Which hearing treatment is right for me?

When you make the decision to address your hearing loss or seek treatment for your child, it always helps to know what options are available. These days you can find a wider variety of hearing loss treatments than ever before, which is great… except, how do you know which one would work best for you or your child?

When it comes to deciding between traditional hearing aids—removable, non-surgically implanted devices—and bone anchored hearing systems, we’d like to help you with your initial research. Please note that ultimately only a hearing care professional can diagnose your hearing loss and recommend which option would best suit you or your child. However, it is always better to go into your initial consultation understanding and feeling prepared to discuss the choices presented.

What are air conduction hearing aids?

Air conduction, or traditional hearing aids, are devices you can purchase from an audiology clinic, and once they have been delivered to the office and fitted to your hearing needs and preferences, worn right out the door. They may be fitted by an audiologist or a hearing instrument specialist in a private office, clinic, “big box” store, or hospital setting.

After purchase, the average wearer should expect periodic in-person follow-up visits with their hearing care provider for adjustments to settings and programs, although some professionals might offer remote follow-ups for minor tweaks, troubleshooting, and adjustments.

Hearing aids are available in behind-the-ear (BTE), receiver-in-canal (RIC), and in-the-ear (ITE) models of varying sizes, some of which are nearly invisible (for wearers who prefer a discreet solution) and other that are larger and more visible (for those who find them easier to handle and don’t care about others seeing their devices).

Some modern hearing aids come loaded with additional features, including therapeutic sounds meant to counteract the annoying “ringing in the ear” known as tinnitus, accessory-routed or direct audio streaming, and rechargeability. The downside is that the more bells-and-whistles that you use, the shorter your battery life, with most users finding they have to replace their batteries weekly or recharge nightly. The overall life expectancy of the hearing aid itself is an average of three to seven years.

Hearing aids are most often used to treat people with sensorineural hearing loss, which involves issues with the inner ear and/or neural pathways from the inner ear to your brain. Sensorineural hearing issues may be caused by one or more of the following:

• Exposure to extremely loud noise
• Presbycusis (i.e., age-related hearing loss)
• A malformed or damaged inner ear
• Use of ototoxic (literally “ear poisoning”) medication
• Genetic/inherited conditions that affect hearing
• Illnesses and disease (e.g., meningitis, diabetes)

Unfortunately most private and public health insurers do not cover the cost of hearing aids as of this writing. The average price for a hearing aid is around $1,000 for a very basic model up to $5,000-plus for a high-end option. Keep in mind that audiology professionals usually recommend wearers use two hearing aids to gain the full benefit of binaural (two ear) hearing, which is how the brain naturally takes in and processes sound. And while options such as CROS (Contralateral Routing of Signal) and BiCROS (Bilateral CROS) hearing aids can help people with single-sided deafness (SSD) hear sounds by routing them from the device worn on the non-hearing ear to the full or partially hearing ear, some wearers find them insufficient.

What are bone conduction hearing aids?

Bone conduction hearing devices are designed to treat conductive hearing loss, which occurs when sound cannot travel through the outer and/or middle ear (usually due to physical blockage or missing all or a portion of the ear). Examples include the following:

• Microtia, (underdeveloped or missing outer ear) with or without atresia (missing or closed ear canal)
• Damage due to otitis media (middle ear infection) or external otitis (ear canal infection)
• Perforated or missing eardrum
• Tumors affecting the eighth cranial nerve or blocking the outer or middle ear (the surgery to remove these tumors may also cause conductive hearing loss)
• Missing or fused stapes (three tiny bones in the ear required for sound conduction)

They can also be an effective option for mixed hearing losses for those who experience a combination of sensorineural and conductive hearing difficulties.

Bone anchored hearing systems are typically purchased from an otolaryngologist (aka, “ear-nose-throat” doctor, or ENT) at a clinic or hospital, or once you have had the implant surgery (alternately, if you are only wearing the device on a softband or headband), directly from the manufacturer. To receive maximum hearing assistance, they are meant to be surgically implanted. Bone anchored hearing systems consist of an implant, which is the portion implanted into your skull (typically behind your ear), an abutment, which is the transcutaneous portion fixed onto the implant, and the processor, which is programmable and gets snapped onto the abutment a few weeks following implantation.

Esthetically, the only difference between most bone anchored hearing devices is shape and size depending on the manufacturer. The majority are built for discretion, but wearers can choose to show off their bone anchored devices by adding colorful skins and stickers.

Once the processor is fit, wearers might require an occasional follow-up for adjustments, but normally fewer than the typical hearing aid wearer—and some may not require your physical presence but rather that you send in your processor for adjustment or repair by mail. As with regular hearing aids, a few hearing care professionals might offer a remote care option as well.

When it comes to extra features, bone anchored hearing processors continue to evolve. Some include audio streaming options via an intermediary streaming accessory, app, or directly into the processor. Rechargeability and tinnitus therapies may become available in the future based on demand and manufacturing capabilities. Bone anchored hearing devices are extremely effective for treating single-sided deafness (SSD) and don’t require use of a second device to improve hearing ability. In fact it is less common for bone anchored wearers to need two devices to enjoy significantly improved hearing than for traditional hearing aid wearers.

As for insurance coverage, the good news is that implantable hearing devices are categorized as medical devices, unlike traditional hearing aids, and as such are often covered all or in part by private and public insurance providers. So, while the retail price per device averages around $3,000-$6,000, you’re less likely to have to pay that much out-of-pocket.

When you’re ready to treat your hearing loss

We hope the information provided here will help you make the best possible decision for your specific hearing healthcare needs. If you are ready to speak to a hearing care professional in your area who includes bone anchored hearing systems among their treatment options, you can visit our handy Find a Clinic tool on our website.