BAHA and cochlear implants

Hearing implants for profound hearing loss

Hearing impairment is not the same for everyone and, in some cases, simple hearing aids cannot be the solution. Hearing implants such as Cochlear and BAHA can be a valid help for profound hearing loss, providing the sense of sound back.

Cochlear and BAHA implants

Cochlear implants and BAHA are implanted devices that can provide the sense of sound to someone with a severe or profound hearing loss. They can be also useful in case of a malformation of the middle ear or of the ear canal (which most of the times is congenital) since this status wouldn't allow to wear hearing aids. Their sophisticated technology stimulates or simulates the auditory nerve and the brain can interpret these signals into sound over time. A bone-anchored hearing solution delivers sound vibrations directly to the inner ear in direct contact with the skull bones, while a cochlear implant (always surgical) completely by-passes the no more working hearing mechanism and stimulates the auditory nerve by internally implanted electrodes.

 

Let's see how they work in detail and their specific purposes.

BAHA: The bone anchored hearing aid

BAHA or Bone Anchored Hearing Aid uses bone conduction to deliver hearing to those with profound hearing loss. Bone-anchored hearing systems, differently from hearing aids, are surgically (or not) implanted devices. They treat hearing loss through sound vibrations transmitted by bone conduction to the inner ear.

 

BAHA™ is the name of a specific brand of bone-anchored hearing aid by the Cochlear Americas company. Usually people may refer to any of the several brands as a "bone-anchored hearing device," or a "bone-anchored hearing system" (BAHS).

How does a BAHA work?

Bone-anchored hearing devices are composed by two parts, one internal and one external: 

1. External part: the sound processor.

the bone-anchored device external microphone and sound processor receive sounds from the environment converting them into vibrations. The vibrations get then transmitted to the embedded implant. 

 

2. Internal part: the titanium implant.

When receiving vibrations from the outside mechanism, the implant vibrates the surrounding bone, transmitting sound waves in the inner ear, the inner ear than stimulates the hair cells and activate the auditory nerve.

 

To surgically implant the BAHA hearing aid, the ear-nose-throat doctor or other surgical specialist installs the titanium implant (which is around 3-4 mm) into the mastoid bone, behind the ear and, over time, the titanium implant integrates with the bone. It will be possible for the patient to attach or remove the external part of the device via a built-in magnet or by clipping, depending on the device set up.

Benefits of bone anchored hearing aids

The BAHA can be also a great non-surgical alternative to cochlear implants, that can be applied simply in clinic and easy to manage for children with hearing loss. The most likely candidates for bone-anchored hearing devices are:

- children or adults who have severe outer or middle ear malformations,

- people suffering from single-sided deafness

- people suffering from chronic ear infections or allergies to traditional hearing aids

The Bone anchored system works best for people who have at least one inner ear that functions normally.

That's why people who typically get the greatest benefit from bone-anchored hearing systems include those who have severe outer or middle ear malformations and those with single-sided deafness.

Amplifon do not provide cochlear implants. We do have access to bone anchored hearing aids (BAHA) which are usually used to treat conductive hearing losses, or cases of single sided deafness. We fit a non-surgical BAHA device by MED-EL.

What is a cochlear implant?

A cochlear implant is a neuroprosthetic device which can be a hearing solution for those with severe to profound hearing loss. They work differently than hearing aids, providing the sense of sound by stimulating the auditory nerve. So, cochlear implants do not cure hearing loss or restore hearing, but give the perception to severely hard of hearing or deaf to hear sound by bypassing the damaged inner ear. Unlike hearing aids and BAHA in some cases, they require surgical implantation.

How does a cochlear implant work?

'The cochlear implant stimulates the auditory nerve which the brain can adapt and interpret sound. Also the cochlear implant uses two main components coupled through a powerful magnet: 

1. External: sound processor (microphone, speech processor and trasmitter)

The microphone and speech processor stay in an unit that looks like a behind-the-ear hearing aid. A wire links them to the transmitter, positioned over the internal part of the device. The microphone receives sounds and sends them to the speech processor. The processor analyses and transform the signal, then sends it to the transmitter. The transmitter codes the signals and sends them to the implanted receiver.

2. Internal: receiver and electrodes 

The internal part of a cochlear implant counts a receiver, placed under the skin on the temporal bone and electrode arrays. The receiver collects the transmitter's signals, converts them to electrical pulses to be dispatched to the electrodes, located into the inner ear. These electrodes directly stimulate the auditory nerve via the cochlea and the brain interprets these signals as sound.

Cochlear implants in children

Cochlear implants can be provided to children, aiding them in their formative years to learn and develop. 12 months old  children with hearing loss may be eligible for a cochlear implant. Cochlear implant can in fact expose children with hearing loss to sounds during the critical period of language acquisition. After implantation, they must undergo intense speech and language therapy to achieve the best possible outcome from the device. 

 

Children are considered the best candidates when they:

- suffer from profound hearing loss in both ears

- get no benefit from hearing aids usage

- are healthy

- can understand their role in the successful use of cochlear implants

- can receive support from an educational program to emphasize the development of auditory skills

 

What to do for hearing loss in children?

It's important for children who are experiencing hearing loss (under 16) are taken to the doctor in the first instance. The doctor will be able to determine if it is an ear infection or something that requires a specialist referral.

How does a cochlear implant work?

The cochlear implant stimulates the auditory nerve which the brain can adapt and interpret sound.

Benefits of cochlear implants

The cochlear implant is a surgical solution to those with profound or severe hearing loss.

Cochlear implants in children

Cochlear implants can be provided to children which can aid in their formative years to learn and develop. 

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