A Guide to Bone Conduction Hearing Aids

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Hearing Solutions

Dr. Robert M. Traynor


Dr. Robert M. Traynor practiced audiology at Audiology Associates, Inc., in Greeley, Colorado, where he provided diagnostic & rehabilitative treatment for hearing loss and tinnitus to patients of all ages.

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Hearing aids have worked wonders for those suffering from hearing loss, but for those with hearing loss in their outer and middle ears, a standard hearing aid may not be the most suitable option. A bone conduction hearing aid is a type of implant that allows people to enjoy a better quality of hearing. There are a lot of misconceptions regarding bone conduction hearing devices. Here’s what you need to know about bone conduction hearing and how it works.

What Are Bone Conduction Hearing Aids?

Bone conduction hearing aids come in both surgical and non-surgical options. Unlike a conventional hearing aid, a conductive hearing aid is implanted into the person. Bone-anchored systems treat hearing loss by conducting sound vibrations to the inner ear. This method contrasts with a standard hearing aid that simply detects and amplifies acoustic sounds. A bone-anchored hearing aid is not for everyone, though. Auditory experts say they are designed for people who suffer from specific types of hearing loss (more on this later).

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How Do Bone Conduction Hearing Aids Work?

Brief explanation

A bone conduction hearing aid has two parts. The first is the external part, known as the processor, and the implanted fixture, which may be surgically implanted. There are two types of bone conduction hearing amplifier. Firstly, the fixture may protrude through the skin, where it can then be attached to the processor. The second option is completely implanted into the skin, and a small magnet inside the processor is used to attach it. These devices capture sound and use bone vibrations to transfer it into your cochlea. In other words, sound skips the outer and middle ears and goes straight into the inner ear.


Conduction hearing creates an entirely new pathway for your hearing. Depending on the person, one or two of these hearing aids may be used. They can also work alongside standard hearing aids to further enhance hearing. But do these hearing aids work as effectively as standard hearing aids? The short answer is yes, the technology is just as advanced. The key difference between these two types of hearing systems is the delivery method. Sounds continue to be detected with bone conduction, but they are detected via vibrations and fed directly into your cochlea.

Previously, those who didn’t take well to conventional hearing aids were out of solutions and typically had to accept a poorer hearing experience. The bone conduction hearing aid has offered a huge revolution in hearing and delivers an incredible level of listening quality.

As we mentioned earlier, these hearing aids can either be implanted surgically or not. Following a quick explanation of both options.


The non-surgical option is ideal for those children. The configuration of the bone-anchored hearing aid is essentially the same, but a soft headband keeps the hearing aid in place. This bone conduction hearing aid without surgery is a major breakthrough, as previously, minor surgery was the only way forward. This is a less popular option for many because it’s not a discreet type of hearing aid. Constantly wearing a headband often makes people feel more self-conscious about their hearing loss.


The most common type of bone conduction hearing aid involves minor surgery. As explained above, there are two options. Either an abutment will protrude through the skin, or a magnet implanted inside the processor will attach to the device hidden underneath the skin. There’s little difference between the two, and if you opt for this type of hearing system, your hearing specialist will be able to give you a rundown of the pros and cons of each option.

Who Should Get Bone Conduction Hearing Aids?

Main reasons

Bone conduction and hearing loss are only suited to certain candidates. You should consult a hearing care professional who will ultimately make the final decision. In most cases, a conductive hearing aid will work best on people who have at least one inner ear that works normally. It’s also an ideal solution for those with inner/middle ear malformation. Patients who receive these hearing devices have typically already found standard hearing aids to be ineffective


Malformations of the middle ear or ear canal can lead to conductive hearing loss. These types of malformations are often present at birth. Bone conduction devices can bypass the malformed parts of the ears to transmit sound directly into the inner ear. For those with malformations, both surgical and non-surgical options are good choices. What has to be taken into account first is whether these malformations can be corrected by other means. In most cases, congenital malformations are permanent and irreversible, unlike other types of conductive hearing loss.

Single-Sided Deafness

Other prime candidates are those with single-sided deafness. These people are unable to hear from a single ear. They may still have normal hearing in the other ear or varying degrees of hearing loss. A bone-anchored hearing aid helps because those with single-sided deafness often struggle to determine where a sound is coming from. This can make listening difficult in noisy environments. The surgical option is the most popular choice for single-sided deafness due to the additional level of discretion.

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Getting a Bone Conduction Hearing Aid

What to Expect

Even though this is a minor surgery, it can still be nerve-wracking for people with hearing loss. If you believe that acoustic hearing aids are not allowing you to hear sufficiently, you need to know what it takes to qualify for and receive a bone conduction device. To help put your mind at ease, here’s what to expect when opting for one of these hearing devices.


Not everyone is suited to one of these types of hearing aids. You’ll start by attending an appointment with a hearing professional who will perform a hearing test to determine your degree and type of hearing loss. If your doctor decides that you qualify for a bone conduction hearing amplifier, you will meet an audiologist to learn about the devices and try some of them on. More tests will be performed while wearing the device to determine if you’ll benefit from undergoing this procedure. The goal is to find out what fits your hearing profile best and make the right choice for your hearing needs and lifestyle. 


Since this is a minor procedure, you will almost certainly return home the same day. Your ear, nose, and throat doctor will begin by implanting a 3-4mm titanium implant into the mastoid bone behind your ear. The titanium plate will integrate into your bone over time. Everything takes place under general anesthesia, so you will not need to be awake for any part of the procedure.

The exact type of surgery depends on which hearing aid you’ll be wearing. For example, Oticon’s bone conduction device involves a MIPS surgery, which takes just 15 minutes and can be done under local anesthesia. Either way, typically, no implantation will take longer than an hour. Make sure you bring a friend or family member along to drive you home while the anesthesia wears off.

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Device Activation

Your hearing aids will not be activated immediately. There’s a healing period to ensure that your mastoid bone takes to the titanium implant properly and everything is stable. The time for healing depends entirely on the device. It can be as little as three weeks or as much as three months. The manufacturer and the type of surgery you receive are the factors involved.

You’re required to attend a post-operative appointment to make sure everything is healing and working as it should. Assuming your doctor is happy with the results, you’ll visit your audiologist again, who will then activate the device and show you how everything works so you can begin enjoying a world of better hearing.


Expect to attend follow-up appointments at least once per month. These additional appointments with your audiologist are designed to confirm that your device is working as it should. Your audiologist will also make periodic upgrades to the processor and make any adjustments to make sure that you’re hearing everything correctly.

Will I Be Able to Hear Clearly?

This is the number one question everyone has about bone conduction hearing aids. After you’ve received your implant, they will work much the same way as acoustic hearing aids. Initially, it may feel strange to hear sounds in this way. There’s also a high likelihood that you’ll need to have adjustments made by your audiologist. Most people take six to eight weeks to fully adjust to their hearing aids and to get used to their new listening experience. If things feel unfamiliar at first, it’s nothing to worry about and a perfectly natural part of the process. Eventually, you’ll be able to hear everything you need to hear. Modern hearing aids of all kinds are incredibly advanced and capable of operating in even the most challenging listening environments.


Hearing technology has come a long way, and bone-anchored systems are just another development helping more people cope with their hearing loss. With surgical and non-surgical devices available, these bone conduction hearing aids are suitable for people of all ages. If you find that standard hearing aids aren’t working for you, then you could be a candidate for a bone-anchored device. Start your journey to better hearing with EarPros and book your free appointment with a licensed hearing professional today.

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