Health Problem: In the United States, it is estimated that 48 million adults have some type of hearing loss. Hearing loss can be broadly classified as sensorineural (inner ear), conductive (external and middle ear), or mixed.

Technology Description: This report evaluates the use of percutaneous bone–anchored hearing aids (BAHA) for single-sided sensorineural deafness (SSD) and conductive or mixed hearing loss. BAHA transmit sound vibrations to the inner ear by direct bone conduction through the skull. A titanium screw implanted into the skull allows removable coupling of the sound processor to the bone. BAHA are intended to improve hearing acuity in individuals who have SSD and moderate-to-severe conductive or mixed hearing loss.

Controversy: Although positive reports of improved speech discrimination and quality of life have led to widespread acceptance and use of percutaneous BAHA for SSD and moderate-to-severe conductive or mixed hearing loss, there is also evidence to suggest that the benefits of percutaneous BAHA may be limited, with no perceived improvement in sound localization. Currently, there is a notable lack of well-designed studies evaluating the effectiveness and safety of long-term use of percutaneous BAHA, particularly comparing this technology with more conservative treatment options such as contralateral routing of signals hearing aids.

Key Questions:

  • Do percutaneous BAHA improve speech perception and speech intelligibility?

  • Are percutaneous BAHA safe?

  • Have specific patient selection criteria for percutaneous BAHA been established?

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