Implanting a Hearing Aid - What You Need to Know

Sounds, including human speech, materialize in our minds. That’s because, in the physical sense noises are vibrations able to pass through gases, air, liquids, and solids.

Our ears capture these vibrations, and conduct them down our ear canals to our ear drums. The vibrations filter past these to our inner ear amplifiers, that convert them to electrochemical signals. These signals travel along the auditory nerve to our brains that transform them to the sounds we hear.

That’s All Good. But What Happens If There’s a Blockage?

Audiologists call these stoppages ‘conductive hearing losses’. They can be in the ear canal, at the ear drum, in the inner ear, or in the auditory nerve. They can occur while our systems are forming, at birth, or from disease or trauma at any stage in our life.

Human Ear Showing Points of Conductive Hearing Loss

Here is a phone of conductive hearing loss, with the ear canal and auditory nerve

Hearing aids can’t help if the conductive hearing loss is severe. That’s because they rely on the system to process the wonderful improvements they make. The only known solutions are cochlear, and bone-anchored hearing aid implants. In headline terms these work as follows:

  • Bone-anchored hearing aids deliver vibrations through bone behind the user’s outer ear. Then, the vibrations travel though the bony material to the inner ear. In other words, they bypass the ear canal and ear drum completely. Average implanted cost: $4,000 per ear excluding surgery and aftercare.
  • Cochlear implants, by contrast, bypass the outer and inner ear completely. They send electrical signals directly to the auditory nerve linking the inner ear to the brain. Average cochlear hearing aid cost: $60,000 to $100,000.

Let’s Find Out More About Bone-Anchored Surgical Hearing Implants

A bone-anchored hearing aid implant may be able to assist a person with conductive hearing loss, or a person or young child who is unable to wear in-ear, or behind-the-ear hearing aids.

All invasive surgery has a risk of complications. Although implant hearing aid infections are usually minor according to Wikipedia. Here’s a diagram of the components of the system to make it easier to follow the process.

Bone-Anchored Hearing Aid Components

Here are the components of a bone-anchored hearing aid


Skip this section if you are sensitive about these things, although the procedure is quite straightforward. The surgeon exposes a small part of the bone behind the patient’s ear. Then they drill a tiny hole, and fit a small titanium prosthesis into it completing the operation.

Titanium implants for hearing aids are often performed on outpatients under local anesthetic, with generous cooling of the operation site to minimize surgical trauma to the bone. The procedure is readily reversible in the event this becomes necessary.


The patient returns to complete the surgical hearing implant procedure after the operation site is fully healed. A hearing specialist attaches an abatement to the exposed part of the titanium implant. The sound processing ‘hearing aid’ and coupling attach to this. The bone-anchored hearing aid is now ready for business.

Let’s Pause and Recap About Implant Hearing Aids

That was quite a romp! Let’s reconfirm the basics of hearing aid implants:

  • Bone-anchored hearing aids deliver hearing to severely deaf people by conducting sound through bone.
  • They are surgically-implanted devices (although the processors and couplings are removable).
  • The microphones in the processor receive sound vibrations from the external environment.
  • The processor transmits these signals to the implant which vibrates imperceptibly.
  • The titanium implant transfers these vibrations to the surrounding bony material.
  • The cochlear in the inner ear receives these, and signals the brain down the auditory nerve.

The Benefits of Bone-Anchored Implant Hearing Aids

Bone implant hearing aids are a simpler, less expensive alternative to cochlear implants. Installation can be done in an outpatient clinic, making them more desirable for small children.

Many adults with severe outer- or middle-ear malformations have benefited greatly. As have also those with chronic ear infections, or allergies to all types of hearing aids. However, the greatest benefits are obtained by patients with at least one functional inner ear.

Sensorineural and Conductive Hearing Loss

The two main causes of deafness are sensorineural and conductive hearing loss. Conductive loss is the result of physical blockage in the hearing system.

Sensorineural hearing loss, on the other hand is caused by disease or damage affecting the inner ear or the auditory nerve. Most adults with impaired hearing have this condition and may not need bone or cochlear implants.

A surprising number of hard-hearing adults also have shades of both conditions. Many have gained sufficient relief from rechargeable, digital hearing aids and avoided the additional expense.