ENT recommended speaking to audi about bone anchored device!

Bone Conduction Hearing Aids
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Hi all,

Just recently had ear tubes fitted. ENT says it can take upto 4 weeks for them to “settle” and see what if any help they are. While discussing my difficulties hearing in any sort of noise etc he mentions speaking to my Audi about. Bone Anchored Device and suggested “Osia or something similar”. I was really taken back by this as I don’t feel I’m “deaf” by any nature or would need anything like that!!! When I asked him he said my conductive loss is enough that he can see me struggle in certain areas. That, and that I have Mastoid Effusion and said my hearing can fluctuate and hearing aids usually don’t work as well.

Has anyone heard of this?

I’m feeling that this might be a little overboard and maybe I just need different hearing aids/ adjusting until we can find the perfect balance?

Regarding the tubes, I have not noticed any improvement with my hearing - In fact I feel it a little worse!!!

Thanks.

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It’s the new BAHA from cochlear.

It’s a very good Aid if you do have a conductive loss.

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I have the Osia. Love it! I also have conductive loss, bad in one ear. What got me the Osia however, I believe was my eustachian tube dysfunction that periodically affected my hearing. The Osia (or any baha) bypasses this.

For me the Osia was far, far better for punching up volume and restoring nearly normal hearing (!) levels of my worse right ear in the middle to upper decibel range. Remarkable! Also, it’s very very good for speech recognition.

You seem to think that it’s an extreme option. Not at all. It’s a different approach to hearing loss. No trad HA can make frequencies sound that have been lost due to conductive damage. A BAHA can as long as your cochlear nerve is fine–mine is normal and capable of transmitting normal range of sound. Hello, bird songs!

the Osia has no post (abutment) which I like. some have issues with infection around the post. Look into a baha, I suggest!

all that said, I also use trad BTE aids with the Osia volume turned down a bit when playing guitar or listening to live music. The sound quality of the Osia for music isn’t that good. For voices and everyday, it’s just fine.

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If you think BAHA is “a little overboard” there are nonsurgical Bone conduction hearing aids. The Adhear, SoundArc and the Ponto can be worn on a headband.

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I’m a bone conduction (Oticon Ponto Plus Power) user since 2016. It is helpful in complex sound settings I just did not find it compelling enough for me to use on a daily basis. I’ve also had constant skin issues around the abutment.

At this point, I’m looking at updating the hardware - electronics technology has improved a lot since the Plus Power was introduced in 2013! I’m hoping that the new sound processors make a big difference in moving to everyday use. My abutment is compatible for both the new Ponto 5 and the BAHA 6. Switching to the Osia is also an interesting idea but would need the regular surgery for placement.

Quick comments after a lot of reading/investigation:

  • Ponto 5 SuperPower has the most power (65 dB - more important for people that are routing to a good ear, not likely an issue for you.) Drawback is that Oticon is selling their Ponto business to Cochlear but Cochlear says they will continue to support Ponto users.
  • Cochlear BAHA 6 Max has the best water/dustproofness (IP68) and seems to the only one supporting direct to Android phone streaming (limited list of models officially supported but seems like many more recent ones are too.)
  • Cochlear Osia 2, best for avoiding skin issues but a little behind the others in technology as it was FDA approved in December 2019. Drawbacks include that the implanted hardware can likely never reach the 65 dB power that I have in my current system if hearing goes downhill in my good ear and that MRIs would require more work.
  • Med-El Bone Bridge/Samba 2, similar approach to Osia 2 and first version came out long before first Osia 2. Despite being FDA approved after Osia 2, seems to not have leapfrogged it in technology. Perhaps Med-El is not just as interested or committed to the market. Not as water dustproof (IP54) as some of the competitors, doesn’t seem to offer direct streaming even via iPhone. Also has the drawbacks of the Osia 2.

Here is a table summarizing what I’m looking at now vs. what I was looking at in 2016.

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If I’ve got anything wrong in the above - please let me know.

At this point if I were getting started over, I would probably choose the Osia 2 and then plan to upgrade to say an eventual Osia 4 (or equivalent) in five years. I’m seriously considering changing to the Osia 2 given my skin issue and have read of others doing the same.

Building on @sholk, my audiologist allowed me to borrow a bone conduction device on a headband to try for a long weekend. Even if it is an older model, it could give a good feel for what it would be like using any of the bone conduction approaches. Bear in mind that a direct connection will have less attenuation and work better.

Hope this is helpful. It is hard to find a good source of information. I’ve heard there is a good facebook group but I try to avoid facebook.

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I just got my Osia activated and it is Great!!! The surgery was much easier than I expected.

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These don’t work nearly as well as an implant or a post. sound has to penetrate the skin. I trialed a headband but was warned that it wouldn’t work nearly as well the implant. It didn’t. this is confirmed 100% by folks on the BAHA forum I frequent.

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Power and frequency output in the processor does not equal actual performance. there are a lot of variables, including the efficiency of the sound transfer. And the structure of the mastoid. The Osia uses a different system for transferring sound vibration to the mastoid than the brands that use posts. It claims to be more efficient.

The car with a larger engine isn’t always the fastest. A v6 in sedan will outperform a V8 in a large truck.

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Actually, that is only true about the nonsurgical options. I had a Ponto on a hardband for a year and this is way better. The Osia has a titanium screw into my skull and the signal link through the skin is electronic not physical.

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Yes the efficiency of the transfer is important - I would compare it to a car’s transmission, a bad automatic Vs a dual plate clutch perhaps.

Th piezoelectric system used by Osia is certainly more efficient than the physical vibration used by Adhear, SoundArc or nonsurgical Ponto. I think the abutments are also very efficient.

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Yep, I have the Osia as well. I’m very happy with it. It’s really restored my middle/high decibel hearing much better than even very good BTE hearing aids.

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This topic of power is interesting and I had a good conversation with my audiologist today on the same subject.

With SSD I’m relying on routing sound to my good ear/cochlea. The result is that power requirements for me are more a function of my good ear than my bad ear. My good ear is quite good for my age. I currently have a very old Ponto Oticon Plus Power that has 65 dB for a fitting range. Given my current hearing in my good ear, I’m not using anywhere near my full power range. The 55 dB “power” of Cochlear 6 Max should be sufficient given for my current hearing in my good ear.

If my hearing significantly declines in my good ear, even due to just aging, I might be wanting more than 55 dB in the future. No problem with a traditional abutment, just at the time get a Cochlear BAHA 8 Super Max (or whatever it is called by then.)

The Osia has the transducer (~motor) implanted and therefore will seemingly always be capped at 55 dB, short of having another surgery done. (It is possible that the transducer has more power than what they are currently using/FDA approved to allow but I wouldn’t assume that was the case.) The result is that significant hearing loss in my good ear could make the Osia a less ideal fit for me in the future.

One issue that is too far out there to directly allow for would be an audio back channel (i.e. voice on a phone call). Technically, it seems like it should be possible to work with an abutment with additional sensors and signal processing to separate the wearer’s voice from the outside sounds. The Osia presumably would have no implanted sensor in the bone, nor protocols for communicating back to the processor meaning that it would be much harder/lower fidelity.

Given my situation, if I were choosing a path now, I would still probably lean towards the Osia instead of an abutment BAHA due to skin issues. Given that I have the abutment, I might try sticking it out with just a new processor for a few years.

Good luck!

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If I thought an abutment gave me better sound quality than the Osia, I would have gone with that and taken the risk of having infections around the post. but the only way to really know is to try them both, and that’s not going to happen!
Again, for me (and others) it’s precisely with people’s voices in various environments where the Osia shines. I tested through the roof with speech in noise while wearing the Osia. And my everyday experience confirms this.

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When you say 55db power on the implant….does that mean that if your loss falls off more you can only get a maximum power gain upto a 55db loss?

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I’m encouraged by the success Jeffrey has had with the Osia. Yes, very right that we can’t do direct comparisons of an abutment and an Osia.

The technology of bone conduction and direct bone contact would suggest similar sound transmission to the cochlea. I don’t see any reason that the sound quality from an abutment would be “better” than an Osia’s transducer unless the magnetic transmission path is more limited in frequency range than an abutment system or the vibration motor (transducer) was more limited.

This prompted me to do a little web search. Cochlear does specify their frequency ranges as being different from their respective spec sheets:
BAHA 6 Max: 200 Hz - 9.7 KHz
Osia 2: 400 Hz - 7 KHz (as per IEC 60118-7)

I’m surprised that their frequency ranges are so different. I’m not sure that the frequency ranges are measured the same way though even though they are from same company.

They both have the same 55 dB fitting range though.

The fitting range of 55 dB is a good proxy for power but really is about how much bone conduction hearing loss the system can handle on the same side as the processor. This figure from Cochlear’s “Osia Candidate Selection” does a nice job explaining it.

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If you are in the yellow range for bone conduction hearing on your bad ear, the Osia has the power to relay sounds to your bad “ear” by bypassing air conduction.

My bone conduction hearing is much worse than a 65 dB loss (sensorineural loss) so an Osia or abutment system needs to send sound to my good ear.

Again, Cochlear’s “Osia Candidate Selection” highlights an audiogram of a classic SSD candidate for an Osia. (My bone conduction hearing on my bad side isn’t quite this bad.)

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Essentially, if the good ear has more than 20dB of loss, the Osia system probably isn’t powerful enough to provide its full benefit.

That is where a more powerful model like the Ponto 5 Super Power (65 dB fitting range) presumably buys you an extra 10 dB of range (hearing loss on the good ear.) The yellow region of the earlier graph should be 10 dB lower.

Maybe the Osia 2’s osseo-integrated transducer has more power that a future Osia 3 or 4 might make use of but I wouldn’t plan on it.

If my hearing in my good ear (really the bone conduction hearing gap on my good side) declines below 20 dB, perhaps due just old age setting in, then I would be left wanting more power.

Result is that I am eagerly awaiting a meeting with the surgeon to find out if I am even a candidate for Osia. Until then, I’ll continue with abutment skin issues and intermittent use of my ancient Ponto.

PS. Sorry for the length of the post - getting a chance to write it down helps me understand the issue better and I would be glad to get corrections if I’m misunderstanding things.

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Happily I have a good functioning cochlear nerve on my ‘bad’ ear, so the Osia transmits sound through my mastoid to that nerve. And, as you well know, also to my left, ‘good’ ear! It’s remarkable really., But this also means that it’s hard–impossible–for me to tell which direction a sound is coming from when wearing the Osia.

that ‘ancient’ Ponto might still be the best option! Or a more powerful processor, which would jsut fit onto your already existing abutment. You know all this. Pontos seem to be very good devices!

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Ahh. With a good cochlea and nerve on your bad side, you have a lot more margin for even regular age related hearing loss than I do.

Glad to hear it works so well for you. I’m a little surprised the Osia doesn’t help you more with directionality since it should give you some approximation of stereo hearing.

No matter what, I’m planning to get something new - whether it is an Osia2 (new surgery), Ponto 5 Super Power, or BAHA 6 Max. My ancient Ponto was FDA certified in 2013 which is like a dinosaur in small electronics. All three would probably give some of the success that you’ve had.

Nice to hear about success stories and thanks for sharing.