Your choices in that scenario used to be quite limited. Either you could spring for a cochlear implant or simply forego hearing aids altogether. 

Thanks to a new technology recently approved by the U.S. Food and Drug Administration, you may soon have a third option — bone-anchored hearing aids, also known as bone conduction hearing devices. 

What Are Bone-Anchored Hearing Aids?

The clue to what a bone-anchored hearing aid does is right there in the name. Ordinarily, a hearing aid amplifies sound and conducts it through the air in the ear canal. A bone-anchored hearing aid instead conducts sound to the cochlea directly through the bone. 

Typically, a bone-anchored hearing aid works best for individuals suffering from either conductive hearing loss or asymmetric deafness (total hearing loss in only a single ear). By transmitting sound directly through the skull, bone-anchored hearing aids are able to bypass the outer and middle ear entirely. Other scenarios where a bone-anchored hearing aid might be a good choice, per Johns Hopkins Medicineare as follows: 

  • Damage, infection, or malformation of the outer or middle ear
  • Chronic ear infections
  • Menière’s disease and other diseases of the middle ear
  • Acoustic neuroma, a benign tumor in the inner or middle ear
  • Cholesteatoma, a type of cyst that develops behind the eardrum
  • Undeveloped or underdeveloped ear canals, known as congenital atresia
  • Some cases of sudden hearing loss
  • Allergies to the materials used in earmolds

They may also be a good choice for patients who find traditional hearing aids uncomfortable but are hesitant to undergo cochlear implant surgery. 

How Do Bone-Anchored Hearing Aids Work?

In many ways, a bone-anchored hearing aid can be viewed as something of a middle ground between cochlear implants and traditional hearing aids. They generally consist of three components:

  • The Processor. Collects sound from the environment via an onboard microphone. 
  • The Implant. Inserted via a minor surgical procedure, this small titanium fixture is fused directly to the skull at the base of the ear. The majority of the device is positioned below the skin, with the exception of a connector for the processor. 
  • The Bridge. Also known as an abutment, this converts the sounds collected by the processor's microphone into vibrations, which are then transmitted to the cochlea via the implant.

What Are The Benefits of Bone-Anchored Hearing Aids?

First and foremost, when compared to cochlear implants, the surgery for a bone-anchored hearing aid is both minor and low-risk. Installation can generally be done in fifteen minutes to an hour, depending on the manufacturer. With that said, the skull and skin must be given time to heal before the hearing aid can be used, which typically takes a few months. 

Additionally, because neither the processor nor the implant are outside the ear — typically fastened to one another via either a magnetic connector or a clip — bone-anchored hearing aids tend to be more comfortable than ordinary hearing aids. Some patients also report that bone-anchored hearing aids sound more natural compared to earmold hearing aids. Bone-anchored hearing aids also tend to be less conspicuous than ordinary hearing aids. 

Finally, as mentioned, bone-anchored hearing aids provide better amplification than standard hearing aids and also tend to be better at transmitting high-frequency sounds. 

What Are The Drawbacks of Bone-Anchored Hearing Aids?

The most significant drawback of a bone-anchored hearing aid is cost. Because the technology is still relatively new, it tends to be prohibitively expensive compared to traditional hearing aids. The combined cost of surgery and the device can range between $10,00-$17,000 USD. 

It's also extremely difficult to remove the titanium fixture if, at some point, you decide you no longer want to use the device. 

Bone-anchored hearing aids also aren't well-suited to anyone with a particularly active lifestyle. They can tend to come unfastened during strenuous activity. They also are neither waterproof nor water resistant.

Should I Use a Bone-Anchored Hearing Aid

The choice of whether to use a bone-anchored hearing aid, a cochlear implant, or a traditional hearing aid is entirely yours to make. That said, if you're having trouble deciding, your audiologist can help you determine the best course of action.