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
