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You Asked; We Answer: What’s the difference between a Cochlear Implant and a Bone Anchored Hearing System? Today, we’re going to look at the differences between Cochlear Implants and Bone Anchored Hearing Systems.
One of the biggest differences between Cochlear Implants and Bone Anchored Hearing Systems is that they are indicated for different hearing conditions. These types of hearing losses are different, so the candidates for bone anchored devices and Cochlear Implants are also different. Candidates for Bone Anchored Device have conductive hearing loss, mixed hearing loss or single-sided deafness. Individuals who have Single Sided Deafness have one ear that does not have a functioning cochlea and one ear that is functioning normally.
The evaluation process for either a Bone Anchored Hearing System or a Cochlear Implant is similar. A Neurotologist, or Otologist is an Ear, Nose and Throat physician who has additional specialized training working with the ear. Many times with Cochlear Implant candidates, the individual has a sense of urgency for a solution to the hearing loss due to the degree of hearing loss and impact the hearing loss is having on their daily living. This entry was posted in Helpful Information and tagged Audiologist, Bone anchored hearing systems, bone conduction, cochlea, Coclear Implants, conductive hearing loss, hearing solutions, ponto, single sided deafness on October 3, 2014 by oticonmedical. Enter your email address to follow this blog and receive notifications of new posts by email. Frequency: The sound frequency or pitch (measured in Hertz) is plotted on the X (horizontal) axis.
Intensity: The sound Intensity or loudness (measured in decibels) is plotted on the Y (vertical) axis. The softest sound a person hears 50% of the times, at each frequency is his Hearing Threshold at that frequency. The difference between the air conduction thresholds of the right and left ear is more than 40db.
By comparing the air conduction and bone conduction thresholds, we can determine if the hearing loss is conductive, sensorineural or mixed. The audiogram shows normal bone conduction thresholds while the air conduction thresholds show a hearing loss greater than 20db (remember 0- 20 db is normal range). Examples: Wax, glue ear, otitis media, perforation of the tympanic membrane, or ossicular abnormalities.

Both the air and bone conduction thresholds are above 20db but the difference between the air and bone conduction threshold is more than 10db. Fig 6: Mixed hearing loss with a conductive loss of 50db at 250hz and 1K, 45 at 500hz and 2k, 65db at 4k and 75db at 8k. Type B: Is a flat, horizontal trace, indicating fluid in the middle ear (in the presence of normal ear canal Volume). The authors of this document have attempted to provide information that is medically sound and up-to-date. With pure tone audiometry one can measure hearing thresholds for conductive and sensorineural hearing loss separately.
The illustration below shows an audiogram, in order to demonstrate how the ABG is calculated.
The result of an operation is assessed by determining the ABG before and some months after the operation. It’s important to note that there are different options based on individual conditions and needs. To do so, we brought in Oticon Medical’s Clinical Regional Manager and one of our top Audiologists, Alison Sabbar.
Bone Anchored Hearing Systems are indicated for conductive hearing loss, mixed hearing loss, or single-sided deafness.
Their cochlea has limited function and the candidate has poor speech discrimination ability.
There are also times that a person’s hearing loss has progressed so gradually throughout the years that the individual may not realize how much difficulty they are really having. He or she will walk you through the process of determining what kind of hearing loss you have. It is the softest sound that a person with normal hearing would be able to hear at least 50% of the times. It is done to prevent nontest ear from detecting the sound presented to the test ear by crossover. The compliance (inverse of stiffness) of the tympano-ossicular system is charted against various pressure changes.
The difference between them in decibels (dB), averaged for a number of frequencies, is called the ‘Air Bone Gap’ (ABG). The symbols refer to the left ear (blue symbols) and the hearing status before an operation.

Their middle ear is not functioning normally and this prevents sounds from getting from the outer ear to the cochlea.
The sound processor picks up sound from the side with hearing loss and sends the sound across the skull to the normal cochlea via bone conduction.
Someone with Single Sided Deafness or even mixed or conductive hearing loss may have more options to choose from to improve their hearing. Then, you and your Audiologist can work together to make the decision of which solution is right for you. The differences between the ‘]’ symbols (conductive hearing loss - bone conduction) and the ‘x’ symbols (total hearing loss = conductive + sensorineural hearing loss) indicate how much attenuation is present in the middle ear for the different frequencies. While Oticon Medical currently specializes in bone anchored hearing systems, we’re here to help you navigate your options. This allows the individual to hear sounds from both sides of their head as opposed to hearing sound from only the side of the head with the normal hearing ear. If otosclerosis continues the inner ear is affected too and a sensorineural hearing loss arises. This enhances communication ability for the listener particularly in difficult listening situations and noisy environments.
In both cases, the patient needs a medical evaluation by an Ear Nose and Throat Physician who implants the device. In rare cases, a bone anchored hearing system user may become a Cochlear Implant candidate if they lost the hearing in their good ear. The aim of an operation is to reduce the attenuation in the middle ear as much as possible.
However, it is still too early for this conclusion because several factors may influence what looks as being better.
These individuals have good speech discrimination ability once the sound gets to the cochlea. The patient also needs an orientation to the device and needs to be counseled about realistic expectations of the benefits of the device.
The cochlear implant enables the recipient to hear sound and it improves their speech discrimination ability to varying degrees depending on the individual recipient.

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