What’s the difference between “regular” Baha and Baha Attract?

Question: I was born deaf and wore two hearing aids for fifty years. Now I have 2 Baha sound processors. They are good , my ears are free at last! What I would like to know is what is the difference between a Baha and a Baha Attract? From what i can see is it magnetic rather than clipping it on.

Also – if the Baha Attract System is better, can I change to that? // Pam

Answer: Dear Pam.

Good to hear that your Baha sound processors work well.

The difference between the Baha Connect and Baha Attract System is the way that the sound processor attaches to the implant. In the Baha Connect System, that you are using, the sound processor snaps on to an abutment. In the Baha Attract System the sound processor is attached to a sound processor magnet. Another magnet is fixed to the implant under the skin and the sound processor is held in place on your head by the two magnets.

The main benefit of the Baha Attract System is that the implants are hidden beneath the skin making the system invisible when the sound processors are not attached.

The benefit of the Baha Connect System is that the direct connection maximises hearing performance.

It is possible to switch between the systems, but that requires another surgery to replace your abutment to the implant magnet, and it may provide you with a slightly different hearing experience (the skin will attenuate the sound slightly). This will of course require a thorough evaluation of the surgery and expected hearing outcome.

Always consult a hearing healthcare specialist who can recommend what hearing solution is best for you.

~ Fredrik Breitholtz, Head of Training and Clinical Communication, Cochlear Bone Anchored Solutions

destiny-baha-attract-magnetdestiny-baha-attract-without-magnet
Baha Attract user Destiny with and without her magnet

Proof lies beneath the surface – the DermaLock Abutment

For more than 30 years, titanium implants have been used in bone conduction hearing implant systems. Titanium is a truly remarkable metal with unique properties that make it ideal for human implantation. Its ability to osseointegrate (bond) with bone is the key to making a Baha System work.

Up until a few years ago, the abutment (part of the implant that sticks through the skin) was also made completely with titanium. While ideal for bonding with bone, titanium does not bond with soft tissue (skin and underlying layers). That’s why it used to be common practice to thin the soft tissue around the abutment. This technique worked well and is still performed today in some cases. However, there are many benefits to preserving the soft tissue around the abutment. These include faster surgery time, aesthetics and leaving in place as much of the body’s natural structures as possible to help prevent infections.

If you DON’T thin the soft tissue around a pure titanium abutment, the skin heals down around it instead of bonding with it. This creates a pocket between the abutment and the skin where debris and bacteria can accumulate. It also blocks the immune system from accessing the area, so it’s not able to fight off potential infections to keep the area healthy.

Scientists knew there were benefits from soft tissue preservation but also knew that titanium alone was not the solution. So that’s the challenge that Cochlear set our research and development team – create an abutment that would bond with the surrounding soft tissue.

In 2013 we released the first abutment specifically designed for soft tissue preservation – the Cochlear Baha DermaLock Abutment (BA400). The abutment is still made of titanium, but features a special surface scientifically known as Hydroxyapatite. This is a substance that is found naturally in your body. It’s what allows your teeth to stick out through your skin and remain healthy and bonded to your gums.

Titanium surface on Baha bone conduction implant

Close up view of a smooth titanium surface. Soft tissue does not bond with titanium the same way it does with bone.

DermaLock surface on Cochlear Baha implant

Close up view of the DermaLock surface, proven to promote integration (bonding) with soft tissue.

What is DermaLock

Baha user Randi with the DermaLock Abutment. No need for hair removal or skin thinning around the area

Before we release new technology there is a lot of work and research that goes into making sure our products will improve the lives of the people who rely on a Baha System to hear and be heard everyday. And after new technology is released there are always numerous, long-term, independent clinical studies that take place to evaluate and verify the benefits. By design these studies often take years to complete. This is of course also true for the DermaLock Abutment.

And now the results are in!

Researchers at Maastricht University Medical Center in the Netherlands have presented results that show integration actually happening in real people. They used advanced imaging techniques to study both a DermaLock Abutment and a traditional titanium abutment (used primarily by other companies) and how they react with the surrounding tissue.

They concluded that only the DermaLock Abutment achieved integration with soft tissue. This is a great achievement and proof that Cochlear’s dedication to innovation ensures people with a Baha System have access to the latest technology that helps to make hearing carefree.

“This study shows the importance of not only choosing the right Baha sound processor, but also an abutment technology that is accepted and integrated by the patient’s own tissue,” says Stina Wigren, MSc in Materials Science and biomaterials specialist at Cochlear Bone Anchored Solutions. “Cochlear developed this ground breaking technology and is the only bone conduction company in the world that offers this. Strong research evidence underlies our continual improvement and innovative use of technologies.”

titanium surface on Baha abutment

This sample was taken from around a titanium abutment. The dark blue layers resemble the outer layers of skin, clearly showing that no soft tissue has bonded to the abutment.

dermalock surface on Baha abutment

This sample was taken from around a DermaLock abutment. The soft tissue has not hardened and resembles inner, living layers of skin. This indicates a bond with the DermaLock surface.

Read the whole article here.

 

 

Can I play rugby with a Baha System?

rugby

Question: Hello Sir/Madam,
4 years ago I got my Baha System installed in my head. After almost 15 years I was able to hear with my left ear (properly) now I’m 17 and I want to start playing rugby again, my question is, can I play rugby with a scrum cap without damaging the titanium thing in my head? //Jelle

Answer: Hi,

Baha users can safely participate in sport activities including rugby as long as they take a few simple precautions.

Always remove your Baha sound processor when playing to avoid damaging or losing it. Regarding the titanium implant, it is not very likely that it would be damaged, however, direct forces onto the abutment may loosen it requiring a new surgery. So a scrum cap is a good idea! You may need to make adjustments to your scrum cap to accomodate the abutment. For those using a Baha Attract System, just remove the external magnet and sound processor and you should be fine.

~ Fredrik Breitholtz, Head of Training and Clinical Communication, Cochlear Bone Anchored Solutions

Why is the Baha abutment made of titanium?

Question: I lost my abutment. It came unscrewed. Is this covered by insurance? I am 74 and had the Baha procedure done 3 years ago. A whole new world opened for me, even at my age. Listening to music for the first time in 50 years! My doctor says the replacement titanium abutment post is very expensive. I am on Medicare. Do you think this is covered? Why does the abutment have to be titanium? I know why the implant has to be titanium but the abutment does not have to integrate to bone. //Will

Answer: Dear Will,

Sorry to hear about your abutment becoming unscrewed. The good thing is that replacement is usually covered by some insurance policies. As there are plenty of variability between policies, you will need to check through you health care professional with the provider. Our team in the USA can give you some guidance with insurance.

Great question on the abutment. Yes, the abutment is also titanium, Either polished or with newer abutments designs it is coated with a thin calcium surface. There are three key reasons why it is also titanium:

  1. As it is exposed to the body it must be medical grade to avoid any adverse reactions
  2. It should be the same metal as the implant as two different metals in contact could lead to corrosion
  3. It is relatively easy to machine, sturdy and lightweight

Regards,

~ Mark C. Flynn, PhD Audiologist, Cochlear Bone Anchored Solutions

 

Baha-abutment-implant-titanium

Illustration of a titanium implant inserted into the bone, and the abutment surrounded by skin

In memoriam: Professor Brånemark’s collaborators remember his work

In December 2014, Professor Per-Ingvar Brånemark passed away at the age of 85.

Professor Brånemark is generally considered the father of osseointegration. He coined the term in the 1960s during studies in bone rheology and defined it as the direct contact between a titanium implant and living bone tissue.

The first clinical application of titanium implants was in oral surgery, where they continue to be used today to anchor dental prosthesis. For the now millions of patients around the world, dental implants have offered a completely new life of being able to chew, swallow, speak and smile.

Discovery of a lifetime

How these dental implants led to the first bone conduction hearing implant is a story of serendipity. In the early days, Brånemark was looking to evaluate how well the titanium implant had fused with the bone. In this process, he tried a new acoustic method of measurement where he put a bone vibrator on a patient with a dental implant. When the vibrator started, the man was quite startled to hear a very loud sound coming from the vibrator, as he suffered from hearing loss and did not expect to hear so well. An amazing new discovery was born – a bone-anchored implant could be used to send sound efficiently through bone! This would open up a totally new way of treating people who had, up until this point, not been able to hear as they could not benefit from traditional air conduction hearing aids.

Brånemark’s discovery gave birth to the Baha System, and today more than 100,000 patients around the world can hear and communicate thanks to a bone conduction hearing solution. And it has all been possible thanks to Professor Brånemark’s pioneering work.

Brånemark’s worked in close cooperation with the Department of Otolaryngology at Sahlgrenska University Hospital and Chalmers University of Technology in Göteborg, Sweden in the early days of bone conduction hearing systems. Two of his closest collaborators were Bo Håkansson, now professor at Chalmers, and Anders Tjellström, M.D., Ph.D., D.Sc.hc.

Prof. Brånemark, Dr Tjellström and Prof. Håkansson in the early 80's

Prof. Brånemark, Dr Tjellström and Prof. Håkansson

Here, they remember Professor Brånemark in their own words.

Bo Håkansson, was the innovator of the original transducer used to help patients hear through a Baha System. He remembers the early years:

“For me, as a young graduate student, it was incredibly inspiring to be part of a research environment where Brånemark tied leading researchers from both Sweden and abroad to the research team. The weekly interrogations were admittedly tough for the students but certainly very educational, and these students have later ended up in senior positions at universities around the world.

Professor Brånemark may have been perceived as tough to work with, especially among company heads with other priorities, but I got to know a soft side of him, a side that genuinely cared about his patients and coworkers. I remember his indomitable quest to meet patients’ needs as a top priority before managements’ profits. One of his doctrines was that everyone involved in research in these areas must meet with patients at least once a week. According to him, it was the basis for any successful medical project.”

Anders Tjellström recalls:

“In the early 70s, I was working as a resident at the ENT department in Sahlgrenska University Hospital in Gothenburg and had the opportunity to assist Professor Brånemark in some of his surgery. Brånemark met many patients with facial defects due to tumour surgery, trauma or congenital malformation. These patients suffered heavily from their defects. Many of them could not be part of social life. Some would not even go out in daylight hours.

Using the same titanium solution as for dental and bone conduction hearing solutions, these patients were able to get implants for the retention of facial prostheses made from silicon. Brånemark took an eager interest in this work and was often the leading surgeon in major defects. The work with cranio-facial prosthesis is today an integrated part of Cochlear; known as the VistaFix System.

Those of us who had the privilege to have Professor Brånemark as our teacher, mentor and friend have been very fortunate. The empty space he has left behind will be hard to fill. One remarkable thing about this world-renowned scientist was his bedside manner with patients. No matter what, the patient was always his main focus.”

Here at Cochlear we are very grateful for Professor Brånemark’s discovery and lifetime focus on patient needs, work that has increased the quality of life for so many people around the world. His spirit still lives on here at Cochlear where we continue his legacy of innovation.

The osseointegrated titanium implant is still the strong foundation of the Baha System, and we thank Professor Brånemark for making it possible.

 

Professor Per-Ingvar Brånemark has passed away

professor-per-ingvar-branemark-death-2014

On December 20, 2014, Per-Ingvar Brånemark passed away after a period of extended illness in his hometown of Gothenburg, Sweden. He was 85.

Professor Brånemark revolutionized the implant dentistry sphere with his discovery of osseointegration in the 1950s – an innovation that would stretch far and beyond the dental world.

After his scientific discovery that the human body would not only tolerate titanium, but also integrate it into living bone tissue, implantable bone conduction solutions have improved the quality of life for millions of people around the world.

A rabbit’s leg

As a young researcher in his native Sweden, Professor Brånemark was not interested in either titanium or implants. He was actually working to advance the world’s knowledge of the anatomy of blood flow, and used an optical device that happened to be enclosed in machined titanium. Attached to a rabbit’s leg, this device made it possible for him to study micro circulation in the bone tissue of rabbits through specially modified light microscopes. When it was time to remove the device from the bone, Brånemark was surprised to find that the bone and the titanium had become inseparable.

Against conventional wisdom

His findings that titanium could integrate in the bone, flew in the face of conventional wisdom. In the mid-1960s, physicians and dentists were still being taught that foreign, non-biological materials could not be integrated into living tissue. The academic world turned against Brånemark’s research.

These were tough times for Brånemark. He was repeatedly turned down when he applied for renewed grants to study tissue anchored implants, yet he persevered. Eventually the US National Institute of Health stepped in and funded his research, which made it possible for him to demonstrate the accuracy of his claims and the success of his surgeries. However, it wasn’t until the 1970s that the Swedish National Board of Health and Welfare finally approved of the Brånemark method.

From teeth to hearing loss

The first clinical application of titanium was in oral surgery, where implants were used for replacing teeth. For his patients with missing dentures, this meant a whole new life of being able to chew, swallow, speak and smile.

After a while, Brånemark tried a new acoustic method to evaluate how well the titanium implant had fused with the bone, and how stable it was. A patient with dental implants was fitted with a bone vibrator on one of his implants. When tested, the patient experienced very loud sound from the vibrator – even though he suffered from hearing loss. An amazing new discovery was born – that sound can travel through bone!

The Baha solution

Both Dr. Tjellström and Håkansson later followed up on Brånemark’s findings and lay the ground of what was to become the bone conduction hearing implant; the Baha solution. So far, more than 100,000 hearing impaired people all over the world have been helped by this technology and professor Brånemark’s legacy.

Prof. Brånemark, Dr Tjellström and Prof. Håkansson in the early 80's

Prof. Brånemark, Dr Tjellström and Prof. Håkansson in the early 80’s