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Bone Anchored Hearing Aid (BAHA)

Bone Anchored Hearing Aid (BAHA): A Solution for Various Hearing Loss Conditions

A bone anchored hearing aid (BAHA) is an implantable device designed to assist patients that suffer from conductive hearing loss, mixed hearing loss, or single sided deafness.

Patients who suffer from chronic ear infections, or have another condition which prevents them from using traditional hearing aids, are also candidates for the BAHA.

BAHA components

  • Titanium implant
  • External abutment
  • Hearing device

The BAHA is implanted in a minor out-patient surgical procedure that is generally performed under local anesthesia. No general anesthesia is required and the procedure takes about 20 minutes to perform.

The procedure involves the placement of a titanium implant in the skull behind the ear, this area is often hidden by the patient’s hair. The external abutment then connects the hearing device to the titanium implant. Once implanted, the hearing device is able to collect sound and transmit it to the titanium implant in the skull thereby causing vibrations in the skull and ear which stimulates the inner ear and leads to hearing.

Advantages of BAHA

  • Greater sound clarity than other bone conduction aids
  • Avoidance of the occlusion effect (echo like sound) 
  • Absence of feedback
  • Absence of any foreign objects in the ear canal that may cause infection 
  • Only need to wear one hearing device instead of two

Currently approximately 48 million Americans suffer from hearing loss. There are many classes of hearing loss however most fit in the categories of conductive, sensorineural, or mixed.

Conductive hearing loss causes

  • External ear conditions
  • Middle ear conditions

Sensorineural hearing loss causes

CNS infections
Degenerative conditions
Vascular disorders
Ototoxic drugs

Mixed hearing loss causes

  • Middle ear conditions
  • Temporal bone fractures

BAHA is usually indicated for certain cases of conductive hearing loss, mixed hearing loss, and single sided sensorineural hearing loss.

Also, some patients are unable to tolerate typical hearing aids due to congenital ear deformity (aural atresia) or chronic ear infections (chronic otitis media or otitis externa and thereby require an alternative form of treatment such as a BAHA.

Dr. Ronen Nazarian is a fellowship trained otologist at the Osborne Head and Neck Institute’s division of otology and restorative hearing surgery. He specializes in the diagnosis and treatment of ear conditions that commonly affect adults and children.

BAHA Attract

What is different about the BAHA Attract?

The BAHA Attract allows qualified patients to enjoy the benefits of the BAHA system without the external abutment that is visible over the skin in the BAHA Connect. Instead, the BAHA Attract uses a small magnet hidden under the skin to send sound vibrations to the affected ear.

BAHA Connect:

Uses an abutment over the skin, which connects with the external hearing device

BAHA Attract:

Uses a magnet under the skin, which then attracts to another magnet within the external hearing device

What are the advantages and disadvantages of the BAHA Attract?

The advantages are that the BAHA Attract is more concealed and easier to place on the head.

Some patients, especially men with short hair or no hair prefer the BAHA Attract due to the fact that there is no external abutment that will be easily seen.

Some patients can have a difficult time placing the BAHA connect directly onto the abutment, and so the BAHA Attract allows them to have more flexibility by just hovering the device over the internal magnet and letting it automatically fall into place.

A disadvantage of the BAHA Attract system is that it can not provide high power for patients with more severe mixed and conductive hearing losses. Additionally, it is not ideal for patients with single sided deafness who also have a moderate hearing loss in the opposite ear. Since there is no external abutment, the sound vibrations have to travel through the skin, which causes some of the energy to dissipate. In these select cases, your otologist will recommend you to have the BAHA Connect system.

How do I know if I qualify for the BAHA Attract?

Your otologist (ear surgeon) will need to perform a thorough history and ear exam. A hearing test (audiogram) will also be necessary. Most patients who have conductive or mixed hearing loss qualify for the Attract system. Patients with single sided deafness, who have normal or mild hearing loss in the opposite ear can also qualify for the BAHA Attract. It is important to seek a fellowship trained otologist to determine which device is best for you.

How is the surgery different from a regular BAHA?

Like the BAHA Connect, the surgery for the BAHA Attract can still be performed in an outpatient surgery center under local anesthesia.

The incision for the BAHA Attract is somewhat larger, since a circular magnet has to be fitted beneath the skin. However, most patients do not mind the larger incision since it is in a region in the scalp that is usually covered by hair.

The recovery period and activation time is also about the same as the BAHA Connect.


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