How To Know if a Bone Conduction Hearing Aid Is Right for You

David Cuthbertson, MD

A little boy wearing a blue shirt and hearing aid with a soccer ball on it

If you’re interested in increasing your ability to hear after experiencing hearing loss, you may find yourself considering hearing aids. Bone conduction hearing aids are only one type of assistive hearing device. They can help many people, but not everyone with hearing loss is a good candidate for them.

Today we’re looking at what a bone conduction hearing aid is, who it can help, and what’s involved in the surgical procedure and recovery.

Types of Hearing Loss

Because a bone conduction hearing aid doesn’t help with all types of hearing loss, let’s first take a look at the three basic types of hearing loss.

Sensorineural Hearing Loss

Sensorineural hearing loss (SNHL) is the most common type of hearing loss and results from a problem in the inner ear. This can involve issues with the nerve pathways between the inner ear and brain or problems with inner ear structures such as the cochlea — a snail-shaped, fluid-filled bone.

SNHL may be present from birth due to a malformation of the inner ear. It can also be caused by repeated exposure to loud noises, head trauma, aging, genetic hearing loss, and certain medications that damage hearing (like certain cancer drugs and a class of antibiotics called aminoglycosides).

People with SNHL find it especially difficult to hear soft sounds, but louder sounds can also seem muffled.

Conductive Hearing Loss

In conductive hearing loss, the nerves and cochlea are still in good working order. The problem is with the transmission (or conduction) of sound to the auditory nerve. The sound waves never reach the nerve, so the brain can never interpret them as sound.

You can think of conductive hearing loss as more of a mechanical issue. Something prevents sound waves from passing all the way through the outer and middle ear to the inner ear.

Anything that interferes with your ear’s system of conducting sound vibrations to the inner ear can cause conductive hearing loss. As long as they receive prompt and proper treatment, some of these problems will likely resolve without causing permanent hearing loss, such as:

Other problems are more likely to cause long-term conductive hearing loss, such as:

  • Congenital malformations of ear structures.
  • Severe trauma to ear structures.
  • Scarring from repeated ear infections.
  • Scarring from multiple ear surgeries.

Mixed Hearing Loss

Mixed hearing loss, like its name suggests, is when someone has a mixture of both SNHL and conductive hearing loss. For example, sometimes an accident can damage the middle ear and the inner ear simultaneously. Or someone born with SNHL can experience a severe fluid buildup that causes conductive hearing loss.

Bone Conduction Hearing Aids

Who Can Benefit From a Bone Conduction Hearing Aid?

Bone conduction hearing aids are specifically useful to conductive hearing loss patients. People with only sensorineural hearing loss don’t benefit from a bone conduction hearing aid. People with mixed hearing loss may find a bone conduction hearing aid helpful, depending on their individual case.

How Does a Bone Conduction Hearing Aid Work?

In young children or people with only mild hearing loss, a nonsurgical bone conduction hearing aid may be a possibility. If this isn’t a good fit, there are two surgical options available, each including an internal and external component:

  • Percutaneous — a titanium abutment protrudes through the skin to provide an attachment site for the external component.
  • Transcutaneous — the internal component uses magnets to attract the external component through the skin.

A surgeon implants a tiny titanium screw into the mastoid bone, directly behind the ear. This screw may have an abutment outside the skin where the hearing aid can “snap” on.

The bone conduction hearing aid acts as a receptor for sound waves from the air, turns those sound waves into vibrations, and uses the skull itself to conduct the sound waves to the auditory nerve. The sound waves bypass the problematic outer ear, eardrum, and ossicles (middle ear bones) entirely.

The Bone Conduction Hearing Aid Placement Procedure

The bone conduction hearing aid placement procedure probably sounds scarier than it actually is. In a simple, outpatient procedure, the area behind the ear is numbed. The surgeon makes a small incision behind the ear and inserts the titanium screw and abutment (if applicable).

If an abutment is involved, it remains protruding from the skin, and the rest of the incision is stitched closed around it to heal. Sometimes a small dressing may be placed over the incision. If no abutment is involved, the incision is allowed to close completely.

Recovery After Bone Conduction Hearing Aid Placement

After your placement procedure, you’ll be instructed to take it easy for a few days and avoid any heavy lifting for about a week. The main challenge of recovery from a bone conduction hearing aid placement is ensuring that skin doesn’t grow over an abutment.

Full recovery generally takes two to four weeks. After this time passes and your surgeon declares that your implant is fully healed, you can be fitted for your hearing aid system.

Are You Interested in Bone Conduction Hearing Aids?

If you have conductive hearing loss or mixed hearing loss and are interested in a bone conduction hearing aid, the first step is getting an ENT exam with hearing tests. Your ENT doctor may also order a CT scan to evaluate your inner ear structures.

After receiving your hearing test and CT scan results, talk with your ENT surgeon and an audiologist to see if bone conduction hearing aids could be the best solution for your ear and type of hearing loss.



Disclaimer: The content on this website is written and/or reviewed by a qualified medical doctor and great care is taken to provide accurate general information. However, it is for informational purposes only and is not to be taken as a substitute for medical advice from your own physician who is familiar with the details of your medical history. Always consult your doctor regarding health concerns before deciding any course of medical action.