Bone-Anchored Hearing System (BAHS)

A bone-anchored hearing system is a special type of hearing device that sends sound through the skull bone to the inner ear, bypassing the ear canal and middle ear. It’s used when traditional hearing aids aren’t a good option.

Bone‑anchored hearing systems are available in two main options, depending on your child’s age, hearing needs and whether surgery is appropriate.

• Softband bone‑anchored hearing system: With this option, the hearing device is worn on a soft, comfortable headband that fits around your child’s head. It allows sound to travel through the bone behind the ear without surgery. This is commonly used for babies and younger children, or as a way to see how well a bone‑anchored system works before deciding on an implant.
• Implanted bone‑anchored hearing system: For children who are old enough, a small titanium implant can be placed in the bone behind the ear during a minor surgical procedure. The sound processor then connects to the implant, either directly or through the skin, allowing sound to be sent more efficiently to the inner ear.

• Conductive hearing loss: This occurs when there are problems with the outer or middle ear that prevent sound from reaching the inner ear. A BAHS can help by sending sound through the bone instead of through the ear canal.
• Single‑sided deafness: Children with normal hearing in one ear and little to no hearing in the other may benefit from a BAHS, which helps carry sound from the weaker side to the better‑hearing ear so they can hear more clearly in everyday situations.
• Mixed hearing loss: This type of hearing loss is a combination of conductive and sensorineural hearing loss. A BAHS may help by improving how sound reaches the inner ear, depending on your child’s specific hearing needs.
• Outer ear or ear canal conditions: Some children have ear shape differences, chronic ear infections or ear canal problems that make wearing traditional hearing aids difficult or uncomfortable. A BAHS offers an alternative that does not rely on the ear canal.

The risks of a BAHS depend on whether your child uses a softband or has an implanted device.

Softband BAHS

• There are no surgical risks with a softband. Care focuses on everyday use, such as keeping the device clean, making sure it fits comfortably and protecting it during play and activities

Implanted BAHS

• Because this option involves a minor surgical procedure, there are some risks to be aware of, including:
• Skin irritation or infection around the implant site, which can usually be treated with good skin care or medication
• The implant not bonding fully with the bone, which is rare but may require additional treatment
• Repair or replacement of the sound processor over time, as the external device can wear out or become damaged with regular use

Your child’s hearing care team will discuss these risks in detail and help you decide which option is safest and most appropriate for your child.

The process for getting a bone‑anchored hearing system (BAHS) depends on whether your child uses a softband or has an implanted device.

• Softband BAHS: No surgery is needed for this option. The hearing device is simply fitted onto a soft headband and adjusted to your child’s hearing needs. This can usually be done during an office visit.
• Implanted BAHS: For children who are ready for an implant, a surgeon places a small titanium post or magnet in the bone behind the ear during a procedure done under general anesthesia. The incision is then closed, and your child will need several weeks to heal before the sound processor is attached and activated.

What happens after your child receives a BAHS depends on the type they use, but ongoing care and follow‑up are important for all options.

• Softband BAHS: Your child can begin using the device right away. You’ll return for follow‑up visits so the audiologist can check the fit, make adjustments and ensure your child is getting the best possible benefit as they grow.
• Implanted BAHS: After surgery, the area behind the ear needs time to heal before the sound processor is attached. Once healing is complete, your child will see an audiologist who will connect and carefully program the device to match their hearing needs.
• Ongoing care for all BAHS options: Regular care includes keeping the device and, if applicable, the skin around the implant clean, protecting the sound processor from damage during daily activities, and attending routine audiology appointments to monitor hearing and make adjustments as needed.

Bone‑anchored hearing systems can make a meaningful difference for many children, even though they may not restore hearing to perfect “normal.”

Most children who use a BAHS notice a significant improvement in everyday listening, such as hearing speech more clearly at home, in school and in noisy environments. While the device may not provide perfect hearing, it is designed to help your child hear better and more comfortably in daily life. Your child’s audiologist will work closely with your family to adjust the system and set realistic expectations based on your child’s unique hearing needs.

Surgery for an implanted bone‑anchored hearing system is usually considered when a child is physically ready for the procedure.

In most cases, this means waiting until the skull bone behind the ear is thick and strong enough to safely hold the implant. This typically happens around age 5 or older, though the exact timing depends on your child’s individual growth and medical needs. Your child’s care team will carefully evaluate readiness and discuss the best timing with your family.

To help keep your child’s BAHS safe and working properly, it’s important to remove the device during certain activities.

Your child should remove the sound processor for contact sports, such as football or soccer, and for swimming or water play, as these activities could damage the device or cause injury. For some non‑contact activities or light water exposure, waterproof covers or accessories may be available, depending on the device, to provide added protection. Your child’s audiologist can help you understand when the device should be removed and which accessories are appropriate for your child’s lifestyle.

The sound processor is small and sits just behind the ear, resting comfortably against the head. Most children and families find it discreet and low‑profile, and it often blends in with hair or can be customized with different colors or covers to suit your child’s style.