Bone Anchored Hearing Aid Implants

What IS A BAHA?

The Bone Anchored Hearing Aid (BAHA) is a surgically implanted device designed to help people with hearing loss. The majority of the conventional hearing aids transmit sound through the medium of air conduction. BAHA stimulates the cochlea by transmitting the sound waves through the bones in our skull, or bone conduction, thereby bypassing the outer and middle ear. Once the cochlea receives the sound signals, the information is converted in to neural signals and transferred to the brain, where it is perceived as sound. thereby bypassing the outer and middle ear.


The Baha System	The Sound Processor

Who Can Benefit From a BAHA?

Patients with chronic middle ear conditions or outer ear problems or congenital defects of the ear who can’t wear hearing aids may be candidates for a BAHA as long as one ear has a cochlea that can hear at a moderate hearing level or better. A second category of candidates are patients with “single sided deafness”. This includes patients who have lost all or most hearing in one ear, in which a conventional hearing aid is not helpful, but have good hearing in the other. A BAHA may provide an excellent hearing alternative for patients who cannot benefit from a traditional hearing aid, or in other words, for an ear that is “un-aidable” with a conventional hearing aid. BAHA is FDA approved for children over the age of 5. For children under the age of 5, a BAHA is available with an adjustable soft head band.

The Baha system, which is based on bone conduction, utilizes a titanium implant, which is placed in the skull bone behind the non-functioning ear. An abutment connects the sound processor with the implant in the bone. This creates direct (percutaneous) bone conduction. In contrast, traditional bone conductors connect indirectly to the bone through unbroken skin (transcutaneous) and work by exerting pressure against the skull.irect bone conduction, provided by Baha, may give improved access to sound when compared to traditional bone conductors because sound is not weakened when passing through the skin, muscle and fat covering the skull.

The Baha System - Ear Associates, San Jose, CA

Images Courtesy of Cochlear

Sound Processor snaps onto abutment. Abutment is attached to the titanium implant placed in the bone.

Images Courtesy of Cochlear

Direct Bone Conduction

1. Sound waves are received by Baha sound processor
2. Sound waves bypass middle ear function and are delivered directly to the working cochlea in both ears

Images Courtesy of Cochlear

Baha for Single Sided Deafness

For people with Single Sided Deafness (SSD), the Baha system allows sound to be heard from the deaf side, provided that hearing is normal in the opposite ear. This is possible because the sound waves are transmitted through the skull bone to the functioning cochlea on the opposite side.

1. Sound waves are received by the Baha sound processor
2. Sound waves travel by bone conduction to the functioning cochlea on the opposite side
3. Sound is received by functioning cochlea

One reason the Baha system works so well is due to its simple design. The Baha system combines a sound processor with an abutment and a small titanium implant. The implant is placed behind the non-functioning ear. Surgery is minor, and Baha recipients report a wide range of advantages over other hearing devices.

After a period of two months (six months for children) the implant will have osseo integrated with the bone. The sound processor may now be attached to the abutment, enabling the recipient to hear with the Baha® system fully in place for the first time.

The audiologist will explain the various functions of the sound processor, and will demonstrate the technique necessary for removal and fitting of the processor.

Connecting and disconnecting the sound processor is very simple. A plastic snap is mounted to the sound processor. It is designed to snap into the abutment and hold the sound processor securely in place.

BAHA Surgery

The implantation of the BAHA is a simple procedure done in the operating room which takes approximately 1 hour. The patient has the choice of general or local anesthesia. A special skin graft is performed behind the deaf ear, and the skin follicles and fat are removed from the scalp. A hole is drilled into the skull and the titanium screw and abutment are inserted together. The skin is brought over the abutment, and a small hole is made in the skin through which the abutment protrudes. The skin is sewn back into position and 2 dressings are applied. The outer dressing is removed the next day and the inner dressing is worn for 7-10 days. There is little post-operative pain and patients are able to return to most functions of their lives the next day. The skin is usually healed within 2 weeks, but the hearing is not worn for 2 months, giving time for the bone to osseo integrate into the titanium screw.


Abutment without the processor in place	Divino processor in place	Hair covering processor
BAHA Divino processor worn by a patient who has undergone a previous acoustic neuroma surgery.

The Baha Divino processor - Ear Associates, San Jose, CA

Short hair provides good cosmetic effect

Advantages of BAHA

Direct Bone Conduction allows the recipient to hear sounds more clearly and naturally.
Potential recipients can easily test the Baha so that they can experience the benefits before they have surgery.
The Baha is comfortable to wear; recipients say that they forget that they have it on.
The Baha is in use by thousands of individuals around the world. The outcomes are predictable and well documented.
The Baha procedure is reversible and does not damage or harm residual hearing. Additionally, the Baha system does not preclude any benefits from future hearing technological advances because it doesn’t compromise middle or inner ear or compromise hearing nerve sensitivity.
Many insurance companies pay for the surgical procedure and some pay for the processor.

Baha Sound Processors

BP 100, Intenso and Cordelle are three BAHA sound processors available in the market today. The new Cochlear BP 100 is the first programmable bone conduction device. The BAHA sound processors are compatible with external equipment such as IPods, MP3 players and cell phones to name a few. The external processor is available with a built-in directional microphone and an adjustable volume control.

Please talk to our medical or audiology team to discuss if you are a BAHA candidate. The test device can be borrowed and tried to see if you are a suitable candidate.