Some people with hearing loss respond well to traditional hearing aids to amplify sound, but others are not so fortunate. Those people may need to go a step further and consider an implant to improve the quality of their hearing.
There are two main types of surgically implanted devices, bone-anchored hearing aids (BAHA) and cochlear implants, which work in different ways and are not a fix for every type of hearing loss. How much do you know about the similarities and differences of these assistive devices?
BAHA and Cochlear Implants at a Glance
BAHA and cochlear implants are both implantable hearing solutions, but each one has its own function and purpose. How do they each work?
BAHA implants bypass the outer or middle ear, capturing sound and turning it into vibrations. A bone conduction hearing implant of this type can be appropriate for mixed hearing loss, single-sided deafness, and conductive hearing loss.
Cochlear implants, on the other hand, rely on electrical stimulation to bypass damaged inner-ear cells. Cochlear implant candidacy can include those who have significant sensorineural hearing loss that other types of hearing aids cannot assist with.
How Each Hearing Implant Works
The most common type of hearing implant is BAHA. BAHA implants have a sound processor, which is an external device worn behind the ear.
The processor has a microphone that picks up all sounds and transforms them into vibrations. These vibrations travel through the skull to the inner ear without requiring your outer ear to process them.
BAHA implants do not restore perfect hearing or make every sound crystal clear. They are intended to help patients with discerning speech and other sounds, making their hearing loss more manageable.
Some patients with more profound hearing loss are unable to successfully use traditional hearing aids nor BAHA implants. These patients may have lost their hearing in both ears, have a poorly functioning inner ear resulting in poor conduction, or even have what is known as nerve deafness, which impacts the auditory nerve. These patients would not be good candidates for a BAHA, which depends on a functional inner ear and auditory nerve to work.
These people may be able to rely on cochlear implants, however. Cochlear implants have external sound processors and transmitters. Using these, the devices transform sounds into digital signals. They then use an implanted electrode array to send electrical impulses right to the auditory nerve. The brain perceives these as sound.
Like the BAHA, the cochlear implant is not a cure for deafness. It can help patients navigate through everyday life by making some sounds, including emergency sirens and speech in person or over the telephone, easier to interpret.
Each of these implantable hearing devices provides access to sound in a different manner.
BAHA vs. Cochlear Implant Comparison
| Consideration | Bone-Anchored Hearing System | Cochlear Implant |
| Type of Hearing Loss | Single-sided, conductive, or mixed | Sensorial hearing loss (limited hearing aid assistance) |
| How Sound Is Delivered | Bone conduction | Electrical stimulation of auditory nerve |
| Inner-Ear Function | Requires a sufficiently functioning cochlea | Bypasses cochlea |
| Surgery | Implant placed near or in skull bone | Electrode array and internal receiver implanted |
| External Component | Sound processor | Sound processors and transmitter coil |
| Activation | After healing and fitting | After healing, activation, and mapping |
| Rehabilitation | Device fitting and adjustments | Programming and auditory rehabilitation |
| Main Goal | Bypass outer or middle ear problems | Offer sound access when hearing aids are not enough |
Who May Be a Candidate?
Candidates for BAHA implants usually have conductive hearing loss, single-sided deafness, or mixed hearing loss. These devices may be appropriate for those who experience chronic ear infections or who have stiff ear bones.
These conditions can make hearing aids very difficult to wear. The same is true for people with middle or outer ear abnormalities.
Cochlear implant candidacy includes people with moderate-to-profound and severe-to-profound hearing loss involving the inner ear, which means they have sensorineural hearing loss. They typically struggle to understand speech despite having fitted hearing aids. They must have suitable auditory nerve and cochlear anatomy.
Candidacy for both of these options will also be impacted by hearing history, age, anatomy, and test results.
Neither of these hearing implants can “cure” hearing loss. Patients may regain the ability to distinguish speech from background noise and possibly hear everyday sounds such as doorbells, telephones, or to hear the television or music. It’s important to be realistic about what implants can do, and understand that, like with any assistive device, they do have limitations. Having a clear understanding of this is essential for anyone who seeks to be a candidate.
Evaluation, Surgery, and Follow-Up Care
One similarity that both types of hearing implant options share is the need for a thorough evaluation. Patients begin by seeing an audiologist, who can perform tests to determine the type of hearing loss and level of function they have.
The surgery necessary for these implants is typically an outpatient procedure. It can take two to three hours. Most patients go home that same day or stay overnight to be monitored.
You’ll need to heal before the device can be activated. After two to four weeks of recovery, you will visit your audiologist, who will turn the implant on. They will conduct mapping, which adjusts the device’s settings.
Cochlear implants generally require rehabilitation because you must learn to interpret new sound signals. Long-term care is necessary to ensure you get the most out of the implants.
Choosing Between BAHA and a Cochlear Implant
To decide between these two implant options, you need to rely on trusted audiologists. These professionals will determine the exact type of hearing loss you have and which option can offer the most effective results.
Everything from your communication needs, medical history, and previous treatment experience to your ability to go through surgery will be considered.
If you’re struggling with hearing loss, choose Happy Ears Hearing Center. Schedule an evaluation for personalized guidance.
