Frequently asked questions for Bone Conduction Hearing Implants (BCHI): Bone Conduction Hearing Devices (BCHD) and Middle Ear Implants(MEI)
You may find answers to some of your questions on the following website – this is by Oticon but applies to any device manaufacturer: https://bahsjourney.com
However, please see below answers to some frequently asked questions:
Which ear should I have implanted?
Not everyone is suitable for a BCHD or MEI in both ears. This will be discussed with you during the assessment process. However, if both ears are suitable, we think the best choice is the ear where you end up with the most hearing possible. Our main aim is to help you hear better or more consistently with a BCHD or an MEI than you do with the hearing aid/s. If the outcome is likely to be better in one ear than the other ear, we will tell you. This may depend on medical factors and the CT scan (if it is required). We will discuss pros and cons of options during the assessment.
Can I try on all the different processors to see which feels most comfortable?
If you are suitable for a BCHD you will have a 2-week trial with a BCHD on a softband, soundarc or sticky pad (depending on the device). If you are offered a choice of BCHD you can try more than one device at home if you wish. The processors used for MEI / Bonebridge / Osia cannot be trialled or tried on your head without the implant in place. If you are suitable for a MEI / Bonebridge / Osia implant we will show you what the devices and processors look like, but the choice of device will depend on your hearing levels and which device the surgeon thinks is best from the scan information.
Can I change manufacturers?
If you have a surgically implanted device mostly you will use a processor from the same manufacturer as the implant / fixture.
If you are using a non-surgical bone conduction device on a softband, sound arc or sticky pad it is possible to change manufacturers when your processor is upgraded.
For BCHDs, you can change manufacturers at upgrade if you have an Oticon abutment, as this can fit to Cochlear or Oticon processors.
If a better BCHD or MEI becomes available, will I be able to have it?
Bone conduction devices and middle ear implant manufacturers have provided processors to patients with existing fixtures / implants. You will be offered a new processor after 5 years of use if one becomes available.
What if my hearing gets worse and I no longer hear well with my BCHD or MEI?
If your hearing gets worse, it may be possible to adjust the BCHD or MEI processor to better suit your new hearing levels. For BCHD there are a range of processors for different levels of bone conduction hearing loss up to 65dB so it may be possible for you to have a more powerful processor. However; if your hearing levels drop further you may not get enough benefit from your device, and you may need a different type of auditory implant.
Can I decide which device to have?
If more than one device is suitable (for your hearing loss and from a surgical point of view) you will be offered a choice. People make choices for different reasons. They may be really interested in the technology, accessories, functions and features of the devices or may like the look or feel of the speech processor.
Can I have X-rays / scans once I have a BCHD or MEI?
If you have a non-surgical fitting, you just remove the processor for X-rays or scans. If you have a surgically implanted part, you can have an X-ray or CT scan - just take off the external equipment.
For MRI scans, these need different actions for different BCHDs and MEIs. It is very important to note that there will be a shadow on the MRI scan which can create a significant artefact on the image. This will be small for abutment fittings (up to 1.8cm around the abutment / 1.2cm around the implant when the abutment is removed) but much larger for Bonebridge / Osia / MEI implants (up to 15 cm around the implant).
What does a BCHD or MEI sound like?
The sound may be a little different at the beginning, but you should quickly get used to the new level.
Will an implant get in the way for activities like football, tennis, swimming etc?
The implant / fixture should not be a problem, but you may need to remove the sound processor for some sports such as swimming if your processor does not come with water wear.
The processors are not waterproof and should not be worn until your hair is completely dry. We advise using a safety line during sports so that if a processor falls off it stays attached to clothes and will not drop to the ground and get damaged.
I wear safety headgear for my job. Will that be a problem?
If you are thinking about having BCHI surgery, bring your helmet to your medical review so you can discuss with the surgeon where your implant / fixture should be to stop contact with the helmet.
Can I sleep with my processor on?
The processor will probably come off and may be uncomfortable if you lie on it. We recommend taking it off before you go to sleep. If you live alone and are thinking about sleeping with your speech processor on for safety reasons, we suggest that an additional assistive listening device might be more practical. There are some suggestions on the Connevans website here: http://www.connevans.co.uk/catalogue/122/Alerting-Devices. Your local Social Services department can advise you too.
What is the best BCHD or MEI for hearing music?
No particular device is better for music.
Can I fly in an aeroplane after implantation?
Yes. Carry your device identification card with you as the security arch you step through may flash (there are metal parts in the implant). If there are no surgical problems, most patients can travel again from two months after surgery. However, it is best to discuss this topic further with your implant surgeon.
Will I need another operation as new technology becomes available?
The fixture / implant is designed to last for a long time. New developments in the external parts can often be used with older fixture / implants.
If a better implant / device becomes available, will I be able to have it?
The hearing implant manufacturers design their implants so that you can get benefits from new technological advances with a new model of external processor without changing the internal implant / fixture.
Should I wait for new implant technology?
If you have a non-surgical fitting you can use suitable new technology when it is available. If you have a fixture or implant the external equipment can incorporate new technology when it is available. Research, development and safety testing for all new technologies take a long time. We cannot see anything coming out soon which would make it worth missing out on what a hearing implant could do for you now. Things might change in the future, but there is no way of knowing whether new inventions might be suitable for you.
How often do I need to come for appointments after implantation / device fitting?
You will need to come in to have your external processor set up to suit your hearing loss. If you have a surgical fixture / implant you will usually need to wait 8 weeks for
the fitting of the external processor. After the processor is fitted there will be a followup at 1 month (adults and children) and then 6 months (children only) and then at a year after the fitting (adults and children). After this, children are reviewed annually, and adults are contacted annually to ask if they wish to have an appointment. You will need to come in for a review when a new model of processor (upgrade) is fitted.
Do
I have to pay for replacements or repairs?
The NHS pays for all the equipment that is essential for the processor to let you hear sound. They will be replaced free of charge by the University of Southampton Auditory Implant Service if they become faulty (unless due to persistent neglect of the device). Some extra accessories provided by the manufacturers, that can be used to connect to Phones / Music Systems / TV / Computers, have a limited manufacturer’s warranty and are not supported by the University of Southampton Auditory Implant Service.
Does the processor have rechargeable batteries and where do I get the batteries from?
The Cochlear Baha 5 superpower processor has rechargeable batteries. The other processors for BCHD and MEI use disposable batteries. You can get batteries from the University of Southampton Auditory Implant Service either when you come in for an appointment or by post. Let us know when you are running short of disposable batteries or when your rechargeable batteries stop holding their charge.
What happens if the implanted part goes wrong?
There are no moving or electronic parts in BCHI abutment fixtures and once the fixture is integrated into the skull bone it is very unlikely to come out. If a fixture does come out, a new fixture will need another operation. For MEI / Osia / Bonebridge options, the implant very rarely goes wrong. If it does go wrong the implant can usually be removed and replaced in another operation. Most patients do just as well with the re-implanted device.
What if one implant manufacturer goes out of business?
The companies we use are all well established with a strong market presence. In the unlikely event that one of these companies stops trading, we will try to maintain existing devices in whatever way we can.
What if I have a medical problem with the implant or processor fitting?
If the processor connects to the implant with a magnet, the skin under the site should not be itchy, red, swollen, painful or sore. The strength of the magnet can be changed to make sure this is comfortable. Equally, if a softband or SoundArc is used, this should be tight enough to maintain a good level of sound input, yet not create soreness or irritation under the connector pad. Patients who have an abutment fitting will be advised on regular care of their abutment and if they develop an infection or soreness
around the abutment they should contact the department, visit a walk-in centre or A&E depending upon the seriousness of the issue.