A bone conduction hearing aid (BCHA) helps with conductive hearing loss, which is caused by damage to the outer and middle parts of your ear.

Keep reading to learn more about BCHA, including how it works, its benefits and risks, costs, and other useful information.

Conductive hearing loss occurs when there’s damage to the outer or middle parts of your ear. This damage can prevent sound from reaching your inner ear, which is responsible for converting sound waves into nerve signals.

This is where a bone conduction hearing aid (BCHA) can help. Unlike some other types of hearing aids, BCHA doesn’t require surgical implantation. Surgical bone conduction devices also exist.

illustration of bone conduction hearing aid without surgery placed on a childShare on Pinterest
Illustration of a nonsurgical bone conduction hearing aid. Jason Hoffman.

A BCHA works by transmitting sound vibrations through the bone of your skull. Unlike traditional hearing aids that amplify the sound, BCHA can bypass your outer ear and middle ear entirely and create a new pathway for hearing.

The device has a tiny microphone that converts the sound into bone vibrations. Then, the sound processor transmits these vibrations into your inner ear.

Since your inner ear is not affected by hearing loss, it can then perform its job of converting vibrations into nerve signals.

People usually wear BCHA on a headband. Sometimes it’s attached directly to the skin with adhesive.

BCHA has some advantages over other types of hearing aid devices:

  • it doesn’t require surgical implantation
  • it can be removed and readjusted
  • unlike some surgically implanted hearing aids, BCHA doesn’t carry a risk of infection

Because BCHA devices don’t require surgery, they have much lower rates of side effects compared with hearing aid implants. The main side effects are skin irritation and discomfort.

But because these devices are worn on the head, they may not be cosmetically appealing.

Finally, BCHA has a limited power output and can cause distortion when reaching a high level of stimulation.

While doctors insert conventional hearing aids in the ear canal, BCHA leaves the canal free. BCHA may be a good option if you can’t use a conventional hearing aid (for example, due to irritated ear canals).

You can be a candidate for BCHA if you have one of the following:

  • conductive hearing loss (hearing loss due to problems in the outer or middle ear)
  • mixed hearing loss (conductive hearing loss together with hearing loss in the inner ear, known as sensorineural hearing loss)
  • profound hearing loss (deafness) in one ear

Children’s bones constantly grow, which complicates the use of surgically implanted hearing aids. Because BCHA doesn’t require surgery, it’s a good choice for many kids. It can also be a good option for older people as it avoids surgery.

You shouldn’t get BCHA if you:

  • have sensorineural hearing loss (unless this hearing loss is significant on one side, in which case the BCHA can be used to route sound to the other side of the head)
  • rely on a hearing aid to help with spatial localization of the sound, as it doesn’t have this ability

The cost of BCHA can vary significantly, depending on the medical facility. It can be anywhere between $4,500 and $12,000.

But some insurance providers cover hearing aids at 100%, when medically indicated. Check with your provider to see if they cover BCHA.

Medicare doesn’t cover hearing aids or exams for fitting hearing aids.

Conductive hearing loss is caused by blockage or damage to your outer or middle ear. Some of the reasons for this include:

  • infections, like swimmer’s ear
  • fluid in your ear
  • narrowing of your ear canal
  • a hole in your eardrum
  • thickening of your eardrum
  • damage to the bones of your middle ear
  • present from birth as part of other conditions, like ossicular abnormalities, microtia, or atresia

Some people use the terms “BCHA” and “BAHA” interchangeably because both of them transmit sound through bone vibrations.

But bone anchored hearing aids are surgically implanted into your skull. BCHA, on the other hand, does not require surgical implantation.

Some doctors consider BCHA a type of BAHA.

Be sure to contact your doctor promptly if you have the following symptoms:

  • difficulty hearing sounds, especially at low volumes
  • difficulty understanding words, especially against background noise or in a crowd
  • trouble hearing consonants
  • sudden hearing loss
  • hearing loss that seems to steadily get worse
  • dizziness that doesn’t go away
  • pain or pressure in one or both of your ears
  • a strange or unpleasant smell or liquid draining from your ear

If you have a BCHA device, speak with your doctor if you experience pain or if your device doesn’t work as expected.

BCHA is a type of hearing aid that helps people who can’t hear well due to damage in their outer or middle ear.

Unlike some other types of hearing aids, BCHA does not require surgery.

Because of that, it doesn’t have many risks or complications and can be used by children or older people. But you shouldn’t get BCHA if you have sensorineural hearing loss unless that hearing loss is profound on only one side.

BCHA devices are quite expensive, but they may be covered but your insurance plan.