Lecture 2- Baha Flashcards
Why would an audiologist considered a Baha for their patient?
- Direct bone conduction
- Device works independently of ear canal & middle ear
- Direct transmission gives clear & natural sound
- Pre-operative testing is possible
- High wearing comfort
- Safe & straightforward surgery
- Predictable outcome
What are the two Baha systems?
Connect (abutment)
Attract (Magnet)
What is osseointegration?
The process by which living bone tissue bonds with titanium
- Makes direct bone conduction possible
- Provides the basis of long-term predictability & success of the Baha system
- Baha Connect: ~12 weeks for recovery time
- Baha Attract: ~4 weeks for recovery time
What patients are being treated with Baha technology?
Mixed and Conductive hearing loss
- Chronic otitis media (ear infections), congenital atresia, cholesteatoma, middle ear dysfunction or disease, external otitis
Single sided deafness (largest population of Baha users)
- Acoustic neuroma tumors, other surgical intervention, sudden SNHL, trauma, ototoxic treatments, genetic/congenital, Meniere’s disease
What is the impact of single-sided deafness?
- Poor localization & spatial awareness, difficulty in noise, children can demonstrate behavioral problems
What is the candidacy for Mixed & Conductive hearing loss?
- Less than 5 years of age (surgical limits)
- Better than or equal to 65 dB HL Bone Conduction PTA (.5, 1, 2, 3 kHz) or less than 15 dB at individual frequencies
What is the candidacy for Single-sided deafness?
- Less than 5 years of age
- Normal hearing in contralateral ear
- Defined as PTA air conduction thresholds equal to or better than 20 dB at 0.5, 1, 2, & 3 kHz
- Functions by transcranial routing of the signal
How can an audiologist determine candidacy for the Baha?
Hearing test: audiogram, determination of hearing handicap
Baha Demo: trial of Baha on softband, BC direct, formal/informal test
What are the pre-operative demo equipment?
Softband
Test rod
Headband
How can you fit a Baha Demo?
- Perform a BC direct measurement using the Baha Fitting software with the sound processor fitted on a Baha softband
- The difference between the BC thresholds and this measurement will give you an estimation of the individual transfer efficiency
- The BC direct thresholds are measured with this technique, should be within the fitting
How can you complete testing during the demo?
- Preoperative testing predicts benefit after surgery
- Speech perception testing
- Speech in noise testing for SSD:
- Speech to Deaf ear and noise to good ear
- Test with and without Baha
- Compare and quantify benefit with Baha
- Pre-op benefit will predict post-op benefit - May also perform informal testing with the demo device
How can you select a device?
- Attract is expected to provide similar or better hearing performance than a Baha sound processor on a soft band
- Due to skin attenuation, the Connect system will always give a better performance especially in the high frequencies
- Based on thresholds
What different sound processors are available?
Baha 5: bone conduction thresholds between 0 and 45 dB HL
- More power in smaller component
- Less distortion and longer battery life
Baha 5 Power: BC thresholds between 0 and 55 dB HL
Baha 5 Super Power: BC thresholds between 0 and 65 dB HL
- Can be worn with a decouple mcrophone and transducer that goes behind the ear or the patient can wear it attached to their shirt (atresia, microtia, or no physical pinna)
What are the current wearing options?
- Transducer can be paired with a microphone piece in the BTE position and the UTE (under the ear) position
- Each patient’s individual needs must be considered when selecting the wearing option
The liklihood that a patient will need UTE or Clip-on increases with the degree of SNHL
What are the current wireless accessories?
- Mini Mic, with FM connectivity
- MFi (made for iPhone)
