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Bone-anchored hearing aids

Bone-anchored hearing aids may help people who cannot wear behind-the-ear hearing aids.

How they work

All bone-anchored hearing aids have 2 parts:

  • A surgical implant that transmits sound by direct conduction through bone to the inner ear.
  • A small sound processor that attaches to the outside of the head behind the ear.

Who they can help

Bone-anchored hearing aids may be able to help children and adults who have:

  • outer ear or middle ear problems that block or restrict the flow of sound waves
  • mixed hearing loss, such as damage to the outer or middle ear, and also the inner ear or hearing nerve
  • hearing loss in 1 ear only
  • difficulty wearing 'in-the-ear' or 'behind-the-ear' hearing aids

The HSE offers 2 types of bone-anchored hearing aid.

Percutaneous system

This transmits sound from the processor to the implant. It does this through a connector that crosses the skin.

Transcutaneous system

This transmits sound from the processor to the implant through the skin. It does this using internal and external magnets.

First appointment

The audiology service will refer adults and children over the age of 3 to an ear, nose and throat (ENT) department for a first consultation.

For children under 3 years of age, the audiology service will fit a percutaneous bone-anchored hearing aid. Once your child is over 3, the audiology service can refer them to ENT. The ENT department can then tell you which type of hearing aid is best for your child.

Hearing aid assessment and trial appointment

If you and the audiologist decide that a bone-anchored hearing aid could help, you'll have another appointment.

At this appointment, you or your child will:

  • have a full assessment to check that a bone-anchored hearing aid is right for you
  • get advice about which of the 2 types of bone-anchored hearing aid is best for you
  • be offered a trial for 2 to 4 weeks to try out the hearing aid
  • be shown how to fit the hearing aid and use it during the trial
  • be given a log to record how you get on with the hearing aid during the trial
  • be given information to support you through the trial period

After the trial

You'll have another appointment to review how you got on during the trial.

The hearing specialist will look at the log that you or your child kept.

The hearing specialist can extend the trial period if you need more time to decide if a bone-anchored hearing aid is right for you.

Decision appointment

After you or your child have trialled the bone-anchored hearing aid, you'll have a final appointment with an:

  • ENT consultant
  • audiologist
  • ENT nurse

This is to decide if you or your child should have the surgery to fit a permanent hearing aid.

They will give you advice about:

  • your options for surgery and treatment, including which type of hearing aid is best
  • how the implant works
  • how long the surgery takes to heal
  • hearing aid hygiene
  • ordering a hearing aid

If you agree, you'll sign a consent form. You or your child will then go on a waiting list for the surgery.

After surgery

Once you or your child has had the surgery for the implant, your team will tell you what to do as you heal.

You or your child will then:

  • have an appointment with a nurse around 5 days after the operation to make sure you're healing properly
  • meet with your audiologist about 4 weeks later to have the hearing aid fitted and learn how to use, clean and maintain it
  • meet your audiologist after another 6 weeks and again after 3 months to follow up on your progress
  • meet your ENT consultant and audiologist once a year to check on progress and ensure the hearing aid is working at its best

Page last reviewed: 31 January 2023
Next review due: 31 January 2026