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Sunday, November 3, 2024

Understanding Cochlear Implants and BAHA Hearing Aids

Key Differences, Cost, and Speech Therapy Approaches



Bone Anchored Hearing Aids (BAHA) and cochlear implants are both devices designed to assist individuals with hearing loss, but they operate differently and suit different types of hearing impairment.

Differences Between BAHA and Cochlear Implants

1. Mechanism of Hearing Support:

BAHA devices use bone conduction to transmit sound directly to the inner ear by bypassing the outer and middle ear. This device is typically used for individuals with conductive or mixed hearing loss or single-sided deafness. The BAHA’s sound processor picks up environmental sounds, transforms them into vibrations, and sends them through the skull bones to the cochlea, where they are interpreted by the auditory nerve.

Cochlear implants are designed for individuals with severe-to-profound sensorineural hearing loss, where the inner ear hair cells are damaged or missing. Cochlear implants bypass the damaged hair cells by directly stimulating the auditory nerve through an array of electrodes placed in the cochlea. The implant converts sounds into electrical signals that the brain interprets as sound.

2. Surgical Requirements:

BAHA surgery involves placing a titanium implant in the skull bone behind the ear, which integrates with the bone over time. A sound processor is then attached to the implant via an abutment or magnet, allowing for vibrations to pass directly to the inner ear.

Cochlear implant surgery is more complex, involving the placement of an internal electrode array in the cochlea and a receiver-stimulator under the skin. The internal parts communicate with an external sound processor through a magnetic transmitter.

3. Suitability and Outcomes:

BAHA is best for those with conductive or mixed hearing loss and single-sided deafness. It provides clear sound perception but doesn’t offer the full auditory range of cochlear implants.

Cochlear implants are suitable for individuals with severe-to-profound sensorineural hearing loss who gain little or no benefit from traditional hearing aids. While they provide a broader range of sounds, the brain needs time to adapt to the new input from the implant.

Cost Comparison

The costs of BAHA and cochlear implants vary by country, provider, and insurance coverage, with cochlear implants generally being more expensive:

BAHA devices generally cost between $4,000 and $12,000. Surgical and follow-up costs vary depending on insurance, though some insurance may cover significant portions of the device and surgery.

Cochlear implants are more costly, typically ranging from $30,000 to $50,000 per ear, including the device, surgical fees, and initial therapy. Insurance coverage may vary, but many insurers will cover cochlear implants due to their established efficacy for severe hearing loss.

Parts of BAHA and Cochlear Implants

BAHA Components:

  • Implant: A titanium implant embedded in the bone behind the ear.
  • Abutment/Magnet: Connects the sound processor to the implant; an abutment attaches through the skin, while newer models use a magnetic attachment that sits under the skin.
  • Sound Processor: Picks up sound and converts it into vibrations transmitted through the skull to the cochlea. 
Cochlear Implant Components:
  • Internal Implant: Consists of a receiver/stimulator placed under the skin and an electrode array implanted in the cochlea.
  • External Processor: Includes a microphone, sound processor, and transmitter coil, which sends sound signals to the internal device via electromagnetic waves.
  • Battery: Powers the external processor and can be rechargeable or disposable.

Speech Therapy for BAHA and Cochlear Implants

Speech Therapy for BAHA Users:

For BAHA users, speech therapy focuses on sound discrimination, language comprehension, and listening skills. Exercises often emphasize recognizing sound direction, differentiating similar sounds, and improving vocabulary. Examples of activities include:

  • Sound Localization: Practicing identifying the source and direction of sounds to improve spatial awareness.
  • Rhyming and Sound Differentiation Games: Discriminating between similar sounds to build phonological awareness.
  • Sentence Completion: Completing sentences or describing objects using a limited set of cues to support language structure.

Speech Therapy for Cochlear Implant Users:

For cochlear implant users, therapy is typically more intensive and includes exercises to help the brain adapt to new auditory input. Key areas of focus include auditory training, speech clarity, and comprehension. Examples of activities include:

  • Sound Identification Exercises: Identifying everyday sounds (e.g., bell, car horn) to strengthen auditory recognition.
  • Auditory Discrimination: Differentiating between various speech sounds and phonemes is crucial as implant users adapt to their “new” sense of hearing.
  • Storytelling and Question-Answer Drills: Reading stories and asking questions about details and context to improve comprehension.
  • Conversational Practice: Practicing real-life conversational skills to improve listening, turn-taking, and expression.

Resources and Video Links

BAHA Resources:

Informational Link: https://www.cochlear.com/us/en/home/products-and-accessories/cochlear-baha-system - Provides device specifications, patient stories, and resources for BAHA users.

YouTube Video: BAHA Bone Conduction Hearing Device - maintenance and accessories

https://youtu.be/NEOg8sGE2UU?si=TbXr9goCeBPJjJXG

Bone Anchored Hearing Aid BAHA https://youtu.be/HD38BIYa1hA?si=PWUa3grWoMc4ErIc


Cochlear Implant Resources:

Informational Link: The Nucleus® Implant System

https://www.cochlear.com/us/en/home/products-and-accessories/cochlear-nucleus-system - Detailed information on cochlear implants, surgery expectations, and success stories.

YouTube Video: What is A Cochlear Implant? | How Hearing Aids and Implants Help Recover Hearing Loss https://youtu.be/qbFi1ui9FU8?si=9Ln4MK9IwgX3Mnhs

 

More Resources:

Cochlear Implant (CI) vs Bone Anchored Hearing Aid (BAHA)

https://youtu.be/cEtpWnvqpa4?si=pbHR7YIlxFFpCn-w

Osia vs Baha (with Cochlear Americas and Dr. Sheryl Lewin) for conductive hearing loss

https://youtu.be/doxlT2rctkE?si=oK8Xgat37UZ9PAo5 Osia for 12 or older

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