Stanford Ear Institute

Implantable Hearing Devices

Untreated hearing loss increases the risk of cognitive decline, dementia, social isolation, depression, and falls. Rehabilitating hearing is therefore of incredible importance in health and lifestyle maintenance. Along with the latest advances in hearing amplification and surgical techniques for hearing reconstruction, clinicians at the Stanford Ear Institute offer cutting edge medical technologies when simple amplification isn’t enough. In most situations, surgery for implantable hearing devices at the Stanford Ear Institute can be done as an outpatient. If you are considering rehabilitating your hearing, or an implantable hearing device we also offer consultations where you can see the various devices and, in some circumstances, test what they are like.

Bone Conduction Hearing Devices

BAHA connect (cochlear)
Image courtesy of cochlear.com

Bone conduction hearing aids are an excellent option for those who aren’t able to wear traditional hearing aids, still have hearing in one ear or in situations where patient’s external or middle ears cannot conduct sound properly. Studies show that over 85% of patient enjoy and wear their device long after implantation. (1)

Bone conduction devices work by driving sound directly through a patients bone into the inner ear rather than directing sound into the ear canal. The sound is driven into both the implanted side and the opposite ear. For people who are deaf on one side, it allows sound to be transferred to their good ear. For people with hearing on that side, it allows sound to bypass problems in their ear canal or middle ear.


We offer the traditional bone anchored hearing aids (BAHAs) where the hearing aid clips onto a small post fixed onto bone and hidden behind the ear such as the Baha Connect (Cochlear) and the Ponto (Oticon).

BAHA connect (cochlear)
Image courtesy of cochlear.com

Ponto (Oticon)
Image courtesy of oticonmedical.com


We now offer the ability to hide the small post under the skin so that when the device is not worn, nothing is visible. This also makes them easier to care for. The devices include the Baha Attract (Cochlear) and Alpha 2 MPO ePLUS (Medtronic).

Alpha 2 MPO ePLUS (Medtronic)
Image courtesy of medtronic.com

BAHA Attract (Cochlear)
Image courtesy of cochlear.com


Bonebridge (Med-El)
Image courtesy of medel.com

Osia (Cochlear)
Image courtesy of cochlear.com

We also offer recently FDA approved devices including The Bonebridge (Med-El), that provides active bone conduction stimulation and the Osia (Cochlear) that provides piezoelectric stimulation.


Cochlear implants

Nucleus cochlear implant (Cochlear)
Image courtesy of cochlear.com

Traditional cochlear implants are an implantable device that converts sound into electrical stimulation that is directed by a tiny electrode placed into the inner ear. There are decades of experience in adults and children with excellent patient satisfaction in treating severe to profound hearing loss. (2) (3) Most private insurers are now approving second side cochlear implants to allow for better understanding of speech in noisy situations and better awareness of sound direction. For patients with hearing loss on both sides. Stanford offers all cochlear implant devices provided by the major cochlear implant companies, Cochlear, Med-El and Advanced Bionics.


Cochlear implants: Electroacoustic stimulation / Hearing preservation

A number of patients have good low frequency hearing but poor middle to high frequency hearing. This means they can hear sound but have difficulty understanding speech. Along with the newest electrode array designs, therapeutic advances and latest surgical techniques, Stanford clinicians aim to save lower frequency hearing while implanting to boost high frequency hearing. This allows patients to keep their natural low frequency hearing and wear a combined hearing aid and cochlear implant. Patient’s report better music appreciation and a more natural sound. 4, 5

HiRes cochlear implant (Advanced Bionics)
Photo courtesy of advancedbionics.com


Cochlear implants – Single Sided Deafness

While there are still excellent hearing aid options and the option of a bone conduction implant for patients with deafness on one side, the FDA recently approved cochlear implantation for single sided deafness, or patients who are deaf in one ear but have good hearing in the other. A cochlear implant is the only available treatment that can return sound to the deaf ear to provide better stereo sound, better understanding of speech in noisy situations and is a good option for those patients with significant tinnitus in that ear.

Bibliography

1. Kompis M, Wimmer W, Caversaccio M. Long term benefit of bone anchored hearing systems in single sided deafness. Acta Otolaryngol. 2017;137(4):398-402. PMID: 27905206

2. Santa Maria PL, Oghalai JS. When is the best timing for the second implant in pediatric bilateral cochlear implantation? Laryngoscope. 2014;124(7):1511-2. PMID: 24122858

3. Blevins NH, Limb CJ, Sorkin DL. Introduction to the Special Issue: 15th Symposium on Cochlear Implants in Children. Otol Neurotol. 2019;40(3):e251. PMID: 30741903

4. Santa Maria PL, Gluth MB, Yuan Y, Atlas MD, Blevins NH. Hearing preservation surgery for cochlear implantation: a meta-analysis. Otol Neurotol. 2014;35(10):e256-69. PMID: 25233333

5. Santa Maria PLD-L, C. Atlas, MD. Hearing Preservation Surgery for Cochlear Implantation – Hearing and Quality of Life After Two Years Otol Neurotol. 2013;34(3):526-31. PMID: 23503094