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Advantages and disadvantages of implantable devices

Photo: It's important to have balanced information so you can make an informed choice

There are a range of advantages and disadvantages to bone conduction hearing implants (BCHIs).

Advantages

  • The sound processor is in direct contact with the bone which gives a better sound quality.
  • The sound processor is clipped onto the abutment or held on with a magnet which makes it feel weightless and more comfortable to wear than a bone conduction soft headband. These bands can be uncomfortable because of the pressure they put on the skull.
  • Conductive deafness needs more amplification from conventional hearing aids than a similar sensorineural deafness. A BCHI can therefore provide less amplification than a conventional hearing aid making the listening more comfortable for the wearer and giving less problems with feedback (whistling) associated with a more powerful conventional hearing aid. 
  • A BCHI is better for hearing in higher frequencies than a BCHD or sound processor fitted on headband because the sound vibrations in the higher frequencies aren’t reduced by the skin and tissue behind the ear.
  • For children with absent or malformed external ears, conventional hearing aids can be very difficult to fit comfortably.
  • For children with ears that discharge or other skin conditions, there is no earmould blocking the ear canal so the ear is kept clear which helps prevent infection.
  • It looks more appealing than a BCHD as they are smaller and less obvious.
  • The implant provides more consistent sound for children with fluctuating hearing levels.
  • Surgery is minimally invasive and there isn’t a risk of further damaging hearing.

Disadvantages

  • Risks associated with general anaesthetics need to be considered. Most children will have a two-stage surgical procedure which means they’ll need two sets of general anaesthetic. Single stage surgery is also possible but is generally used for older children and young adults as their skull bone is more developed.
  • As with all surgery there is a risk of complications, such as infection. Find out more about preparing your child for surgery
  • The abutment area needs to be kept clean which requires regular help from another person until your child is old enough to care for the site themselves. This may carry on into adulthood for people with learning difficulties.
  • As with many procedures, there is a risk of infection and inflammation at the implant site after surgery.
  • There is a small risk that the growth of new bone around the implant (osseointegration) will fail. If this happens the implant may fall out and you should seek advice from your audiologist on what to do next.
  • There is a risk that any head trauma, e.g. a blow to the implant site (with or without the presence of the processor), may have more serious consequences than what might happen with a conventional hearing aid. This may include an infection of the skin around the implant site, the implant falling out and having to use a sleeper implant or repeat surgery for a new implant. Precautions need to be considered, such as head protection for sports.
  • BCHI centres are widely available, however there are still fewer UK services than audiology departments which could result in increased travel for assessment, surgery and ongoing care for the family. 

You should discuss all of the advantages and disadvantages with your hearing implant team to make sure that you have all the information you need to make an informed decision.