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: Transcutaneous bone–anchored hearing aids (tBAHAs) transmit sound vibrations from the environment to the inner ear by direct bone conduction through the skull. Unlike percutaneous BAHA (pBAHA) systems that employ a skin-penetrating implant, tBAHA systems use a magnetic connection to join the sound processor and the implant, leaving the skin intact. tBAHAs are intended to improve hearing acuity in individuals who have sensorineural deafness and unilateral or bilateral, moderate-to-severe conductive or mixed hearing loss. The devices are implanted surgically in an outpatient setting.

Controversy: Although tBAHAs were developed to reduce or eliminate wound care and minimize the risk of infection associated with skin-penetrating pBAHA devices, there is a notable lack of well-designed studies evaluating the effectiveness and safety of long-term use of tBAHAs and comparing these devices with pBAHAs and more conservative treatment options, such as contralateral routing of signals hearing aids. A drawback of tBAHAs compared with pBAHAs is a slight loss of hearing gain in order to avoid skin irritation by the magnetic force.

Key Questions:

  • Do tBAHAs improve speech perception and speech intelligibility?

  • Are tBAHAs safe?

  • Have specific patient-selection criteria for tBAHAs been established?

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