Review of Bone Conduction Hearing Devices

Abstract

Bone conduction is an efficient pathway of sound transmission which can be harnessed to provide hearing amplification. Bone conduction hearing devices may be indicated when ear canal pathology precludes the use of a conventional hearing aid, as well as in cases of single-sided deafness. Several different technologies exist which transmit sound via bone conduction. Here, we will review the physiology of bone conduction, the indications for bone conduction amplification, and the specifics of currently available devices.

Keywords: bone conduction; bone-anchored hearing aid; osseointegrated implant; percutaneous bone conduction; transcutaneous bone conduction.

Figure 1

This figure depicts the fitting ranges for the described devices. The dark grey shaded area represents the range of recommended bone conduction thresholds in patients being considered for bone conduction hearing devices. The light grey shaded area demonstrates possible air conduction thresholds. (A) represents a 45 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 [15], Ponto 4 [15], Baha^® 5 [17], Alpha 2 MPO ePlus^TM [42], and SAMBA 2 [30] processors. (B) represents a 55 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 Power [15], Baha^® 5 Power [17], Baha^® 6 Max [16], and Osia^® 2 [25] processors. (C) represents a 65 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 SueprPower [15] and the Baha^® 5 SuperPower [17]. (D) represents a 25 dB BC PTA, the recommended bone conduction hearing threshold for the ADHEAR processor [31]. (E) represents a 20 dB BC PTA. For patients with SSD, the contralateral ear should have normal hearing—a BC and AC PTA of 20 dB or better. These figures were created from publicly available device information and reproduced with permission from Cochlear^TM, MED-EL, Medtronic, and Oticon representatives.

Figure 1

This figure depicts the fitting ranges for the described devices. The dark grey shaded area represents the range of recommended bone conduction thresholds in patients being considered for bone conduction hearing devices. The light grey shaded area demonstrates possible air conduction thresholds. (A) represents a 45 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 [15], Ponto 4 [15], Baha^® 5 [17], Alpha 2 MPO ePlus^TM [42], and SAMBA 2 [30] processors. (B) represents a 55 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 Power [15], Baha^® 5 Power [17], Baha^® 6 Max [16], and Osia^® 2 [25] processors. (C) represents a 65 dB BC PTA, the recommended bone conduction hearing threshold for the Ponto 3 SueprPower [15] and the Baha^® 5 SuperPower [17]. (D) represents a 25 dB BC PTA, the recommended bone conduction hearing threshold for the ADHEAR processor [31]. (E) represents a 20 dB BC PTA. For patients with SSD, the contralateral ear should have normal hearing—a BC and AC PTA of 20 dB or better. These figures were created from publicly available device information and reproduced with permission from Cochlear^TM, MED-EL, Medtronic, and Oticon representatives.