Bone conduction hearing aids

Bone conduction hearing aids are often recommended for children with conductive deafness, where sound cannot pass effectively through the outer and middle ear to the cochlea and auditory nerve. They may also be suitable for mixed deafness or unilateral (single-sided) deafness. 

Learn about other types of hearing aids.

How it works

Bone conduction hearing aids transmit sound vibrations through the bones of the skull to the inner ear, bypassing the outer and middle ear.

There are two different styles:

• Hearing aid with separate bone vibrator (transducer): For this style, the hearing aid is connected to a bone vibrator by a wire. The hearing aid and bone vibrator are typically worn on a metal or soft fabric headband (called a softband) or sometimes on the arms of glasses.
• Sound processor: This style combines a microphone, sound processor and bone vibrator into one unit. It's meant to simulate how a bone anchored hearing aid (BAHA) works. It's usually worn on a soft fabric headband or sticky pad. 

In both styles, the bone vibrator sits on the mastoid bone, which is the large bone located behind the ear. 

The hearing aid or sound processor picks up sound through a microphone and converts it into vibrations. These vibrations travel through the skull to the cochlea (in the inner ear) where they are turned into electrical signals that the brain interprets as sound. 

Who can use it

Bone conduction hearing aids may be an option for children with temporary or permanent conductive deafness who do not benefit from behind-the-ear hearing aids. They may be recommended for children with: 

• perforated eardrums
• atresia/microtia (underdeveloped ear canal and outer ear)
• glue ear or persistent ear infections
• cholesteatoma
• certain syndromes including Down’s syndrome or Treacher Collins syndrome

They may also be suitable for children with mixed deafness (both conductive and sensorineural deafness) or unilateral (single-sided) deafness.

Additionally, bone conduction hearing aids may also be an option for children too young for bone anchored hearing aid (implant) surgery. Find out more about bone anchored hearing aids.

How sound is perceived

Bone conduction hearing aids can make sounds clearer, not louder. While it’s difficult to fully understand the experience, you can get a rough idea by plugging your ears and holding the hearing aid to your mastoid bone. 

It's important to remember that bone conduction aids do not restore typical hearing. Children may still struggle to hear if the person speaking is not facing them, if they’re too far away, or if there’s background noise.

Models and brands

The NHS usually provides hearing aids from these paediatric ranges:

• Cochlear BAHA Start (usually used as a trial for implantable devices)
• Contact Forte
• Contact Mini
• MED-EL ADHEAR (usually used as a trial for implantable devices)
• Oticon Ponto (usually used as a trial for implantable devices)

These brands offer a limited range of colours and styles. There may also be styles that are more suitable for children who wear glasses. 

There may be other brands or ranges better suited for young deaf people transitioning to adult services. 

The availability of different brands on the NHS depends on where you live and your local department's arrangements. Your audiologist should recommend the best available option.

There's no evidence that one model is better than another. The most important thing is that the hearing aid is programmed to meet the specific needs of the child or young person.