BAHA Surgery

What is BAHA

A BAHA (Bone Anchored Hearing Aid) is an auditory implant and sound processor. The Baha is a surgically implantable system for treatment of hearing loss that works through direct bone conduction. It has been used since 1977,it is as a treatment for conductive and mixed hearing losses.

Baha is used to help people with chronic ear infections, congenital external auditory canal atresia and single sided deafness who cannot benefit from conventional hearing aids. The system is surgically implanted and allows sound to be conducted through the bone rather than via the middle ear – a process known as direct bone conduction.

Who can be helped by BAHA?

BAHA is a treatment option for people with moderate to severe hearing loss who don’t benefit from normal (air conduction) hearing aids. The commonest reasons for considering BAHA are

  1. chronic ear infection – when wearing normal hearing aids makes the infection worse.
  2. The fluid inside the cochlea picks up the vibrations and carries them to thousands of tiny hair cells.
  3. The small ear bones vibrate along with the eardrum, transferring the sound across the middle ear to the cochlea.
  4. Hair cells convert mechanical vibrations into electrical impulses. The electric impulses are sent along the auditory nerve to the brain. The hearing centre of the brain interprets the impulses as sound.

How does a Baha work?

The Baha consists of three parts:

  • A titanium implant
  • An external abutment and
  • A sound processor.

The system works by enhancing natural bone transmission as a pathway for sound to travel to the inner ear, bypassing the external auditory canal and middle ear. The titanium implant is placed during a short surgical 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 vibrating implant sets up vibrations within the skull and inner ear that finally stimulate the nerve fibers of the inner ear, allowing hearing.

Who is a Candidate for the Baha System?

The Baha is used to rehabilitate people with conductive and mixed loss hearing impairment. This includes people with chronic infection of the ear canal, people with absence of or a very narrow ear canal as a result of a congenital ear malformation, infection, or surgery, and people with a single sided hearing loss as a result of surgery for a vestibular schwannoma (a tumor of the balance and hearing nerves).
Chronic Ear Infection
Treatment for hearing losses with the Baha is suitable for people with a conductive or mixed hearing impairment caused by a chronic infection of the middle or outer ear that results in a persistent and unpleasant discharge. The first goal, of course, is to manage the infection. In rare cases, chronic infections fail to respond to treatment, but are determined to be non-threatening. In other cases, infections respond to treatment, but recur with use of a conventional in-the-canal hearing aid. When a hearing aid is placed in a susceptible ear canal, a chronic or recurrent infection may be aggravated by the obstruction of the canal and the resulting excessive humidity and lack of drainage. In these cases, the Baha may be a good solution for hearing rehabilitation. The Baha sound processor transmits sound directly to the hearing nerve without involving the ear canal. With Baha there is no occlusion of the ear canal to aggravate infection. A Baha sound processor offers sound quality at least as good as a conventional air conduction device. For those who need high levels of amplification, problems related to feedback and discomfort are usually resolved.

Hygiene and cleaning of site

You have a lifelong commitment to cleaning and hygiene around the abutment. The BAHA is based on the same titanium technology used for dental implants. If you don’t clean your teeth every day, you will develop gum disease. Infection will set in and loosen the tooth and it will fall out. The same will happen with the BAHA unless you look after it. You may need daily cleaning with a baby toothbrush around the abutment, though some patients do not seem to need to clean so often.


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