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Implantable Hearing Aid: What is it and who does it affect? ​​When the inner ear, which is the organ of hearing, functions normally, but there is some damage to the system that transmits sound from the external environment to the organ of hearing, then the resulting hearing loss is called conductive hearing loss.

The most common example of conductive hearing loss is the hearing loss that occurs during an acute otitis media. In this case, the pus that is concentrated in the middle ear cavity does not allow the smooth movement of the eardrum and the small bones that are connected to it, and thus our hearing is reduced. Of course, in otitis, hearing loss is temporary, since hearing returns to normal after the infection is resolved. However, there are cases where conductive hearing loss is permanent, such as in eardrum perforation, bone erosion from chronic otitis, cholesteatoma and otosclerosis.

The good news is that most causes of conductive hearing loss are treatable: acute with medication, chronic with surgery. However, there are patients whose general health condition does not allow for surgery, or who have already had surgery, perhaps more than once, but their ears continue to drain pus. Also, children with syndromes may have a high degree of conductive hearing loss, due to a defective structure of their ear, and surgical repair is extremely difficult, with questionable results.

Many of these patients cannot use classic hearing aids, either because they are not easy to apply, or because it is not allowed to block an ear that often drains pus with the earpiece. For these difficult cases, modern technology has provided the solution: The implantable hearing aid.

Implantable hearing aid

The Implantable (bone-anchored) hearing aid (BHA) is a high-tech electronic device that collects sounds from the environment with a sensitive microphone and transmits them to the inner ear directly through the bones of the skull, bypassing the problematic sound conduction system.

The BAHA is fitted onto a tiny titanium screw, similar, but smaller, to the screws of dental implants. This screw is implanted with a simple operation in the bone behind the ear and the BAHA “clicks” onto it with the help of a special connecting element. Titanium has the property of osseointegration, which means that after a short period of time, it integrates (becomes “one”) with the bone, without local reaction, i.e. without forming a reactive capsule. Osseointegration gives the screw great stability, which allows it to be loaded with the weight of the hearing aid and gives perfect acoustic performance, without any loss of sound from the connection.

In which patients is the implantable hearing aid applied?

• In any conductive hearing loss (damage to the tympanic membrane and/or bones), when the patient cannot or does not want to undergo surgery.
• In cases of chronic otitis, in which the patient has already undergone surgery, but the ears are unstable and pus is flowing, thus not allowing the application of normal hearing aids.
• Childhood hearing loss: In congenital conductive hearing loss and syndromes (e.g. Treacher Collins).
• In selected sensorineural hearing loss, when the application of a normal hearing aid is not possible hearing aid.

What is the application process?

Under local or general anesthesia, with a small incision behind the ear, the titanium screw is implanted. After healing is complete, the screw can be loaded with the weight of the hearing aid, through a special connecting element. The new generation devices are adapted to connecting elements with a special hydroxyapatite coating, which have simplified the placement procedure. Also, modern titanium screws allow for immediate loading, unlike the older ones, which required a wait of approximately 3 months. The adjustment is made immediately by the technicians, based on the patient’s audiogram.

What are the advantages of the implanted hearing aid?

• Impressive sound quality. All patients are thrilled with their new hearing!
• Small size, easily hidden in the hair (available in various colors, depending on the patient’s hair color).
• The hearing aid does not come into contact with the ear and is hardly noticeable.

What are the disadvantages?

• The only disadvantage of the BHA is the cost. As a high-tech device, it is not cheap. Under certain conditions, part of the cost may be reimbursed by EOPYY.

Our team’s pioneering work related to VAHA

The ENT Clinic of the Athens Medical Center has a special relationship with VAHA. Timoleon Terzis installed the first VAHA in Greece in 1998 at the Naval Hospital of Athens, while in 2016 he installed the first new generation VAHA in a private hospital in Athens.