My patients frequently ask me the difference between cochlear implants and bone anchored hearing systems, particularly those that have done some research on the Internet. What is the best way to help my patients understand the difference, without overcomplicating it?
We commonly get questions about the differences in various hearing solutions. While Oticon Medical currently specializes in bone anchored hearing systems, we’re here to help people navigate the options.
First, it may help to explain to your patient that cochlear implants and bone anchored hearing systems are indicated for different hearing conditions. Bone anchored hearing systems are indicated for conductive hearing loss, mixed hearing loss, or single-sided deafness. Cochlear Implants are indicated for bilateral severe to profound sensorineural hearing loss.
Next, discussing candidacy for both types of systems can help your patients to understand the differences between them. A cochlear implant candidate typically has bilateral severe to profound sensorineural hearing loss. Their cochleae have limited function and the candidate has poor speech discrimination ability. They also receive limited benefit from traditional hearing aids. The cochlear implant electrode is surgically implanted into the cochlea. An external speech processor delivers sound to the internal device. The electrode will send the signals directly to the auditory nerve. The cochlear implant enables the recipient to hear sound and it improves their speech discrimination ability to varying degrees depending on the individual recipient.
Candidates for bone anchored devices have conductive hearing loss, mixed hearing loss or single-sided deafness (SSD). The individuals with conductive or mixed hearing loss have functioning cochleae. The hearing issue results from a middle ear issue, that prevents sound transmission from the outer ear to the cochlea at the intended levels. Improving hearing in these cases is a matter of getting the sound to the cochlea. A bone anchored device makes use of the individual’s existing cochlear function. The bone anchored system stimulates the cochlea through vibration via bone conduction. These individuals have good speech discrimination ability once the sound gets to the cochlea.
Individuals who have SSD have one ear that does not have a functioning cochlea and one ear that is functioning normally. When fit with a bone anchored solution, these individuals wear a sound processor on the side with hearing loss. The sound processor picks up sound from the side with hearing loss and sends the sound across the skull to the normal cochlea via bone conduction. This allows the individual to hear sounds from both sides of their head as opposed to hearing sound from only the side of the head with the normal hearing ear. This enhances communication ability for the listener particularly in difficult listening situations and noisy environments.
Evaluation and Implant Process
Finally, you can point out that the evaluation process for either a bone anchored hearing system or a cochlear implant is similar. Emphasize that both start with a visit to an audiologist. An audiological evaluation will determine the degree and type of hearing loss, which in turn determines the most appropriate solution or treatment. If the patient is a candidate for a bone anchored system or a cochlear implant, the patient will need a medical evaluation by an otolaryngologist.
You can explain that neurotologists and otologists are ear, nose and throat physicians who have additional specialized training working with the ear and typically perform the surgery to implant cochlear implants and bone anchored hearing systems. Many general ENT physicians also implant bone anchored hearing systems, while audiologists are generally responsible for pre-operation and post-operation testing, programming of the device, orientation to using the device, counseling regarding expectations, and maximizing hearing outcomes.
I hope this information is helpful to you in educating your patients about these solutions. You will find other resources to support your patient counseling on our website or by contacting your Oticon Medical account representative.