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Device for the hearing impaired uses bone, not air, to conduct sound

February 22, 2013|By MARIE GILBERT | marieg@herald-mail.com
  • Dr. Kirby Scott with Central ENT Consultants in Hagerstown holds a bone-anchored hearing aid that is mounted behind and above the ear.
Photo by Joe Crocetta/Staff Photographer

Nothing can prepare a person for living in silence.

After all, the world is filled with sound — car horns beeping, babies crying, conversations and music bouncing off the walls of a noisy restaurant.

But sometimes, those sounds disappear, either gradually or suddenly, only to be replaced by frustration and social isolation.

According to a study by the Archives of Internal Medicine, there are 48 million hearing-impaired Americans, over 15 percent of the population. Nearly one in six people 12 years of age and older has hearing loss in at least one ear.

While there are several options for the hearing impaired, not all devices are adequate solutions, particularly for individuals who want to avoid a more invasive procedure, such as cochlear implants.

An option, says Dr. Kirby Scott, is the bone anchored hearing aid or BAHA.

A physician with Central ENT Consultants in Hagerstown, Scott said the BAHA system is a hearing device that uses bone rather than air to conduct sound.

"Conventional hearing aids rely on air conduction from the ear canal through the ear drum and middle ear to the inner ear," he explained. "The BAHA bypasses the outer and middle ear using conduction through the patient's bone (skull) to send sound to the functioning inner ear."

Scott said bone anchored hearing aids were introduced more than a decade ago, but, as far as he knows, his office is one of the few in the Tri-State area that offers the device.

"Central ENT Consultants has performed implants since February of 2012, but, personally, I've been performing them for several years," he noted.

Scott said BAHA is recommended for individuals with conductive hearing loss, mixed hearing loss and single-sided deafness and has become an established treatment option for both children and adults.

The University of Maryland Medical Center notes that BAHA was cleared by the FDA in 1996 as a treatment for conductive and mixed hearing losses in the United States. In 1999, it was approved for use by children 5 years of age and older; and in 2002, it was approved for the treatment of unilateral sensorineural hearing loss. Which, according to the American Family Physicians is a disorder that affects the inner ear and neural pathways to the auditory cortex.

BAHA is used to help people with such disabilities as chronic ear infections, congenital ear malformation and one-sided deafness who cannot benefit from conventional hearing aids, the center said.

It consists of three parts: a titanium implant, an external abutment and a sound processor. The titanium implant is placed behind the ear during a short procedure and over time naturally integrates with the skull bone. For hearing, the sound processor transmits sound vibrations through the external abutment to the titanium implant. The implant sets up vibrations within the skull and inner ear that stimulate the nerve fibers of the inner ear, allowing hearing.

Scott said the risks are comparable to any outpatient procedure.

"The procedure takes about an hour and the patient goes home later that same day," he said.

The University of Maryland Medical Center reports there can be skin reactions in the area of the abutment, which should be immediately treated to avoid extrusion of the implant or infection.

While costs for BAHA can vary, Scott said it is covered by many private insurance policies, as well as Medicare and Medicaid, provided certain criteria and requirements are met.

"Candidates for the BAHA procedure are encouraged to consult with their insurance carrier for exact requirements, as benefits may differ from carrier to carrier," he said. "When the decision is made to proceed, our office contacts the insurance company for a predetermination so the patient is aware of what their portion of the cost may be."

There is a trial period with BAHA units for patients prior to the procedure. The unit can be worn with a strap — usually for two to four weeks — to determine whether or not it provides the type of result the patient is hoping to achieve.

Scott said response from patients who have bone anchored hearing aid implants "is very favorable."

"It's so amazing to see a person's face when you initially put it on them," said April Evans, office manager for ENT Consultants. "It's enough to make you cry. And some of the patients actually do. Those are the days we live for in a physician's office."


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