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Cochlear America's BAHA

Bone Anchored Hearing Aid

What is a Baha?


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A Baha is a surgically implanted bone-anchored hearing aid. The device consists of three parts:

  • A Sound Processor: The sound processor sits behind the ear and picks up sound through a microphone. The sound is amplified and converted into sound vibrations. The sound processor is connected to the head by the abutment.
  • An Abutment: The abutment is the "middle man" between the sound processor and the titanium implant. It transfers the sound vibrations from the sound processor to the titanium implant.
  • A Titanium Implant: The titanium implant is a small fixture that is surgically placed behind the ear. The implant naturally fuses with the bone (this is called osseointegration) and transfers the sound vibrations from the abutment to the cochleas (or inner ears).


What is bone-conduction hearing?

Conventional hearing aids rely on air conduction to perceive sound; an amplified sound gets sent down the ear canal, strikes the ear drum causing the middle ear bones to vibrate. The vibrations are transferred to the cochlea (inner ear) fluids, which are then converted into electrical impulses by tiny hair cells in the cochlea. These electrical impulses are sent to the brain to be perceived as sound.


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The Baha provides the user with another way to perceive sound--bone conduction. The Baha bypasses the outer and middle ear and sends vibrations directly to the cochleas. Once in the cochlea, the sound is treated the same as an air-conducted signal. Between cochleas, there is zero interaural attenuation time. In other words, when bone conduction hearing occurs, both cochleas are delivered the sound at the same time. The cochlea with the better hearing perceives the sound. Therefore, if a user has single-sided deafness, the Baha can be placed above the poor ear to pick up sound from that side. The Baha will deliver the sound through the skull to the better ear to be perceived as sound.

Who can benefit from the Baha?

The Baha is for patients who:

  • Hear only from one side (unilateral hearing loss)
  • Have single-sided deafness
  • Have malformed ears, or chronically draining ears with hearing loss
  • Have a conductive hearing loss (CHL definition: A hearing loss that involves the outer or middle ear's inability to "conduct" the sound to a healthy inner ear, or cochlea)
  • Have a mixed hearing loss (MHL definition: A hearing loss that involves the outer, middle, and inner ear. In other words, the patient has a degree of inner ear hearing loss that is intensified by an outer and/or middle ear problem)


Pathologies or conditions appropriate for the Baha include, but are not limited to:

  • Atresia (absence of external ear canal)
  • Stenosis (narrowing of the ear canal)
  • Chronic suppurative otitis media
  • Complications of radical mastoidectomy
  • Ossicular malformation (malformation of the middle ear bones)
  • Severe tympanosclerosis (calcification of tissue in the ear drum)
  • Intolerance or allergy to earmolds used for conventional hearing aid use
  • Post-operative mastoid cavity with chronic otorrhea (ear drainage)


How long does it take to get the sound processor?

In adults, the joining of the sound processor to the abutment is typically performed three months after surgery to allow the bone to osseointegrate with the titanium implant. Osseointegration means the bone and prosthetic device will make a functional connection.

Considerations for Baha Surgery

Baha surgery is a one hour, low-risk, typically out-patient surgery. There is a low rate of complications with a high safety profile. If proper after-care is not followed, there is a risk of local wound infections. The sound processor is susceptible to mechanical failure and repairs, though the device comes with a three year warranty. Additionally, a small percentage of abutments do not osseointegrate. Overall, however, patients experience a high level of satisfaction.

Am I a candidate?

Learn more about the Baha sound processor options from your audiologist. A hearing evaluation will be performed and Baha candidacy will be reviewed. A demonstration of the Baha can be done in the office to "test drive" the device before undergoing surgery. This can be done by placing a Baha processor on a headband. Please contact us to make an appointment.

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About Dr. Prasad

Dr. Sanjay Prasad MD FACS is a board certified physician and surgeon with over thirty-two years of sub-specialty experience in Otology, Neurotology, advanced head and neck oncologic surgery, and cranial base surgery. He is chief surgeon and founder of the private practice, Metropolitan NeuroEar Group, located in the metropolitan Washington D.C. area.

About Dr. Baradar

Dr. Veeda Baradar is a talented audiologist who specializes in cochlear implants, hearing aids, electrophysiologic assessment, and vestibular evaluation and management. She is fluent in both English and Farsi, and carries certification from the national American Speech-Language-Hearing Association (ASHA). Dr. Baradar earned her Bachelor’s and Doctorate degrees in Audiology from University of Maryland, College Park, and is licensed in both Maryland and Washington, D.C..