What is the difference between a Cochlear Implant and a Bone Anchored Implant?

July 23, 2012 Stacey D. Watson, MS, CCC-A

a young woman with a cochlear implant sits with a medical professional


In this article:

  • A Swedish audiologist explains that people who suffer from hearing loss may qualify for implants, which can be used by even small children.

  • Bone-anchored implants may be appropriate for those who find traditional hearing aids inefficient.

  • Cochlear implants are for individuals with more severe hearing loss.

When someone with hearing loss comes into our center, we talk with them about many different technology options to help them reconnect to their world. Most people are familiar with hearing aids. However, many have questions about a cochlear implant or a bone-anchored hearing aid implant (or BAHA) and wonder if these implants would be an option for them.

A bone-anchored implant is appropriate for someone for whom traditional hearing aids are not efficient because of draining ears or chronic infections, blockage or damage in the outer or middle ear or loss of all hearing in one ear. Candidates have either a conductive hearing loss or a single sided deafness.

The bone-anchored implant uses a titanium device placed in the skull behind the ear and a sound processor that attaches to the implant. The sound processor collects sounds from the environment sending vibrations into the implant, which in turn vibrates the bone. This bone vibration bypasses the outer and middle ear and stimulates the inner ear. The hair cells inside the inner ear convert the sound to electrical impulses that travel to the brain, allowing the recipient to hear naturally. 

A bone-anchored Implant can be surgically placed on a child starting around five years of age. However, even infants can successfully use this implant with a soft band to hold the processor in place. For adults, there is no upper age limit. Recipients report being happy to be free of hearing aid earmolds and that they understand speech better than they were able to with their hearing aids.

A cochlear implant candidate differs from a bone-anchored Implant candidate in that they have a greater degree of hearing loss. They have a severe to profound sensorineural hearing loss (often called “nerve deafness”) in both ears to the point that traditional amplification is no longer beneficial. Often candidates report that wearing a more powerful aid or increasing the volume is like turning up the volume on a bad speaker. It can make sound louder but more distorted. A sensorineural hearing loss can be caused by illness, head trauma, malformation of the inner ear, exposure to loud noise, general aging or other unknown causes. 

The cochlear implant is a two-part system that consists of an internal device that is surgically placed under the skin and a sound processor that sits on the outside of the ear capturing sounds from the environment. The processor translates the captured sound into digital information and sends it to the internal implant, which in turn converts the digital information into an electrical signal that stimulates the auditory nerve, bypassing the damaged portion of the inner ear. The electrical signals are sent to the brain and are perceived as sound.

Cochlear implants can be placed on children as young as 12 months of age and there is no upper age limit. Cochlear implant recipients report that they are able to relax and not work so hard to communicate with friends and family. They are excited to share stories of all the “new” sounds they forgot were in their world.

Find a doctor

If you have questions about hearing loss or implants, contact Swedish Audiology Services. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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