Cochlear Osia vs Cochlear BAHA for SSD

Bone Conduction Hearing Aids
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I have had single-sided deafness since childhood as a result of Cholesteatoma. Have not had any problems since second mastoidectomy in early teens. Bone is in good shape according to most recent audiology exam, a couple of years ago. Am now 60 years old.

Am now considering a Baja or Osia implant. Would love to hear from people who’ve had experience as patients with either of these Cochlear brand systems. Or, if you had an excellent experience with another branded product, feel free to let me know.

Based on the amount of research, I’ve done so far, I’m not actively considering CROS systems. If some of you have had great experience with CROS systems, please let me know.

Plan to make an appointment to discuss options with ENT in the next one to two months, and would like to hear real life stories from others so that I’m not led down the primrose path only to discover that one, the other or both turn out to be a nightmare.

Thank you!

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I am sorry that I didn’t see this before now. I am 72 and I have been SSD since 1995. I lost 100% of my speech comprehension and 60% of my sound hearing, although, when I hear sound in that ear, I cannot identify what it is. That ear also does not help locate the direction of sound unless it’s a loud bang. I wore a CROS system for about three years, before switching to a Cochlear Osia.

The CROS sysftem was the Phonak Paradise Audeo P70. It was better than not having anything, but only just better. When I first put it on, I was excited about hearing things on my left that I was missing before. My excitement soon turned to disappointment. I kept ramping up the volume on the left microphones and complaining that they weren’t loud enough. The Audiologist begrudgingly gave me a little more volume, but it still wasn’t enough.

I wore the CROS aids for three years. I wore them every day, not just every once in a while, so I gave them a good workout. On every visit to the audiologist, I complained they didn’t help, other than to give me the lost frequencies on the right that I had lost due to age.

One day, she asked if I had ever considered a Cochlear Implant (CI). I told her I tried to get one when I went on the CROS system, but I did not qualify according to the surgeon. He said I was too old to put in the time to learn how to use them. He suggested a BAHA system from MedEl. Knowing what I do know, I should have said yes and proceeded with the surgery. But I was so biased against this surgeon because of the too old remark, I turned it down and left.

But, now with three years of CROS experience under my belt, I was willing to try to qualify again, but with a different surgeon. This time I didn’t meet Medicare’s constantly changing requirements for a CI, but I did meet their requirements for an Osia. I thought it over for a week, researching everything I could about it and at the end of a week, I scheduled the surgery.

That was not quite a year ago. I wa implanted on December 21st, and activated on January 19th. I can without reservation say that short of a CI, and having the sounds sent to the processing center in my brain for the left side, this is as good as it can get.

I now hear those sounds. That I previously missed on the left. I hear those words and understand their pronunciation, and since the left ear still functions to pick up sounds, I often recognize speech that is spoken to me bad ear on the left. Since you are totally deaf on you bad side, I don’t look for this to happen for you, but it was an unexpected surprise for me.

I now wear the Osia. Every time I do anything that requires hearing, or every time that I leave the house. I often wonder if a CI would have been a better choice, but I’m a believer that God protects us from some of our bad choices by throwing up roadblocks to those choices and opening doors to other opportunities. Had I chosen the CI, and failed to train my brain to use it, I would have been worse than I was before being implanted. No, I am perfectly happy with my choice and I will stay with my OSIA.

If you have any questions, let me know.

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Why are you considering Osia/Baha instead of a cochlear implant?

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A third option was approved in July, the Oticon Sentio.

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#1 More invasive surgery
#2 More hardware
#3 Likelihood of destroying remaining hearing
#4 Not everyone wants to spend hours and possibly years doing rehab
#5 Audiophiles with near perfect hearing in good ear don’t have confidence that a CI will sound good for music. Quite the contrary, in fact.

My question is: why do so many on this forum bring up CI as if it’s as simple a procedure as getting a hearing aid? It’s beginning to sound like a religion.

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Hi,

The main reason why: My ENT previously recommended a BAHA when I saw him a number of years ago.

My understanding is that I would not be a good candidate for a complete CI (with the wire leading to the cochlea of my deaf ear) because my deafness is only single-sided, combined with my age, and the simple fact that I have lived successfully for about 45 years with SSD.

Thanks for raising the question,

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Hi,

Thank you for your reply. It’s definitely helpful. I have been thinking that the Osia would probably be my most beneficial option.

But I honestly am concerned about having something implanted. It’s the fear of the things that could go wrong.

Mind you, I had two tonsilladenoidectomies, a mastoidectomy, an eardrum and bones reconstruction, and a second mastoidectomy, all between the ages of 6 and 14.

So it’s not like I am a stranger to the world of general anesthesia, having a huge bandage on my head, and having the exterior of my right ear be completely numb for months while the nerves came back.

But since I have done pretty well with SSD — many people probably don’t know I have any kind of hearing handicap.

Thank you. Any further thoughts?

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I have the Osia. I love it. same issue, conductive loss due to cholesteotoma. I only have the Osia for my right ear. My test. scores with the Osia were startling–my right ear hearing was nearly normal, flat all the way across. You can click on my audiogram for comparison). My real life experience confirms this.

I debated getting a ‘post’ style baha but there can be infection issues. Once implanted the Osia is forgotten and trouble free, painless. The surgery was a piece of cake, although some have reported problems. I’m guessing surgeons are better at it now with more experience. I was teh first patient receiving and Osia at Kaiser in Oakland and my surgeon nailed it. No. pain after less than a week, no issues with healing. Recall that the device is implanted just under the skin and against the mastoid bone on teh outside of the skull. There’s no need to go into the middle ear at all. any complications have ahd to do with the suture becoming infected. Theres a forum site dedicated to Baha users but I forget its name. Worth looking for!

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No one (including me) suggests that it is as simple as getting a hearing aid. I am a case in point.
In another post I’ve even written “CI is not a better hearing aid” and I’ve written about many variables when considering CI, such as readiness for rehabilitation etc., not just hearing tests. This variabels is such as you described in your points.

My question stemmed from a willingness to ensure that the OP made an informed decision, as any CROS setting requires a degree of confidence that hearing in the better ear won’t get worse. So it isn’t about religion.

However, there are many CI users who were previously afraid of having a CI and put it off. After the operation and rehabilitation, they regret that they didn’t have that procedure earlier. The forum is therefore a platform that provides a bit of courage and reassurance when users actually qualify for CI.

No one wants to ruin someone’s residual hearing if the ear is “too good” for a CI. If I remember correctly - OP has nothing to lose on the poorer ear.

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Thank you for your reply. That sounds reasonable. I hope you’ve discussed it again with the ENT.

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I have an Osia device, which uses an implant to vibrate a titanium screw that is mounted in my mastoid bone.

I notice that you have had both mastoid bones removed. If they proceed with the Osia, where are they going to mount the titanium screw?

I was originally considering a CI for my bad ear, but because I’m 72, and because I still have 40% of my hearing in that ear, the surgeon was hesitant to destroy the remaining hearing to implant the CI considering that i might have trouble learning to interpret the signals into sounds. When it came back that Medicare wouldn’t cover it because of my 40% hearing that remained. It didn’t seem to matter to Medicare that I have 0% comprehension in that ear.

But that brings me back to your situation. Where are they going to anchor the implant screw?

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What do you mean saying “40%”, when in other sentence you say about 0% in (probably) Word Recognition Score?

Age is not an absolute contraindication to CI, especially if you do not have another serious illness or other factors that may make rehabilitation more difficult…

coch-counselreferralpatientsresource.pdf (248.9 KB)

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EDIT:

Okay, I’ve read it now. I understand that your evaluation was in the past. There may have been completely different indications and contraindications for CI based on scientific research. My mistake.

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I think you have it now. In a way, I’m glad things turned out the way they did. I’m perfectly happy with the Osia, and I always had a touch of doubt that I would be able to use the CI.

No one was ever able to figure out where my hearing loss was, and what caused it. There was always the possibility that the CI signals might not make it to the audio center in my brain, and that I would give up the 40% hearing that I do have in that ear. Granted I am not able to understand any sounds I hear in that ear, I still hear something.

What I have now was totally unexpected, and when I tell my audiologist and my ENT, they say that they are happy for me and give me that look like they are just agreeing with the crazy old man to keep him happy.

What is happening is; when someone in my sound shadow speaks, my Osia picks up the speech and sends it to both cochlea via the bone structure in my head. My right ear & brain sound processing system process the sound into speech. The left ear & brain sound processing system detect a sound that it doesn’t understand. The speech center in my brain puts the two together and realizes the speech it hears in the right ear belong to the noise coming in on the left ear, so the brain hears the sound as if it comes in on the left.

About now you’ve got that look on your face that you’re reading the rambling of a crazy old man, and it could be. But, that IS what I perceive, and it’s my story and I’m sticking to it.

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You meant at the end: “as if it comes on the right [better ear]”? Interesting - it is something that looks like the “binaural squelch” phenomenon.

However, I thought that it occurs only when the ear and neural pathway on the noise side are functioning - by healthy or artificial CI listening. I would not expect that phenomenon when only one cochlea is involved in the analysis of the sound environment.

I wonder if your poorer left ear gets some better speech understanding due to more accurate sound directed to the left cochlea. However, it is probably very difficult (if even possible) to check it because your better right cochlea gets the signal from Osia.

I am happy to see you have gotten benefits from it.

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I’ve been thinking about this some more and realized that the Osia sends sound to both cochlea. I can’t believe I forget this little detail.

Since the sound from the Osia transducer is transferred to the bone in my skull behind my left ear (the non functioning ear) that cochlea receives the vibrations as well as the right side cochlea. So if the defect in my hearing is between the outside and the cilia, the sound vibrations should also be received and converted to electrical impulses by the left cochlea. That may be what is happening.

I just don’t understand the details of how the cilia creates the electrical impulses for the brain, and how the Osia device causes that to work on the good ear. Does the Osia need good cilia present inside the cochlea to create the electrical impulses?

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Yes, indications for the Osia is e.g. conductive hearing loss untreatable by other way (defects things between outside and cochlea). For CROS use it requires healthy cochlea, because that organ is the place where mechanical signal is transformed to electrical.

It’s because mechanical vibrations reach the cochlea of the better (contralateral) ear through the skull bones.

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This may help future forum users to make more informed choices:

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Source:
FUN4699-SSD-White-Paper.pdf

FUN4610-Impact-and-Considerations-for-SSD.pdf

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Exactly. I have the Osia on my right side only. But the Osia definitely sends sound signals to my left ear through vibrations in my skull/mastoid. this. does make it a bit tricky to determine where any sound is coming from. No matter! I love the Osia. But I have primarily conductive loss–and the sensorineural loss is on my left side. So the hearing on my right side with the Osia is almost normal—!!! look at my audiogram.The Osia performs better than my RIC trad hearing aids. I’m very lucky that Kaiser sprung for the Osia.

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For conductive hearing loss (with normal or near normal bone conduction thresholds in the audiogram), bone conduction implants usually provide excellent results.

I talked about sensorineural SSD, so I wrote about CI/Baha consideration for it.

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the Osia IS a baha…it uses the mastoid bone to conduct sound to the cochlear nerve. although I’ve seen that a lot of folks don’t include the Osia when they speak about Baha aids.