Children's Hospital Colorado

Bone Conduction and Bone-Anchored Hearing Aids

As one of the largest pediatric ear, nose and throat teams in the U.S., we offer care in six convenient locations for children in Colorado and beyond.



What are the different types of hearing loss?

Hearing loss is classified into conductive and sensorineural (or nerve) hearing loss. With sensorineural hearing loss, there is an abnormality of the inner ear or in the nerve that carries sensory information to the brain. Conductive hearing loss occurs when sound is not being transmitted into the inner ear. The most common cause of conductive hearing loss is fluid in the middle ear from chronic ear infections. Other causes include malformation of the outer ear, ear canal, eardrum and bones behind the eardrum.

What is a bone conduction hearing aid?

A bone conduction hearing aid works to bypass whatever is preventing normal sound transmission into the inner ear by vibrating the skull bone directly. It is held in place with a headband that a child wears over the top of the head or a Velcro band (also called a soft band).

What are bone-anchored hearing aids?

Bone-anchored hearing aids are approved by the FDA for children older than 5 years of age. They work in the same way as bone conduction hearing aids in principle, but they are implants. The surgeon surgically places a titanium screw into the skull. The bone-anchored hearing aid or sound processor attaches to the screw with a magnet or screw attachment. The surgeon does a minor one- or two-stage surgical procedure to implant the small screw or magnet that holds the hearing aid, or sound processor, in place.

Conditions treated with bone conduction and bone-anchored hearing aids

Children can benefit from bone conduction hearing aids and bone-anchored hearing aids if they have been diagnosed with any of the following:

  • Microtia
  • External ear canal atresia (no external ear canal or an ear canal that is closed)
  • External ear canal stenosis (narrowing of the external ear canal)
  • Conductive hearing loss
  • Single-side sensorineural hearing loss

Who is eligible for bone conduction hearing aids?

Children with microtia, external ear canal atresia and external ear canal stenosis may be candidates for bone conduction hearing aids and bone-anchored hearing aids.

Typically, children use bone conduction hearing aids until the age of 5, and then they may be candidates for bone-anchored hearing aids.

What are the benefits of bone conduction or bone-anchored hearing aids?

Bone conduction and bone-anchored hearing aids can help children hear better when other methods of sound amplification, such as regular hearing aids, do not work. The use of hearing aids early in infancy has been shown to enhance brain development and sound pathways in the brain. It has also been shown to improve speech and language development.

Improved hearing, speech and language development helps children perform better in school. It also helps children communicate better outside the classroom.

What can we expect from the placement of bone conduction hearing aids?

Bone conduction hearing aids do not require surgery. The hearing aid is worn with a headband or special clip that fits over the top of the head. Our audiologists do special testing and fitting during several appointments.

What can we expect from bone-anchored hearing aid surgery?

Our pediatric (ear, nose and throat) ENT surgeons perform surgery to attach the bone-anchored hearing aids to your child’s skull using a special screw or magnet.

The surgery for placing a bone-anchored hearing aid usually lasts about one to two hours. Your child can go home the same day that the procedure is performed.

After your child completely heals from the surgery, an audiologist fits and tests the sound processor during a series of appointments.

Are bone-anchored hearing aids painful?

Your child may have mild discomfort following the surgery for about one week. The pain can usually be controlled with acetaminophen (Tylenol) and/or ibuprofen (Advil).

How will I care for my child after bone-anchored hearing aid surgery?

Keep the surgical site clean and dry and give your child pain medicine as directed by your child’s healthcare provider. Your child may also need to take antibiotics. The stitches will slowly dissolve over one to two weeks.

Your child will have follow-up appointments one to two weeks after the procedure. After that, your child will have regular follow-up appointments every six to 12 months to make sure the implant and sound processor are working as well as possible.

Why choose Children’s Hospital Colorado for bone conduction and bone-anchored hearing aids?

The Bill Daniels Center for Childhood Hearing Loss at Children’s Colorado is the largest and most comprehensive multidisciplinary clinic focused on hearing disorders in Colorado and the surrounding states.

The ENT surgeons and audiologists at Children’s Colorado have more experience with bone conduction and bone-anchored hearing aids than any other specialists in Colorado or the surrounding states. Our surgeons and audiologists have also been involved in testing, clinical studies and scientific publications for these devices and procedures.

Our multidisciplinary approach to treating children with hearing difficulties

Pediatric (Ear, Nose and Throat) ENT surgeons work closely within and outside the Bill Daniels Center for Childhood Hearing Loss with specialists in the Department of Audiology, Speech and Learning to evaluate and manage children with hearing impairment.