Have you tried the Baha® 5 sound processor on a Baha Softband and decided to move on with a bone conduction implant? Has your child been scheduled for the implant procedure and you need to know how to prepare?
Jennifer Brown, Clinical Product Manager at Cochlear and audiologist, answers the ten most frequently asked questions about the bone conduction procedure.
Jennifer has more than six years of clinical experience in the United States with both pediatric and adult cochlear implant recipients, and she has worked for Cochlear in a variety of roles for the past four years.
(Picture: an audiologist fits a Baha Softband on a toddler’s head. A Baha 5 sound processor is attached to the Softband)
1. How do I prepare for the implant procedure?
The good news is that no special preparations are needed before the procedure. The procedure is fast and minimally invasive. Your physician will give you all the details to plan for a successful procedure.
2. Will the procedure be painful?
The procedure is performed under anesthesia. The type of anaesthesia – local or general – is determined by a number of factors, like age, or pre-existing conditions. Ultimately, which anesthesia is right for you is determined by you and your surgeon. Post-operatively, you may experience swelling or skin sensitivity at the implant site. Should it be necessary, your doctor can prescribe pain reliever. Always discuss the procedure and any concerns you may have with your surgeon.
3. Will I be able to go home from the hospital the same day?
In the vast majority of cases, patients go home the same day. While rare, sometimes in the case of small children or individuals with multiple involvements, the physician may take a precaution and keep the patient over night, but this seldom happens.
4. Can I shower after the procedure?
Usually, patients are allowed to shower the day after procedure. Avoid rubbing the area when drying as this may knock off the healing cap. Cover the cap area by holding a dry towel over it. Here’s what Dr. Pete Weber said in an earlier post.
“The site will still get wet. Since the incision is now very small for Baha Connect surgery, getting the site wet is usually not an issue. Full shower when cap and packing off. The best shampoos to use are the hypoallergenic ones, such as baby shampoos. I also let my Baha Attract patients shower the next day after removing the dressing. Again telling them to pat dry the area and not rub.”
5. If I choose an abutment or a magnet system, how long after surgery until I can wear the sound processor?
Different countries have different regulations.
- If you choose the abutment system – Baha Connect: depending on where you live it can be anywhere from two weeks to three months before receiving the sound processor.
- If you choose the magnet system – Baha Attract: depending on where you live it can be anywhere from two weeks to five weeks before receiving the sound processor.
Your doctor will examine the implant site before fitting the sound processor.
6. Are post-operative skin infections common and how are they treated?
As discussed in question 2, there could be swelling or sensitivity at the implant site after the procedure. Post-operative skin infections might occur, although the probability is low. Most skin-related issues happen in the abutment system, because it is skin protruding. In most cases, issues are mild, and can be resolved medically after consultation with your physician. Usually, the skin issues do not affect your ability to wear the sound processor. In the rare incident of persistent skin issues, it may be beneficial to transition to the magnet system.
7. How do I know if an abutment system or a magnet system is appropriate for me?
Both of the Cochlear Baha systems are indicated for individuals with hearing loss in one ear (single-sided deafness, or SSD), or for individuals with conductive/mixed hearing loss. Whether to choose a Baha Connect or a Baha Attract depends upon a variety of factors, including the degree of hearing loss.
The magnetic system – Baha Attract – is a transcutaneous, or an under-the-skin implant system. It is comprised of the internal fixture, with a magnet attached to it. Individuals with the hearing losses noted above are candidates for this system, but it is important to remember that because the sound must pass through the skin, it may be necessary to use a more powerful sound processor, like the Baha 5 Power or the Baha 5 SuperPower.
The abutment system – Baha Connect – is a percutaneous, or through-the-skin implant system. It too, uses the internal fixture but has an abutment attached to it. It is appropriate for individuals with SSD or conductive/mixed hearing loss, but unlike the Baha Attract system, there is no skin attenuation of the sound. This is a great option for individuals needing more power.
In some instances, it may be possible or necessary to transition from one system to another. For instance, if a recipient chooses the Baha Attract system, and notices a change in his/her hearing, it is possible to remove the magnet and attach an abutment to eliminate dampening of the sound through the skin and to offer more direct bone conduction. Conversely, if a recipient needs to transition to a completely under-the-skin system because of lifestyle or soft tissue concerns, the abutment can be removed and the magnet can be attached. In both instances, the recipient can likely continue to use the same sound processor. Cochlear is the only manufacturer that allows for this flexibility based on the patient’s needs.
8. Why do I have to wait so long before I get fitted with a sound processor?
Bone bonds well to titanium, which is what the internal fixture is comprised of. To allow for osseointegration, it is recommended that appropriate healing time be allotted. In an abutment system, the surrounding skin also needs time to adhere to the abutment, to minimize skin issues. In a magnet system, it is important to wait the allotted time to give a chance for the swelling to reduce so that the patient can wear the weakest external magnet possible and still have adequate retention.
9. Will my child need a new implant as she or he grows?
No, an implant is designed for life. There are no pediatric-specific implants, abutments, or magnets. In the event that the child’s hearing changes, non-surgical options – such as a more powerful sound processor – should be tried first. Only in the event of a transition would a procedure be required, but keep in mind the same internal implant is used.
10. Will the Baha® System affect my child’s choices in sports or other activities?
A bone conduction implant is designed to allow your child a world of sound in every activity. While hearing loss is the most important factor to consider when choosing an abutment or a magnet system, lifestyle plays an important role. Some sports may be more conducive to having an under-the-skin magnet system. It is important to choose a manufacturer that offers your child choices in hearing solutions – whether an abutment, or a magnet.
Remember, communication is key. Always discuss your options and thoughts with your audiologist and surgeon. Your hearing professional will be able to provide timely, accurate, and documented information.