bone conduction. It is worn behind the affected ear and is connected via adhesive.


In order to best determine if you are a good candidate for a bone anchored hearing system and what device is right for you, please contact one of our offices to schedule an appointment today.

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