Ear Center: BAHA Hearing Implant

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BAHA Summary      Sound      Conditions      Single Sided Deafness      Candidacy
     
A Different Approach    |   BAHA4 System: Connect & Attract

BAHA 3 Sound Processors    |   BAHA 3 BP-100    |  BAHA 3 BP-110 Power               

Intenso   |    Cordelle II      

BAHA 210 Abutment    |    BAHA 3 Abutment | BAHA DermaLock
          
Control of Feedback  |    Indications   |   Accessories   |    Insurance Coverage  |   Support/Repair 

BAHA Upgrades

References

BAHA - Direct Bone Conduction Hearing Implants, 2 Options

The BAHA osseointegrated hearing implant has been successfully used to treat over 35,000 patients worldwide and consists of:

  • Option 1: various lengths of percutaneous BAHA4 Connect fixture/abutments that are surgically implanted in the skull bone behind the ear.
  • Option 2: a BAHA4 Attract fixture/magnet implanted subcutaneously in the skull bone behind the ear.

With Option 1, the BAHA4 Connect system, an external digital sound processor containing directional microphones and a battery supply is then "snap coupled" to a percutaneous abutment.

With Option 2, the BAHA4 Attract system, an external digital sound processor is is coupled to an external magnet that couples transcutaneously with an implanted magnet attached to the implanted titanium fixture.

The BAHA surgical procedure is performed through a short vertical incision behind the ear under general anesthesia and takes approximately one hour. The fixture is permitted to heal into the bone for 4 weeks before the external sound processor is attached. The BAHA implant requires minimal skin care, does not occlude the ear canal, and provides hearing to both inner ears by completely bypassing the outer ear, ear canal, and middle ear.

Sound

We receive sound in two ways, by air conduction via the ear canal, eardrum, and ossicles, and by bone conduction where the sound is transmitted directly through the jaw and skull bone bypassing the outer ear and the middle ear.

Conditions

In most cases, hearing impaired patients will be fitted with air conduction devices. These are placed inside the ear canal or behind the ear. However, some hearing impaired patients are unable to benefit from this type of conventional hearing aid. They may have a congenital condition, such as never developing an ear canal (atresia) so there is no functional ear canal present in which to place a hearing aid. They may have chronic ear infection in the middle ear or the outer ear that is made worse when a hearing aid mold is placed in the ear canal causing occlusion.

Single Sided Deafness

Another hearing loss condition is "Single Sided Deafness" (SSD) which may be due to previous surgery, trauma, ear disease, sudden hearing loss, etc. which leaves the individual with no hearing in one ear. Traditionally, patients with SSD were offered either traditional bone conduction devices which were large, cumbersome, and required the wearing of a steel spring headband or a CROS hearing aid system (contralateral routing of signal). CROS devices required wearing a microphone on the dead ear connected by wired or wireless connection a second hearing aid in the opposite ear. Most patients rejected both types of devices

Candidacy

The BAHA system is recommend for adults and children older than 5 years of age. Its specific indications include:

  • conductive hearing loss, in one or both ears, with average bone thresholds better than 45 dB
  • congenital absence of the ear canal(s) (congenital atresia)
  • single sided deafness in which one ear is completely without hearing and the other ear hears normally

Two Different Approaches Compared to Traditional Bone Conduction Hearing Aids

The BAHA hearing implant works through a different approach to bone conduction. Whereas traditional bone-conductors are transcutaneous and work by exerting pressure against the skull, the BAHA system works either percutaneously (BAHA4 Connect) or transcutaneously with an implanted fixture/magnet (BAHA4 Attract). A small titanium implant is implanted in the skull behind the ear where it osseointegrates with the living bone. With the BAHA4 Connect, a percutaneous abutment is attached the implant, and a sound processor is snap-coupled to the abutment. The sound processor can be worn or taken off at any time. The BAHA sound processor is comfortable and discreet. With the BAHA4 Attract, a subcutaneous fixture/magnet is implanted and the externally worn sound processor magnetically attracts transcutaneously to the subcutaneous fixture/magnet.

 

BAHA 4 System - New technology with 2 options: Connect vs. Attract

Option #1 - BAHA 4 Connect System

The BAHA 4 Connect System is the newest of the classic percutaneous osseointegrated implants from Cochlear Americas. It is uses a percutaneous BAHA 4 DermaLock implant and new BAHA 4 Sound Processor that is directly coupled to the titanium implant. The new BAHA 4 Sound Processor is 3x faster, has 8x more memory than previous BAHA SP's, uses 2.4 GHz digital wireless connectivity, and has remote control capability.

BAHA4_connect_SP BAHA4_connect_graphic BAHA4_connect_girl
BAHA4 Connect System
BAHA4 Connect Graphic
Percutaneous BAHA4 Connect Implant

 

Option #2 - BAHA 4 Attract System

The BAHA 4 Attract System is the first transcutaneous osseointegrated implants from Cochlear Americas. It is uses a BAHA 4 osseointegrated titanium implant, subcutaneous magnet attached to the osseointegrated implant, an external sister magnet, and a new BAHA 4 Sound Processor that is coupled to externally worn magnet. The new BAHA 4 Sound Processor is 3x faster, has 8x more memory than previous BAHA SP's, uses 2.4 GHz digital wireless connectivity, and has remote control capability.

 

BAHA4_attract_SP BAHA4_attract_graphic BAHA4_attract_man_withSP BAHA4_attract_man_withoutSP
BAHA4 Attract Implant & SP
BAHA4 Attract Graphic
BAHA4 Attract SP in place
Transcutaneous BAHA4 Attract SP removed

 

Click here to learn more about the BAHA4 System from Cochlear Americas

 

BAHA 3 Sound Processors - Previous Technology

  1. BAHA 3
    1. BP-100 - BAHA sound processor, introduced in 2009, programmable
    2. BP-110 Power - BAHA sound processor, introduced in 2011, programmable
  2. Intenso - slightly larger processor for more severe hearing losses, not programmable
  3. Divino* - second generation of original sound processor (discontinued for sale effective September 1, 2009)
  • *Service and repair for the Divino will continue until the product obsolescence date, June 30, 2012. For questions related to the Divino, you may contact Cochlear Americas Customer Service at 877-883-3101.

Baha_3_processors

BP-100 - The First Programmable Bone Conduction Hearing Implant

The BP-100 was introduced in August 2009 and is the industry's first programmable bone conduction hearing implant.BAHA BP-100 image

Features of the BP-100 include:

  • Clarity of Sound
    • 12 Channel sound analysis
    • Automatic multi-band directional microphones
    • Advanced noise reduction & feedback management systems
  • Brilliance in Design
    • GORE-Tex® covers to protect the microphone
    • 3-button interface for volume & programming changes
    • Key lock function to keep kids safe from dislodged batteries
    • Tamper-proof battery doors (optional)
  • Simplicity in Use
    • Three distinct fitting options
    • NOAH-compatible Cochlear Fitting Software
    • Automatic features for seamless listening in changing environments
    • Universal Europin connector for a variety of accessories like FM systems
    • LEDs permit parents & caregivers to know whether the processor is on and if the battery is good

Click to learn more about the BAHA BP-100 at: www.cochlearamericas.com/professionals/bp100

BAHA BP-110 Power - Previous BAHA Sound Processor

The BP-110 Power sound processor was introduced in 2011, is programmable, and has more power than the BP-100.

Features of the BP-110 Power include:

  • The Most Powerful Head-worn Baha
  • Thinnest Programmable Power Baha
  • Better Fittings Made Easier
  • Designed for performance
    • The first power sound processor with directional microphones
    • Most powerful transducer
    • Better sound quality

The Cochlear Baha 3 System* set the standard for advanced bone conduction hearing solutions. The new Cochlear Baha 3 BP-110 Power Sound Processor with the most powerful Baha transducer, provides more amplification where many patients need it the most - in the high frequencies. Baha 3 BP-110 Power is designed to give patients better speech understanding and superior sound quality, compared with previous generations of processors.

Intenso - When More Gain is Needed

The digital Intenso is the most powerful head worn BAHA sound processor. The Intenso contains a stronger transducer (vibrator) with active, multi-band feedback cancellation that allows for increased amplification for patients with significant hearing losses. The Intenso is more comparable to the Cordelle body worn processor in terms of available gain characteristics. The Intenso is available in black, blonde, silver-grey, and brown. Other features include:

  • tone control
  • gain control,
  • three program settings (setting 1 for normal listening situations, setting 2 for noisy environments, and Program E for muting when using accessories),
  • automatic gain control to limit distortion in noise,
  • electrical input to connect accessories such as an audio adapter, telecoil unit, a Phonak MicroLink Baha FM-receiver,
  • information beeps to identify program mode and low battery status.
  • (Reference from the BAHA Intenso Data Sheet, March 2007

 

BAHA Cordelle II - Body Worn Sound Processor

The BAHA Cordelle II is the second generation of body worn BAHA sound processors. The Cordelle II is ideal for patients who require significant energy for substantial hearing losses.

Features of the BAHA Cordelle II include:

  • Body-worn Super Power
  • Designed for more substantial hearing losses
  • The body-worn Baha Cordelle II is the strongest member of the Baha family

You will hear more than ever, with less feedback and distortion than conventional hearing aids. The Baha Cordelle II is the most powerful Baha sound processor offered by Cochlear, consisting of an ear-level transducer and a body-worn unit. This model has a built in telecoil, which allows wearers to utilize teleloop facilities or as a telephone pick-up to help enhance sound quality.

 

BAHA 210 Series Abutment

                                                            BAHA_210_Abutment

The BAHA 210 Abutment was designed with a concave profile to help prevent skin from overgrowing the abutment.

 

BAHA 3 Series Abutment

baha_BI300

Cochlear Baha 3 BI300 Implant

 

Baha_3_system 

 

Improved stability

  • Wider diameter
  • Small sized threads below flange
  • TiOblast™ surface (promotes integration with bone)
  • New conical shape

Trusted solution

  • Market leader and innovator
  • Tri-lobe connection
  • Helium-tight seal
  • Precise countersinking

Simplified surgery

  • Single-use instrument kit
  • Improved packaging
  • Fewer tools and steps

Control of Feedback

Feedback is annoying for all patients who wear hearing devices. With the BAHA system, feedback is either mechanical (400-1000 Hz range) or acoustic (1500-3000 Hz range). One way to reduce potential feedback is to reduce gain or apply a notch filter. These solutions lead to a loss of power (gain), audibility, and decreased hearing. The Intenso uses phase cancellation technology to automatically, and effectively, cancel the feedback with an out-of-phase sound signal of the matched frequency, amplitude, and phase.

Indications

Indications for the BAHA Intenso include conductive or mixed hearing losses for patients whose bone conduction thresholds are within the 0 - 45 dB range across the speech frequencies and for patients who have Single Sided Deafness (SSD).

Accessories

Intenso accessories that are available include:

  • an audio adapter for direct input from stereos, TV's, MP3's, and other Hi-Fi equipment,
  • a Phonak MicroLink Baha FM-receiver
  • a telecoil unit to access loop facilities in phones, homes, theaters, seminar halls, etc.

The BAHA Intenso Sound Processor is slightly larger than the BAHA Divino Sound Processor.

Located on inside surface, the surface closer to the head, are the the snap connector, tone and gain controls, a battery compartment, and an attachment point for an optional safety line. The Intenso weighs 14 grams, including a 675 battery.

 

BAHA DermaLock Implants with Abutments

Cochlear Americas is now manufacturing the BAHA DermaLock implants with abutments (model BIA400) and the BAHA DermaLock abutments (model BA400). The new abutments are made of titanium and are coated with a 80um thick coating of hydroxyapatite (Ca5(PO4)3(OH). The surface roughness (Ra) is approximately 7um. The implants are available in 3 mm and 4 mm models (B1300). Abutment length is determined according to scalp tissue thickness. The hydroxyapatite coating has been developed to improve tissue integration with the implant.

 

baha_dermalock_implants

Click here to learn more about the Cochlear Baha DermaLock Abutment.

 

Insurance Coverage

More and more third party insurance companies are covering the BAHA system. In North Carolina, the BAHA system is covered by Blue Cross and Blue Shield (except for single sided deafness), the North Carolina State Employees Health Plan, and several other companies. Medicare began covering the BAHA system in January of 2006. Please contact your insurance company to inquire as to whether they cover the BAHA system or contact our office for guidance.

Support for BAHA Classic and Compact Processors

As of June 30, 2011, Cochlear Corporation no longer supports the BAHA Classic or Compact.

For Classic recipients:

  • Before April 1, 2010, repair of the Classic will cost $445, or
  • The patient may purchase a new BAHA BP100 Sound Processor

For Compact recipients:

  • Before July 1, 2011, repairs of the Compact will cost $445, or
  • The patient may purchase a new BAHA BP100 Sound Processor

For more information about the BAHA system, go to: www.cochlearamericas.com

If you or one of your loved ones is interested in learning more about:

  1. the BAHA Hearing Implant and Sound Processors,
  2. BAHA candidacy,
  3. the BAHA operative procedure,
  4. BAHA fitting, or
  5. BAHA warranty information

Please contact our office at (336) 273-9932 and ask to speak to one of our Audiologists.

 

BAHA Upgrades

Depending on your insurance coverage, your BAHA upgrade may or may not be covered as a "replacement sound processor."

At this time, The Ear Center is unable to order an upgraded BAHA sound processor for BAHA users. It will be necessary for you to contact Cochlear Americas at 1-800-633-4667, option 2 or at email: reimbursement@cochlear.com.

Click here to learn more about BAHA upgrade options provided by Cochlear.

 

References:

  1. Davids T, Gordon KA, Clutton D, Papsin BC. Bone-anchored hearing aids in infants and children younger than 5 years. Arch Oto HNS, 133(1) (January), 51-55, 2007.
  2. Wazen JJ, Gupta R, Ghossaini S, Spitzer J, Farrugia M, Tjellstrom A. Osseointegration timing for Baha System Loading. Laryngoscope, 117, 794-796, 2007.
  3. Linstrom CJ, Silverman CA, Yu GP. Efficacy of the bone-anchored hearing aid for single-sided deafness. Laryngoscope, 119, 2009, 713-720.
  4. McDermott AL, Williams J, et.al. Quality of life in children fitted with a bone-anchored hearing aid. Otol Neurotol, 30 (April), 2009, 344-349
  5. Wazen JJ, Van Ess MJ, Alameda J, Ortega C, Modisett M, Pinsky K. The Baha system in patients with single-sided deafness and contralateral hearing loss. Oto HNS, 142 (4), April, 2010, 554-559.
  6. House JW, Kutz JW, Chung J, Fisher LM. Bone-anchored hearing aid subjective benefit for unilateral deafness. Laryngoscope, 120(3), March, 2010, 601-607.
  7. German M, Fine E, Djalilian HR. Traumatic impact to bone-anchored hearing aid resulting in epidural hematoma. Arch Otol, 136(11), 1136-1138.
  8. Zeitler DM, Snapp HA, et.al. Early loading after single-stage bone-anchored implantation in adults. Otolaryngol Head Neck Surg 2011;144 (March):402-407.
  9. Monksfield P, Jowett S, et al. Cost effectiveness analysis of the bone-anchored hearing device. Otol Neurotol 2011;32 (October):1192-1197.

Page last updated January 20, 2014