Before the first implantable Cochlear™ Baha® System was launched, one of the only solutions available to those that could not benefit from air conduction hearing aids was bone conductors fitted to steel headbands or glasses. Although it is commonly agreed that a preoperative trial is important to provide candidates with realistic expectations,1-3 similar devices are still being used for patients testing bone conduction as part of the counselling process for an implantable solution. In 2002, the Baha Softband was developed by Cochlear as a solution for children that were too young, or not ready for an implantable solution. This device has sometimes been used as a demo solution, providing a more comfortable alternative to headbands or testbands. However, the aesthetics of the Softband do not appeal to everyone. Indeed, previous research has shown that the most common reason to reject the proposal of an implantable bone conduction solution is the cosmesis.4 It could be hypothesized that the use of steel headbands and the Softband as demonstration devices have created additional barriers to the adoption of an implantable solution. Clinicians have also raised concerns that for older children that reject the Softband due to aesthetics there is no alternative solution, which in the worst case may leave them without amplification. This whitepaper summarizes the outcomes from the testing performed on the Cochlear Baha SoundArc to ensure it meets the expectations of users and their hearing care professionals.
1. Desmet J, Bouzegta R, Hofkens A, De Backer A, Lambrechts P, Wouters K, Claes J, De Bodt M, Van de Heyning P. Clinical need for a Baha trial in patients with single-sided sensorineural deafness. Analysis of a Baha database of 196 patients. Eur Arch Otorhinolaryngol. 2012; 269(3):799-805.
Cochlear Guest Author
By Skylar Mason
Thanks to the Made for iPhone connectivity of the Cochlear™ Nucleus® 7 and Baha® 5 Sound Processors, staying connected is easier than ever. Your patients can stream calls, music, and other sounds straight from their phone to their sound processor.
Here are some ways to take your patients’ hearing to the next level with Cochlear’s Made for iPhone technology:
Pairing a sound processor to a phone is simple and Cochlear has made it even easier with video tutorials. Click the links below to watch the step-by-step process or follow the instructions below:
Unlock the iPhone®. Go to ‘Settings,’ tap ‘General,’ and then tap ‘Accessibility.’ Navigate to ‘MFi Hearing Devices’. Then, turn the sound processor off and back on again. The Apple® device will then search for the sound processor and display it in the ‘Devices’ section. Tap on the name of the sound processor and it will bring up a Bluetooth® pairing request. Tap ‘Pair’ and it will connect. The patient will hear six beeps to indicate that pairing has started. The sound processor light will flash blue for four seconds. The pairing will be finished when your patient hears a ripple tone and the sound processor light flashes blue for another four seconds. (Note: The pairing process may take up to two minutes.)
If your patient is bilaterally implanted, both of the sound processors need to be paired at the same time. Just tap ‘Pair’ to connect each of them individually.
Make sure the sound processor is turned off. Unlock the iPhone. Go to ‘Settings’, tap ‘General’ and then tap ‘Accessibility.’ Leave that page open as you turn on the sound processor (by closing the battery door.) Then navigate to ‘MFi Hearing Devices’.
Tap on the name of the sound processor and it will bring up a Bluetooth pairing request. Tap ‘Pair’ and it will connect. The sound processor will beep with an upward trill to indicate the pairing is complete. (Note: The pairing process may take up to two minutes.)
Share this illustrated guide to iPhone connectivity with a Baha 5 sound processor with your patients.
- Stream audio straight to the processor
Now that your patient’s iPhone is connected, they may be wondering exactly how to use it. The answer to that depends on how they use their iPhone—the possibilities are endless!
Here’s a few ideas to get started:
- Stream audio from phone calls directly to the sound processor
- FaceTime® without worrying about volume
- Listen to music discreetly- no headphones needed!
- Watch videos or shows from streaming apps
- Play games
- Use it to hear GPS directions clearly
- Utilize the Smart App
As part of the Made for iPhone connectivity, both the Nucleus 7 and Baha 5 sound processors have apps that allow patients to control their processor’s settings—directly from the palm of their hand.
The Nucleus Smart App allows them to monitor their battery life, adjust the mixing ratio to increase/decrease background noise, track their progress with a Hearing Tracker and locate a lost or misplaced sound processor.
The Baha 5 Smart App allows them to change programs, activate streaming and adjust their processor volume. They can also adjust treble and bass to customize their settings and locate a lost or misplaced sound processor.
The Cochlear website offers a ton of resources to help recipients connect their sound processor(s) to their phone—check it out: iPhone connectivity.
About our guest author:
Skylar Mason is a journalism student, Baha recipient, and Anders Tjellström Scholarship winner. She is excited to join the team at Cochlear as an intern to tell the stories of other CI and Baha recipients! She attends the Walter Cronkite School of Journalism at Arizona State University.
The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Cochlear is under license.
The Nucleus 7 Sound Processor is compatible with the Nucleus Profile Series, CI500 Series, CI24RE (Freedom) Series, CI24R and CI24M implants. The timeframe for Nucleus 7 Sound Processor compatibility for other implants depends on research and development timelines, manufacturing processes and regulatory approvals.
The Cochlear Nucleus 7 Sound Processor is compatible with iPhone, iPad and iPod touch. For compatibility information visit www.cochlear.com/compatibility
Apple, the Apple logo, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries.
The Cochlear Nucleus Smart App is available on App Store and Google Play. For compatibility information visit www.cochlear.com/compatibility
By George Cire, Principal Clinical Project Manager at Cochlear
The heart of any bone conduction system is the vibrator or actuator that functions as a mechanism to convert amplified sound to mechanical vibration, which can in turn drive the bones in the skull to access the bone conduction pathway to the cochlea or inner ear. The Cochlear™ Osia® System applies a new and innovative way to create a bone conduction transducer that will produce high frequencies and thus positively impact speech understanding.
Evolution of Bone Conduction Technology
Historically, the actuator is an electromagnetic device that contains a magnet, coil and counterweight. By application of an alternating polarity signal from the sound processor to the actuator, an electromagnetic field is produced that excites the magnet element and counterweight. This produces movement or vibration within the actuator to change the electrical signal to vibration that can move through the bone conduction pathway to stimulate the cochlea, thus facilitating hearing.
It’s easy to visualize the complex design of springs, magnets, coils and a counterweight that form a “moving mass” system that facilitates a mechanical interaction between parts. The electromagnetic actuator can be placed against the skull externally where the vibration must traverse soft tissue before stimulating the bone conduction pathway, providing a transcutaneous bone conduction system. This method advantageously provides a non-surgical option for candidates that need or require a bone conduction amplification system.
Innovations with the Baha® System
The Baha Connect system was developed to provide a direct drive access system where a surgically implanted titanium fixture can be placed in the bone where it will osseointergrate. Attached to this implanted fixture is a titanium abutment that protrudes through the skin and provides a snap coupling that accepts the Baha Sound Processor, referred to as a percutaneous system.
Later, the Baha Attract system allowed an implant magnet to attach to the implant fixture, positioning the tissue flap to be in place over the implant fixture and implant magnet. Then the sound processor can be attached to an external magnet that is held in place with the magnetic attraction between a “sandwich of tissue” and the internal implant magnet to hold the entire system in place. Vibration from the actuator in the sound processor then passes though the system to the internal components to excite the same bone conduction pathway described above in the Baha Connect system.
It forms an alternative transcutaneous system that offers candidates for bone conduction hearing treatment with a more cosmetic system that does not require the same hygiene regimen as the Baha Connect system. The direct drive Baha Connect system provides the most effective transfer of vibrational energy with out the damping effect of the skin between the vibrating actuator and the bone conduction pathway.1,2
The Osia System and Piezoelectric Technology
As a natural evolution of bone conduction technology, the Osia System was created to combine the best of the direct drive, Baha Connect system and the hygiene and cosmetic advantages of the Baha Attract system. The Osia System is a new approach to an active transcutaneous system. Like other bone conduction systems, the actuator is the “heart” of the process. Designers and engineers looked toward the use of piezoelectric technology to create a smaller and most robust actuator that had clear advantages over traditional electromagnetic technology. 1,2
In piezoelectric technology, a crystalline material can be formed into compact wafers that are laminated or bonded together. When an electrical current is applied to this crystalline material, contraction and expansion is created that follows the electrical signal. Because these wafers are laminated, the design allows for carefully controlled vibration to occur with out the need for a complex mechanical design containing moving parts and springs. The actual size of the piezoelectric actuator can be formed into a package for optimal temporal bone placement where it can be mated with an osseointegrated fixture to apply vibration to excite the bone conduction pathway. Application of this approach can be accomplished with modifications to the existing knowledge base of traditional Baha surgery.
The remaining components of the Osia Implant System include the magnet/coil assembly and a demodulator. The external Osia sound processor contains a battery-operated circuit that acts to pick up the acoustic signals of interest and then to amplify them. Additionally, this circuit creates a digitally encoded radio frequency link that permits the combination of the amplified acoustic signal to the digital RF carrier to supply power to the implant via an inductive link between two coils (one in the external processor and one in the implanted package). These two coils are held in place with magnets that only serve to provide a secure coupling and alignment. This elegant design allows for the critical power supply to be maintained in the externally worn device.
Through the design and efficiency of power in this system, the Osia device provides the ability for clinicians to treat up to a 55dB HL sensorineural hearing level. 1,2 It has the advantage of hearing performance seen in our direct drive Baha Connect system combined with the non-skin penetrating transcutaneous system that provides a more cosmetic approach to the application of bone conduction amplification. 1,2
Overall the Osia System, an active transcutaneous osseointergrated implant system, combines the hearing performance seen in the Baha Connect system and the convenience and attractiveness of the Baha Attract system.
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- Dotevall M. Technical Report: Available gain in Osia vs Baha 5 Power. D1664198. Cochlear Bone Anchored Solutions AB, Sweden 2019
- D1478473 CIR final report 12 month Data, Cochlear Bone Anchored Solutions AB. Sweden October 2019