Download A Proven Natural Pathway to Better Hearing

FOR PROFESSIONALS
A Proven Natural Pathway
to Better Hearing
A BONE CONDUCTION HEARING SOLUTION
Rerouting Sound –
Naturally
Cochlear ™ Baha® offers a natural pathway to sound. It is a simple and effective
hearing solution for people with conductive hearing loss, mixed hearing loss and
Single-sided Sensorineural Deafness (SSD).
Arnold, Baha user
2|
Effective Solutions
Proven Outcomes
Simple and Safe
Baha can deliver amplification more
effectively than air conduction hearing
aids for suitable candidates.1, 2 It bypasses
the conductive element of the hearing
loss, delivering sound directly to the
cochlea with less gain and distortion.
The Baha System is proven by more
than 77,000 users, and its benefits have
been documented in hundreds of clinical
articles over more than 30 years.
Baha is an implantable hearing solution
that can be tested before use. Surgery is
a straightforward procedure, often in an
outpatient scenario. This involves no risk
of further hearing loss, and once fitted
Baha requires minimal aftercare.
Cochlear Baha 3 Sound
Processor (BP100)
Cochlear Baha 3 Power
Sound Processor (BP110)
— actual size
— actual size
We hear sound in two ways — through air conduction and bone
conduction. The Cochlear ™ Baha® System takes advantage of our
natural ability to hear through bone conduction.
Benefits
30 dB Air-bone gap or more?
Choose Baha ...
In Single-sided Sensorineural Deafness, Baha will bypass
the deaf ear entirely and deliver sound directly to the
hearing cochlea. This will overcome the head shadow effect,
which leads to improved speech understanding 4, 5, 6 and
360° sound awareness.
Choose Baha...
Air/Bone Gap > 30 dB?
Baha System Outperforms Hearing Aids1
Comparative Benefits of Baha vs Hearing Aids
for Mixed Hearing Loss
+
Baha performance
Baha 3
Hearing Aid
HA
Air/bone gap
In mixed hearing losses, air conduction hearing devices
must compensate for both the conductive and sensorineural
element. Unlike sensorineural losses that are amplified
according to the half-gain rule, the conductive component
requires up to 100% compensation.3 By completely avoiding
the conductive element and delivering sound directly to the
cochlea, Baha reduces required gain, producing less
feedback and distortion.
Better comfort and better sound quality
Baha clients do not need to battle with earmolds that
can cause sore or irritated ears. Nor do they need to
accept distorted sound and insufficient loudness from
air conduction aids in the struggle to compensate for the
conductive component. They can also say goodbye to
drawbacks like cables and skin pressure associated with
CROS and conventional bone conduction devices.
Benefit
When the conductive component is greater than 30 dB,
Baha should be the amplification method of choice.1, 2
Baha bypasses the conductive element delivering
amplification more effectively than air conduction
hearing solutions to these patients.
When your patients struggle with:
pe
rfo
rm
an
ce
• Insufficient loudness
• Feedback and distorted sound quality
• Draining ears or malformed ear canals
• Sore and irritated ears
• No hearing from one side
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0
30
dB HL Conductive Loss
60
As the air/bone gap increases, hearing aid performance
decreases. Baha performance is not affected.
Julian, Baha Softband user
Proven
Conductive Losses
2, 4, 5, 6, 7, 8, 9, 10
'Bypassing the Roadblock'
• Cholesteatoma
• Chronic otitis media
• Congenital aural atresia
• External otitis
• Genetic causes
• A practical, effective solution in cases of
draining ears, atresia or malformations.
• Less saturation, distortion and feedback than
conventional hearing aids due to reduced
required gain.
• No discomfort or infections due to
large earmolds.
125
250
500
1K
2K
1.5K
750
-10
4K
3K
8K
6K
0
10
• Otosclerosis
125
An audiogram representing
total conductive hearing loss.
Angle brackets indicate bone
conduction thresholds.
Circles indicate air
conduction thresholds.
20
30
40
50
60
70
80
250
2K
1.5K
4K
3K
8K
6K
Aided Baha thresholds
indicating the sound-field
thresholds that could be
achieved from a Baha for people
with a conductive hearing loss.
0
20
30
40
50
60
70
80
90
90
100
100
110
110
120
Frequency (Hz)
Frequency (Hz)
'Targeting the Sensorineural'
• Disease related factors
• Genetic causes
• Noise trauma
• Ototoxic treatments
• Presbycusis
• Cochlear otosclerosis
• Significantly less required gain means
that sufficient amplification is available to
compensate for a mild to moderate degree of
sensorineural impairment.
• Baha performs significantly better than air
conduction hearing aids in terms of aided
thresholds, speech perception measurements
and subjective reports. 2
125
250
500
2K
1K
1.5K
750
-10
4K
3K
8K
6K
0
10
• Less saturation, distortion and feedback due
to reduced required gain.
125
An audiogram showing an
example of significant mixed
hearing loss. Angle brackets
represent bone conduction
thresholds . Circles represent
air conduction thresholds.
20
30
40
50
60
70
80
90
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500
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750
-10
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Example of typical aided soundfield thresholds following the
fitting of a Baha for a person
with mixed hearing loss.
0
10
Hearing Level (dB HL)
Typical causes of the
sensorineural component:
Hearing Level (dB HL)
Baha is an effective solution for
mixed hearing losses because it
totally bypasses the conductive
element of the hearing loss and
only needs to address the
sensorineural component. Studies
suggest that Baha will improve
speech understanding in mixed
hearing loss. 2, 9
1K
750
10
120
Mixed Losses
500
-10
Hearing Level (dB HL)
Typical causes of conductive loss:
Hearing Level (dB HL)
With the Baha System, the
conductive roadblock is completely
bypassed by rerouting the sound
directly to the cochlea. There are
numerous studies detailing the
advantages of bone conduction for
these patients.7, 8
The Baha® System has proven to be an effective hearing solution
and several clinical studies demonstrate patient benefits.
20
30
40
50
60
70
80
90
100
100
110
110
120
120
Frequency (Hz)
Frequency (Hz)
• More comfortable because it doesn’t require
any earmolds.
Typical causes of SSD:
• Acoustic neuroma tumor
• Genetic causes
• Ménière’s disease
• Neurological degenerative disease
• Ototoxic drugs
• Sudden deafness
• Surgical interventions
• Trauma
• Studies 4, 6 indicate that Baha provides
a superior solution compared to a
Contralateral Routing of Signal
(CROS) hearing aid.
• Substantial subjective benefit reported
from several clinical studies.4, 10
• Reduces the head shadow effect and
provides better overall sound awareness.
• Improved speech understanding in
noisy environments.6
• Keeps the healthy ear free.
125
-10
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750
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1.5K
0
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20
30
40
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4K
3K
125
8K
6K
An audiogram representing an
SSD hearing loss. Angle brackets
indicate no response bone
conduction thresholds for the
right deaf ear. Circles represent
no response air conduction
thresholds for the same ear.
Crosses represent air conduction
thresholds for the left (good) ear.
-10
250
500
2K
1K
750
1.5K
0
10
Hearing Level (dB HL)
For people with Single-sided
Sensorineural Deafness (SSD), a
number of studies 4, 5, 6 indicate that
the Baha System effectively transfers
sound from the deaf side directly to
the healthy cochlea, eliminating the
head shadow effect.
'Eliminating the Head Shadow'
Hearing Level (dB HL)
Single-Sided Sensorineural Deafness
20
30
40
50
60
70
80
90
100
110
120
120
Frequency (Hz)
Frequency (Hz)
4K
3K
8K
6K
Aided Baha thresholds
demonstrating good audibility
of sounds transferred from the
right side to the left cochlea for
a client with SSD.10
The Baha® System consists of three parts:
The processor detects sound,
cleans, amplifies and transforms
it into vibrations.
1
The connecting abutment receives the
amplified vibrations and transfers it to
the osseointegrated titanium implant.
The titanium implant transfers
sound vibrations directly to the
cochlea via bone conduction.
2
3
Effective
By bypassing the outer and middle ear, Baha offers a natural pathway
to hearing for people who cannot sufficiently benefit from air conduction
hearing aids or who find other bone conduction devices uncomfortable
and ineffective.
The Baha System combines a high performance sound processor, a connecting
abutment and a titanium implant. Titanium is used due to the ability of human bone
to integrate with the titanium implant through the unique process of osseointegration,
a proven technique that has been used in reconstructive surgery, dental implants and
Baha, with great success for more than 30 years. This process enables sound to be
conducted directly to the cochlea.
8|
Bilateral benefits
For candidates with binaural hearing loss, a bilateral
fitting of Baha should be considered. This improves speech
understanding, sound localization, as well as increasing
the personal safety of the patient.8
Simple
Getting a Baha® is a straightforward process:
• The candidate can test the Baha before the surgery.
• Surgery often takes place in an outpatient setting.
• The procedure holds no risk of further hearing loss.
• Patients can often resume normal activities within a few days.
Test and Try
Straightforward Procedure
Fitting and Fine Tuning
Minimal Aftercare
A hearing test determines candidate suitability.
Patient is referred to a qualified Baha surgeon.
The candidate can try the Baha using an external test
band, test rod or a Baha Softband and experience the
potential improvement.
Implant surgery takes place, typically in an outpatient setting.
Once the implant osseointegrates, the Baha Sound
Processor is fitted.
Patient receives an aftercare kit which provides information
about use and care for the Baha System.
Settings are adjusted to patient's individual hearing needs
manually or through the Cochlear™ Baha® Fitting Software.
These
simple tasks include keeping the abutment clean and
the sound processor dry.
TEST BAND
The patient can resume normal activity within just a few days.
IMPLANT PROCEDURE
COCHLEAR BAHA FITTING SOFTWARE
AFTERCARE KIT
Reimbursement
Many insurance companies and health care systems reimburse Baha treatment. Contact your local Cochlear office for full details
and information. To ensure the best treatment for your patient, contact your local Baha clinic. Here, surgical and audiological
specialists collaborate to provide the highest standards of patient care. Contact details for Baha clinics are available at
www.CochlearAmericas.com or from your local Cochlear office.
10 |
Child-Friendly
Children with hearing losses face unique challenges with respect to their
educational and personal development. Selecting the correct solution should
be a carefully considered process. With Baha® we strive to make this defining
decision and the procedure it involves as straightforward as possible – for
children and parents.
Selection
Correct Device
With Cochlear ™ You Have More Choices
Indications for Baha for a child are similar to those of an
adult. Very young children can be fitted with the Baha®
Softband until they are old enough to receive an implant.
Because children may be unable to understand how a
sound processor works, device selection is important. Sound
processor features that give parental confidence such as
tamper resistance, visual confirmation, and FM connectivity
are important considerations.
Choices for Pediatric Patients:
Follow-Up
• Tamper-proof buttons
Follow-up appointments will be important. For children,
fine-tuning the sound processor should be performed
more regularly.
• Visual indicator for processor status
Timing
A child should receive a Baha as early as possible*, in order
to facilitate normal development in terms of language and
speech comprehension.
Counseling
The need for counseling in the case of a child is greater
than that of an adult. Parents need to be shown how the
sound processor operates as well as receive instructions
about daily care.
Baha Softband ­— gently
introducing a new world
For children who are not yet ready for an implant*, the Baha® Softband is the ideal
alternative. Easy to use and comfortable, providing infants and toddlers with the
amplification they need to facilitate language development.
•
•
•
•
Consists of soft, elastic headband and plastic snap connector.
Holds processor firmly but gently in place.
Adjustable fastening facilitates easy pressure adjustment.
Easy to shift position, increasing comfort and usefulness
when child is in car seat or stroller.
• Built-in safety release.
• Water protection
• Tamper-proof battery doors
• Fun colors for battery doors
• Keylock feature
• Universal Europin accessory connector
• Safety line
• More Softband options
Joshua, bilateral Baha user
Baha —
the experience
that matters.
No one has more experience of bone conduction hearing
solutions than Cochlear ™. For over 30 years we have
dedicated ourselves to researching, developing and
applying solutions that can give adults and children the
gift of better hearing — and we will continue to do so
with the same level of commitment in the future.
* In the US and Canada, the Baha Implant is indicated for children 5 years and older.
12 |
| 13
Individual
Every patient is different. Our broad product portfolio
reflects the needs of a diverse patient base:
Cochlear Baha 3 Power
Processor (BP110)
Cochlear Baha
Cordelle II
Premium Performance
Most Powerful
Head-Worn Baha
Body Worn Super Power
The Cochlear Baha 3 Sound Processor
is world’s first programmable bone
conduction sound processor based on
a new audiological toolkit dedicated to
direct bone conduction.
Audio Adapter
Enjoy direct input sound
from stereo systems, TVs
and MP3 players.
The most powerful head-worn fully
programmable sound processor. Ideal
for those with a substantial mixed
hearing loss, risk of progressive hearing
loss and patients with SSD.
•  Dedicated signal processing and
amplification strategies for direct
bone conduction.
FM-Receiver
An FM receiver enables the
use of most FM systems that
are commonly used in school
classrooms, improving the
hearing performance in
noisy environments.
•  A
utomatic signal processing and
automatic noise reduction.
•  A
djustable trim controls to normalize
loud or quiet sounds.
• 
Ergonomic operation ­— three button
user interface enables quick volume
adjustments and uncomplicated
program changes.
•  E asily integrate accessories such as
FM systems or MP3 players using the
standard Europin connector.
•  Built-in telecoil.
• Direct Audio Input (DAI) using the
standard Europin connector, easily
integrates accessories such as FM
systems or MP3 players.
• 
Two LEDs provide a visual indication
of processor status and settings.
0
-10
0
10
COLORS AVAILABLE
-10
0
NOTE: Not all processors are available in colors shown. Processors
not available in all markets. Contact your local
Cochlear office for more information. Images not to scale.
10
10
20
* Available for the headworn devices only. The Baha Cordelle II
30
has a built-in telecoil for convenience.
Bone Conduction
Fitting Range forThresholds
Baha 3 (BP100)
30
dBHL
10
60
Bone Conduction
Thresholds
20
30
70
dBHL
110
90
60
100
Bone Conduction
Thresholds
30
30
110
90
250
120
125
500
250
500
1000
1000
2000
Frequency
[Hz]
4000
2000
4000
8000
Frequency [Hz]
Bone-conduction
thresholds
≤ HL
45averaged
dB HL averaged
Bone-conduction thresholds
≤ 45 dB
across
500,1000,
1000, 2000,
and and
3000 3000
Hz
across
500,
2000,
Hz
Air-conduction thresholds may extend into this area
Air-conduction thresholds may extend into this area
Fitting range for Cochlear™ Baha® BP100
0
10
60
20
Bone Conduction
Thresholds
30
70
40
80
50
90
60
70
100
50
60
70
80
110
90
90
100
100
110
-10
50
80
80
Conduction
Fitting RangeBone
for Baha
Cordelle II
Thresholds
40
80
50
100
120
125
60
20
70
100
10
70
40
90
0
dBHL
50
50
20
40
-10
-10
0
80
14 |
Bone Conduction
Fitting Range forThresholds
Baha 3 Power (BP110)
dBHL
40
dBHL
Nancy, bilateral Baha user
20
40
* * Not available with Cordelle II sound processor.
•  Adjustable tone controls.
• Automatic noise management.
•  Titanium backing provides durability.
-10
•  Body-worn unit for maximum power.
• Thinnest programmable
power processor.
•  Direct Audio Input (DAI) connector.
Colored Battery Doors**
•  E nsures that even for progressive
hearing losses, a Baha solution
is available.
•  Same advanced digital signal
processing as Baha 3 Sound Processor,
provides the best hearing across a
variety of sound environments.
•  Fully programmable.
Provides improved hearing
over the phone, and in buildings
supplied with a loop facility
e.g. schools, cinemas. The
telecoil sends the signal directly
to your Baha.
•  P rovides a solution in cases of
substantial hearing losses.
• New directional microphones for
better hearing in noisy environment.
•  D
eveloped to take advantage of bone
conduction hearing.
Telecoil*
The Baha Cordelle II is the most powerful
Baha sound processor, specifically
designed to provide maximum power to
those with severe mixed hearing losses.
dBHL
Personalized Accessories
Cochlear ™ Baha® 3
Sound Processor (BP100)
120
125 110
8000
250
120
125
500
250
500
1000
Frequency
[Hz]
1000
2000
4000
2000
4000
8000
Frequency [Hz]
120
125 8000
110
250
120
125
500
250
500
1000
Frequency
[Hz]
1000
2000
2000
4000
4000
8000
Frequency [Hz]
Bone-conduction
thresholds ≤ 55 dB HL averaged
Bone-conduction thresholds ≤ 55 dB HL averaged
across
500,
1000,
2000,
3000 Hz
across
500,
1000, 2000,
andand
3000 Hz
Bone-conduction thresholds ≤ 65 dB HL averaged
Bone-conduction thresholds ≤ 65 dB HL averaged
across
500,
1000,
2000,
Hz
across
500,
1000, 2000,
andand
30003000
Hz
Air-conduction thresholds may extend into this area
Air-conduction
thresholds may extend into this area
Air-conduction thresholds
thresholds maymay
extendextend
into this area
Air-conduction
into this area
Fitting range for Baha® Intenso™
Fitting range for Baha® Cordelle II
8000
REFERENCES
This is the Cochlear ™ promise to you. As the global leader in hearing
solutions, Cochlear is dedicated to bringing the gift of sound to people all
over the world. With our hearing solutions, Cochlear has reconnected over
250,000 cochlear implant and Baha® users to their families, friends and
communities in more than 100 countries.
Along with the industry’s largest investment in research and development,
we continue to partner with leading international researchers and hearing
professionals, ensuring that we are at the forefront in the science of hearing.
For patients receiving any Cochlear hearing system, our commitment is that
for the rest of your life we will be here to support you.
Act now !
Open a Baha clinic or start referring your
patients who are potential Baha candidates
to your nearest Baha clinic
As your patient’s partner in hearing for life, Cochlear believes it is important to convey not
only the benefits, but also the potential risks associated with a Baha procedure.
Not everyone with hearing loss is a candidate for a Baha. Baha is contraindicated in
patients with inadequate bone quality or quantity to provide stability and support for the
implant, or in patients who will be unable to maintain and clean the skin around
the abutment. In the U.S., use of the implanted fixture is also contraindicated in children
under age 5 years.
All surgical procedures include an element of risk, and it is impossible to guarantee success.
The device may fail to osseointegrate for a number of reasons, including physiological
and surgical issues as well as traumatic impact to the implant site. On rare occasions the
skin around the abutment may become inflamed from a mild infection or the skin may
grow back towards its original thickness. For complete information regarding the risks and
benefits of a Baha procedure, please refer to the instructions for use for the Baha implant
available at www.CochlearAmericas.com/BahaIndications
www.CochlearAmericas.com
Cochlear Americas
13059 East Peakview Avenue
Centennial CO 80111
USA
Tel: 1 303 790 9010
Fax: 1 303 792 9025
Cochlear Canada Inc
2500-120 Adelaide Street West
Toronto, ON M5H 1T1
Canada
Tel: 1 416 972 5082
Fax: 1 416 972 5083
VELCRO is a registered trademark of Velcro Industries B.V. Baha and Baha Divino are trademarks of
Cochlear Bone Anchored Solutions.
Cochlear and the elliptical logo are trademarks of Cochlear Limited. © Cochlear Bone Anchored Solutions 2011.
BUN018 ISS2 JUL11
1 Snik AF, Mylannus EA, Proops DW, et. al.
Consensus statements on BAHA system:
where do we stand at present? The Annals
of Otology, Rhinology & Laryngology
2005; 195:1-12.
2 Hol MK, Snik AF, Mylanus EA, Cremers
CW. Longterm results of bone-anchored
hearing aid recipients who had previously
used air-conduction hearing aids. Archives
of Otolaryngology-Head & Neck Surgery
2005;131 (4): 321-5.
3 Dillon, H. Hearing Aids, New York,
Thieme, 2001.
4 Lin LM, Bowditch S, Anderson MJ, May B,
Cox KM, Niparko K. Amplification in the
rehabilitation of unilateral deafness: speech
in noise and directional hearing effects with
bone-anchored hearing and contralateral
routing of signal amplification. Otology and
Neurology 2006;27(2):172-82.
5 Wazen JJ, Spitzer JB, Ghossaini SN,
et al. Transcranial contralateral
cochlear stimulation in unilateral
deafness. Otolaryngol Head Neck Surg
2003;129(3):248-54.
6 Hol MK, Bosman AJ, Snik AF, Mylanus EA,
Cremers CW. Bone-anchored hearing aids
in unilateral inner ear deafness: an
evaluation of audiometric and patient
outcome measurements. Otology and
Neurology 2005;26(5):999-1006.
7 Watson GJ, Silva S, Lawless T, Harling JL,
Sheehan PZ. Bone anchored hearing aids:
a preliminary assessment of the impact on
outpatients and cost when rehabilitating
hearing in chronic suppurative otitis media.
Clin. Otolaryngol. 2008, 33, 338–342.
8 Priwin C, Jönsson R, Hultcrantz M, Granström
G. BAHA in children and adolescents with
unilateral or bilateral conductive hearing
loss: a study of outcome. Int J Pediatr
Otorhinolaryngol. 2007 Jan;71(1):135-45.
9 Flynn MC, Sadeghi A, Halvarsson G. Baha
solutions for patients with severe mixed
hearing loss. Cochlear Implants Int. 2009;
10(S1):43–47.
10 Kunst SJ, Hol MK, Snik AF, Bosman AJ,
Mylanus EA, Cremers CW. Bone anchored
hearing aid in patients with acquired and
congenital unilateral inner ear deafness
(Baha CROS): clinical evaluation of 56 cases.
Doctoral dissertation, Radboud University
Nijmegen Medical Centre, Nijmegen, The
Netherlands. 2008.