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Doctor, can I hear better through bone conduction?

Dear friends, TGIF once again!

Welcome back to TGIF Dr Euan's blog.

Today's blog post is a guest post written by Mr Deepak D’Souza, Senior Principal Audiologist and Co-founder of D&S Audiology Pte Ltd. We will be looking at Bone Conduction Devices even as many such devices are gaining popularity and entering even the general / sport / exercise market.

Bone conduction devices have gained significant attention in the field of audiology and hearing rehabilitation. By bypassing the outer and middle ear, these devices transmit sound vibrations directly to the inner ear through bone conduction. This article provides an overview of bone conduction devices, including their indications and criteria for use, as well as an introduction to the different devices available in the market.

Bone conduction Hearing

Indications for Bone Conduction Devices:

Bone conduction devices are commonly recommended for individuals who experience hearing loss or have certain conditions affecting the outer or middle ear. The following are some indications for using bone conduction devices:

1. Conductive Hearing Loss: When conventional air conduction is ineffective due to issues in the outer or middle ear, bone conduction devices offer an alternative by transmitting sound directly to the inner ear.

2. Unilateral Hearing Loss: For individuals with hearing loss in one ear, bone conduction devices can help overcome the challenges of localization and sound awareness. For individuals with total hearing loss in one ear, bone conduction devices can transmit sound to the better-hearing ear, improving overall sound perception and communication.

3. Aural Atresia or Microtia: These congenital conditions affect the development of the outer or middle ear thus making it difficult or challenging for patients to use conventional hearing aids. Bone conduction devices can provide significant hearing improvement for individuals with these congenital conditions.

4. Chronic Otitis Media: Recurrent or persistent ear infections may cause conductive hearing loss. Some of these patients are unable to wear conventional aids because of persistent ear discharge. In such cases, Bone conduction devices can be a viable alternative.

Criteria for Using Bone Conduction Devices:

While each case is unique, your hearing care team will evaluate a patient's suitability for bone conduction devices:

Medical Evaluation: A medical examination, including an evaluation by an otolaryngologist or ENT surgeon like Dr Euan Murugasu at Euan's ENT Surgery & Clinic, is crucial to identify any underlying medical conditions that may affect the candidacy for bone conduction devices.

Audiological Evaluation: Next, your bone conduction specialist audiologist, like D&S Audiology Pte Ltd, will do a comprehensive audiological assessment to determine the type and degree of hearing loss. The audiologist will discuss the available bone conduction options and put you on a trial with bone conduction devices and recommend the appropriate technology based on your bone conduction hearing assessment.

Image Credit: Medel

A. Bone bridge Audiological criteria (BC within 45dB)

B. Bone bridge Audiological criteria for single-sided deafness (BC in the contralateral ear should be within 20dB)

C.BAHA Audiological criteria for their Various processors (BC within 55dB)

Expectations and Counselling: Clear communication with the patient and their caregivers is essential to establish realistic expectations and address any concerns or questions they may have regarding the device.

Follow-up Care: Regular follow-up appointments are necessary to monitor the patient's progress, make adjustments as needed, and upgrade external devices when they are due to ensure optimal device performance and satisfaction.

Different Bone Conduction Devices in the Market:

Singapore market offers several bone conduction devices from various manufacturers. Here are some of the commonly used devices:

Bone-Anchored Hearing Aid (BAHA): Bone-anchored hearing system consists of a surgically implanted titanium fixture (abutment) or a magnet and an external sound processor. The sound processor captures sound, converts it into vibrations, and transmits it through the abutment to the bone, stimulating the inner ear.

BAHA connect System BAHA Attract system

Image Credit: Cochlear Ltd

Headbands and soft Bands: Non-surgical bone conduction devices are available like the sound arc or worn as the soft band that holds the sound transducer in place over the temporal bone. They are often used as a temporary measure before a patient is ready for an implantable solution or in pediatric cases.

BAHA with Sound Arc BAHA with soft band

Image Credit: Cochlear Ltd

Bone Conduction Implants: The Bone Bridge device involves a surgically implanted fixture. They transmit sound transcutaneously leaving an intact skin system which can be cosmetically appealing to patients.

Bone Bridge Implant with external Samba Processor

Image Credit: Medel


Bone conduction devices offer a valuable alternative for individuals with conductive hearing loss, unilateral hearing loss, aural atresia, chronic otitis media, or with single-sided deafness. By directly transmitting sound vibrations to the inner ear, these devices bypass the outer and middle ear, overcoming certain auditory obstacles. The choice of a specific bone conduction device depends on various factors, including the individual's audiological and medical evaluation, personal preferences, and lifestyle. With continuous advancements in technology, bone conduction devices are expected to further improve in terms of performance, comfort, and aesthetics, providing enhanced hearing solutions for a wider range of individuals.

Thank you once again to Deepak D’Souza, and D&S Audiology Pte Ltd. for informing us more about BAHA hearing aids. If you are interested to find out more or want to know about their comprehensive patient-centric services, you may check out their website or reach them at Telephone Number: 80449632.

If you would like to consult an ENT Specialist about you or your child's hearing capabilities, please feel free to Contact Us at Euan's ENT Surgery & Clinic or telephone number: 6694 4282 to make an appointment.


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