Most hearing-impaired people find that their problem is often relieved with a typical air or bone conduction hearing aid. But for those not helped by these traditional methods, there is now a highly effective and exciting option on the horizon - the bone-anchored hearing aid (BAHA).

The BAHA is a simple combination of a sound processor attached to a small titanium implant or fixture, which is placed in the bone behind the ear during a routine surgical procedure. The bone acts as a pathway for sound to travel to the inner ear without involving the ear canal.

Offering fresh hope to the hearing impaired, the BAHA is most beneficial to those whose hearing problems are also complicated by ear canal problems (i.e., constantly draining ears, chronic infection, congenital ear malformations and either missing or incomplete ear canals). A traditional hearing aid can often aggravate an ongoing infection because it blocks the ear canal and does not allow it dry. Since a dry ear is necessary for good hearing, the BAHA, worn away from the ear canal, is the perfect solution!

"Patients who have a BAHA are very happy with it," says Dr. Sujana S. Chandrasekhar, Director of Otology/Neurotology at UMDNJ-University Hospital and Associate Professor of Surgery at the New Jersey Medical School. "Patients report that it has literally changed their world. It's not the dramatic "silence-to-sound" effect that you get from a cochlear implant, but for people who need a hearing aid and can't wear one because of ear canal problems or traumatic injury, it provides a whole new lease on life," adds Chandrasekhar.

Human beings receive sound in two ways - by air conduction via the ear canal, eardrum and ossicles and by bone conduction, whereby sound is transmitted directly through the jaw and skull bones by passing the middle ear. Conventional hearing aids use both routes.

Hearing impaired people who have incomplete ear canals or chronic ear infection can't use either device because they block the ear canal and exacerbate any existing problems. "In the past, people in this situation would only wear their hearing aid if they absolutely had to hear - but if you think about it, you really need to hear 18 hours a day," reports Chandrasekhar.

For patients who need a hearing aid, but just can't handle it physically, the BAHA opens up a whole new world. Dr. Chandrasekhar recalled going to dinner with a friend who had two BAHAs implanted. "We were seated in a large, really noisy, busy restaurant. In addition to us, there was another person at our table with a heavy Swiss accent. My friend with the BAHAs was able to follow and respond to our entire conversation. In that environment, it would have been difficult to hear for someone with even the best of hearing," says Chandrasekhar.

Besides the obvious benefit of helping people hear, the BAHA offers many other advantages. It is a tremendous asset for people with middle ear infections because the ear canal can remain open, allowing infection to heal. For those with an incomplete or missing ear canal, the BAHA is more comfortable, because it works without any pressure on the skin. Finally, acoustic feedback is minimized, battery consumption is less and BAHA users are more likely to wear the sound processor for longer periods of time than other devices.

The BAHA procedure is simple, straightforward and doesn't involve any surgery in the ear itself. Surgery is normally carried out in one stage and can be done under either local or general anesthetic. The operation takes 45 minutes to one hour to perform.

The abutment is attached to the fixture.
A small titanium screw is implanted into the bone directly behind the ear and a titanium sleeve or abutment is then connected to the implant through the skin. Twelve weeks are given for complete healing, that is, osseointegration of the titanium into the bone. To add to the simplicity of the surgical procedure, it is also a very low risk operation. And if for any reason the patient is unhappy, it is possible to disconnect the abutment and remove the fixture. This type of situation is extremely uncommon with only a few cases reported amongst the thousands of patients treated.

For two to four weeks after the operation, the surgical site is dressed and cleaned in the office. Approximately twelve weeks after the operation the audiologist fits the patient with the BAHA sound processor.

The BAHA in place.
The patient is then familiarized with the volume and tone controls and is shown how to connect and disconnect the hearing aid from the abutment. Routine audiological tests and regular check ups follow.

Is the surgery and all that goes along with it worth it? Just ask the woman who can now enjoy conversation in a busy, crowded restaurant. "Having the BAHA changed my life!"

For more information on the bone anchored hearing aid and other hearing services, call (973) 972-4967. Looking for an expert physician in another field? Click on the Physician/Services Directory at www.TheUniversityHospital.com