One thing that surprised me when working with children who were excellent candidates for an osseointegrated (OI) device was the fact that no one had ever mentioned it was an option for them!
Unless you or your child is seeing an ear, nose, and throat physician or neurotologist that is well educated in the use of an OI system, they may not mention it. It is not uncommon for standard amplification options to be recommended despite an OI system to be a much more appropriate recommendation.
First, what is an OI device?
An OI device is an amplification processor that sends sound directly to the inner ear (bypassing the external and middle ear) through bone conduction transmission. Essentially, vibrations send the sound signals to the cochlea of the inner ear, where the sound is then sent to the brain through the auditory nervous system.
An OI device can be worn on a soft headband (softband OI Device) or have a surgical component depending on the age and needs of the patient. However, even when there is a surgical component it is important to understand that an OI device is not the same thing as a cochlear implant.
A softband OI device is a good option for:
- Patients under 5 years old
- Patients with a conductive hearing loss that’s anticipated to be “temporary”
- Patients who do not want a surgically implanted component to their device
While surgery can be a scary thought, the benefit of a surgical component to an OI device is often better sound quality, more comfort, and less feedback (the whistling created by amplification when it is fitting inappropriately or covered by something). The part that is surgically implanted is either a magnet that holds the device to the head or an abutment the device snaps onto.
I have worked many years with OI devices and I LOVE THEM! For those who are candidates, they are a much better option than traditional hearing aids!
Which brings me to the next question? Who is a candidate for an OI device?
OI devices are intended for children and adults with a conductive component to their hearing loss. A conductive hearing loss means that some or all of the hearing loss is due to a problem with the outer or middle ear sending sound into the inner ear. This can be a result of craniofacial anomalies, chronic middle ear dysfunction, a problem with either the eardrum or bones in the middle ear, etc.
To be eligible for this type of amplification device:
- The conductive component of hearing loss is greater than 30 dB (as defined by an ABR or Audiogram)
- If there is additional hearing loss due to cochlear damage (sensorineural component) the hearing loss is less than around 55dBHL, depending on the specific product. If the cochlear damage is greater than this and there is additional conductive hearing loss, you may be a good candidate for a cochlear implant.
For those who have been fit with an OI device that have previously worn traditional hearing aids, reports of better sound quality and ease of use is phenomenal. There is nothing that goes in the ear and the sound gets directly to the part of the ear that is functioning best instead of needing additional gain to transmit the sound through the areas of the ear that are damaged and/or malfunctioning.
Like most good quality hearing aids, OI devices can connect directly to other electronic systems through Bluetooth and also have accessories that allow a patient to have sound sent directly to the device, offering better sound to noise ratio. For any child or adult this can be a significant benefit in the classroom as the speaker can wear a microphone that sends the sound directly to the device itself.
Some patients choose to use traditional amplification (i.e., hearing aids) when possible due to the cost. OI devices are more expensive than traditional hearing aids. Insurance coverage varies, similarly to hearing aid coverage. You will want to work with the audiologist and neurotologist to determine insurance coverage.
If your insurance does not cover the cost of an OI device, there are other ways to try to have your device funded. For children, the most consistent grants we have found for the funding of OI devices (and/or hearing aids) are the United Healthcare Children’s Foundation and the Children’s Hearing Aid Program (CHAP) for Utah residents. If you live in a different state, contact your state department of health to see if there is a state program for those who do not qualify for Medicaid (which DOES cover devices) but need help with funding. I know Wyoming has a program called WYCHAP which is similar to the Utah CHAP program to help with the costs associated with hearing devices.
Our clinic supports the following OI devices as we feel they offer the best functionality and support:
- Cochlear Baha
- Cochlear Osia
- Oticon Medical Ponto
We also have close relationships with neurotologists that we can refer to if you are needing to get established with a physician who specializes in medical and surgical intervention (where we specialize in the hearing component). When it comes to hearing loss, it really requires both an audiologist and either and ear, nose, and throat physician or neurotologist to collaborate best care.
For more information on the OI devices we most recommend, click here for Cochlear Osia surgical solution , Cochlear Baha surgical or softband solution, and Oticon Medical Ponto solution.
We offer an OI device evaluation which includes fitting an OI device on a softband in the office for you or your child to see the difference the sound can make. To schedule an appointment, click here.
Of note, OI devices are sometimes used for cases of single-sided deafness (i.e., on ear hears well and the other ear has no usable hearing), however, our office recommends cochlear implantation over an OI device for these cases. However, in the event a cochlear implant is not desired, an OI device is an option for those with single-sided deafness. In these cases, the device is not sending sound to the ear with deafness but rather sending the sound from that side of the head to the other ear.