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Cochlear Bone Anchored Solutions

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The Baha 4 Systems
File:Cochlear Baha 4 Systems.PNG
The Baha 4 Systems display the Baha Attract och Baha Connect Systems and how they are connected
TypeCochlear Baha 4 Systems
ManufacturerCochlear Bone Anchored Solutions AB
Country of origin Sweden. Purchased by Australian company Cochlear in 2005.
Introduced1977
Websitewww.cochlear.com

Cochlear Bone Anchored Solutions AB is a company based in Gothenburg, Sweden, that manufactures and distributes bone conduction hearing solutions under the trademark Baha®. The company was created in 1999 and was then called Entific Medical Systems. When Cochlear bought the company in 2005, the name changed to Cochlear Bone Anchored Solutions AB . The acronym "BAHA" (for bone anchored hearing aid) was trademarked into Baha, since it is not considered a hearing aid by insurance companies.

The Baha® System is a bone conduction hearing system designed, developed and marketed by Cochlear Bone Anchored Solutions.

The Baha System is a semi-implantable percutaneous bone conduction hearing device coupled to the skull by an osseointegrated titanium fixture.[1] The system transfers sound to the inner ear through the bone, thereby bypassing problems in the outer or middle ear. Candidates with a conductive, mixed or single-sided sensorineural hearing loss can therefore benefit from bone conduction hearing solutions.

Since dr Anders Tjellström at Sahlgrenska University Hospital in Gothenburg, Sweden, implanted and fitted the first patient with a Baha sound processor in 1977, an increasing number of clinics around the world offer implantable bone conduction hearing solutions as a method of treatment. More adults and children are implanted with a Baha solution every year, from only 3 in 1977 to over 100,000 users today.[2]

History

Dr Anders Tjellström, the founder of Baha, testing the Cochlear Baha wireless accessories

Professor Per-Ingvar Brånemark famously discovered osseointegration in the 1950s which allows titanium implants to fuse with human bone. The discovery led to wide use in dental implants. In the mid-1970s Brånemark, together with his ENT colleague Dr Anders Tjellström, glued an Oticon bone vibrator to a snap coupling fitted to a dental implant and then connected it to an audiometer. The patient reported a very high, clear sound. It was obvious that the sound propagated very well through the bones of the maxilla to the inner ear. This became the starting point for the future development of the hearing device Baha together with the titanium implant.[3]

Surgery

The process involved in getting a Baha is relatively simple. Surgery generally takes place in an outpatient setting, causing minimum disruption and stress. Normal activity can be resumed within a few days.[citation needed]

Implantation

The procedure is minor and often performed in an outpatient facility with local or general anaesthesia. The surgeon prepares a small area behind the ear, 50–55 mm from the ear canal and line with the top of the pinna, removing a small amount of hair follicles. The area (approximately 24 mm in diameter) closest to the abutment will remain hair free. A Baha titanium implant with an abutment will be inserted in the centre of this area. The implant is 4 mm long and the abutment is 6 mm. When surgery is complete, the top of the abutment is on the same level as the skin.[citation needed]

Healing

After surgery, a dressing which should be changed regularly is required. The stitched are usually removed within 10–14 days. Some numbness in the area around the abutment can occur (except when using the DermaLock procedure). Most likely this condition is temporary. Once the dressing is removed it is important to keep the abutment area clean using a supplied cleaning brush. Good hygiene is critical to maintaining normal usage of Baha sound processors. Users who are unable to clean the skin themselves need help from family members or caregivers.Template:Citatuion needed

Osseointegration

With the improved size and surface of the Baha 3 Implant (BI300) it is no longer necessary to wait 12 weeks after surgery for fitting. Studies show that osseointegration now occurs as early as three weeks after surgery.[citation needed]

Fitting

The Baha sound processor will be fitted at a hearing clinic. A hearing care professional adjusts the sound settings to suit the patient's personal requirements. The sound processor is designed to snap onto the abutment by holding it at a slight angle and put into place with a click. To take it off, place one finger under the device and gently tilt off.[citation needed]

Candidates and indications

In cases where there are complications with the middle ear, or when one ear does not function, sound can't reach its destination. Hearing care professionals agree that for these types of problems Baha is a more effective solution than air conduction devices.[4]

Candidates for Baha include patients with outer or middle ear problems (conductive hearing loss), middle and inner ear problems (mixed hearing loss) and no hearing at all in one ear (Single-Sided Deafness). In the first two cases, Baha reroutes the sound via the skull to the cochlea. In SSD, Baha transfers the signal directly to the hearing ear, making it possible to perceive sounds from both sides.[citation needed]

There are several other medical indications where Baha can be treated for hearing loss:

  • Atresia/Microtia where malformations of the ears cause a conductive hearing loss and sound cannot travel to the inner ear.[citation needed]
  • Chronic Otitis Media increases the risk of middle-ear problems that can cause a conductive hearing loss. Conventional hearing aids worn in the ear can be uncomfortable and sometimes impossible to wear when a child has an ear infection. Because Baha doesn't obstruct the ear canal, the discharges associated with chronic ear infections are allowed to dry properly which reduces the risk of recurring problems.[citation needed]
  • Cleft lip and palate usually causes middle ear problems since the muscles that open the Eustachian tube lack an anchor to function effectively.[citation needed]
  • Down Syndrome children usually face an increased risk of chronic ear infections and neural transmission problems that can cause hearing loss. Especially narrow ear canals are a common condition with Down Syndrome. Baha can be implemented early in life and thus enable Down children to hear and learn language from a young age.[citation needed]
  • Treacher Collins syndrome is a very rare genetic disorder resulting in deformities of the skull. Patients are usually born with underdeveloped mandible and maxilla that result in a distorted jaw and eyelids. Hearing loss in Treacher Collins Syndrome is caused by deformed outer and middle ears, therefore the sound cannot reach the functioning cochlea.[citation needed]

See also

References

  1. ^ Dun, Catharina A. J.; Faber, Hubert T.; de Wolf, Maarten J. F.; Cremers, Cor W. R. J.; Hol, Myrthe K. S. (2011). "An Overview of Different Systems: The Bone-Anchored Hearing Aid". In Kompis, Martin; Caversaccio, Marco-Domenico (eds.). Implantable Bone Conduction Hearing Aids. Advances in Oto-Rhino-Laryngology. Vol. 71. pp. 22–31. doi:10.1159/000323577. ISBN 978-3-8055-9700-5.
  2. ^ Gompelmann, Daniela; Eberhardt, Ralf; Heuβel, Claus-Peter; Hoffmann, Hans; Dienemann, Hendrik; Schuhmann, Maren; Böckler, Dittmar; Schnabel, Philipp A.; et al. (2011). "Lung Sequestration: A Rare Cause for Pulmonary Symptoms in Adulthood". Respiration. 82 (5): 445–50. doi:10.1159/000323562. PMID 21311173.
  3. ^ Brånemark, PI; Hansson, BO; Adell, R; Breine, U; Lindström, J; Hallén, O; Ohman, A (1977). "Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period". Scandinavian journal of plastic and reconstructive surgery. Supplementum. 16: 1–132. PMID 356184.
  4. ^ Snik, AF; Mylanus, EA; Proops, DW; Wolfaardt, JF; Hodgetts, WE; Somers, T; Niparko, JK; Wazen, JJ; Sterkers, O; Cremers, C. W.; Tjellström, A (2005). "Consensus statements on the BAHA system: Where do we stand at present?". Annals of Otology, Rhinology, and Laryngology. Supplement. 195: 2–12. PMID 16619473.