Active OS implants

Learn more about how active implants work and how they may improve your hearing.


What you'll find on this page

  • How active implants work.
  • The main components of a Cochlear™ Osia® System.
  • The benefits of active implants.

What is bone conduction hearing?

Most people hear in two ways: by air conduction (sound traveling through the air to the ears) and bone conduction (sound passing through the bones in the head). They work together to help us listen to and perceive sound.

Problems in your outer or middle ear can restrict sound waves from getting through to your inner ear which results in hearing loss. A common cause is recurring ear infections or chronic otitis media (COM). The underlying medical condition may be treated with surgeries, but the hearing loss remains in 30% of these cases1 and the need for additional surgeries is common.2

A bone conduction solution works by bypassing blocked or impaired parts of the natural hearing pathway to help you hear, and the surgery won't cause any loss of the remaining hearing you may have in your ear. They leave the ear canal free, which lowers the risk of recurring ear infections compared to wearing a hearing aid.3,4

How active implants work

Bone conduction systems consist of two key parts, a sound processor and an implant.

The sound processor sits externally, just off the ear, and is held in place by a magnetic connection. Microphones in the sound processor capture sound, and the sound processor converts it to a digital signal which is sent through the skin to the implant.

In traditional bone conduction implant systems, the sound vibrations are created in the sound processor. In an active bone conduction implant system, these vibrations are created in the implant.

Inside the implant, a piezoelectric Piezo Power™ transducer converts the signal to vibrations and sends them through the implant to the bone.

The vibrations are transmitted through the skull to the inner ear, where they are picked up by the hearing nerve and sent to the brain to be interpreted as sound.

What are the benefits?

Research and decades of experience have shown that bone conduction solutions may help you or your child: 

  • Improve your understanding of speech in quiet7 to enjoy quiet moments.
  • Hear better in noisy situations for all the busy parts of life.8,9,10
  • Enjoy clear and natural sound (compared to hearing aids) by bypassing the blocked or impaired part of the ear to reduce the amount of amplification needed to hear better.11

Try a bone conduction solution, then decide

If you've been told a bone conduction implant is a treatment option for your hearing loss, you can experience the benefits of bone conduction hearing with Baha® Start, our non-surgical bone conduction solution, before deciding whether to get an implant.

You can trial a Baha sound processor before surgery, either with your hearing health professional or at home.

Find a hearing specialist near you


Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always follow the directions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

For a full list of Cochlear’s trademarks, please visit our Terms of Use page.

In Australia, Cochlear™ Nucleus® implant systems are intended for the treatment of moderately severe to profound hearing loss.

In Australia, Baha® bone conduction implant systems are intended for the treatment of moderate to profound hearing loss.

In Australia, the Cochlear™ Osia® System is indicated for patients with conductive, mixed hearing loss and single-sided sensorineural deafness (SSD) aged 10 years and above with up to 55 decibels sensorineural hearing loss. Patients should have sufficient bone quality and quantity to support successful implant placement. Surgery is required to use this product. Any surgical procedure carries risk.

For Cochlear™ Nucleus®, Osia® and Baha® systems: This product is not available for purchase by the general public. For information on funding and reimbursement please contact your health care professional.

Any testimonial featured on this website is intended for an Australian audience only.


  1. Lewis A, Vanaelst B, Hua H, et al. Success rates in restoring hearing loss in patients with chronic otitis media: A systematic review. Laryngoscope Investig Otolaryngol. 2021 May 12;6(3):522-530.
  2. Berenholz L, Burkey J, Lippy W. Total ossiculoplasty: advantages of two-point stabilization technique. Int J Otolaryngo. 2012;346260: 9.
  3. Ahmad N, Etheridge C, Farrington M, Baguley DM. Prospective study of the microbiological flora of hearing aid moulds and the efficacy of current cleaning techniques. J Laryngol Otol. 2007;121(2):110–3.
  4. Karaca CT, Akçay SS, Toros SZ, et al. External auditory canal microbiology and hearing aid use. Am. J. Otolaryngol. 2013;34(4): 278-281.
  5. Nelissen RC, Stalfors J, de Wolf MJ et al. Long-term stability, survival, and tolerability of a novel osseointegrated implant for bone conduction hearing: 3-year data from a multicenter, randomized, controlled, clinical investigation. Otol Neurotol. 2014, 35(8):1486-91
  6. Cochlear Limited. Osia OSI200 Implant Technical Brief. Cochlear Limited, Sweden. 2020; D1602089.
  7. Lau K, Scotta G, Wright K, Proctor V, Greenwood L, Dawoud M, Ray J. First United Kingdom experience of the novel Osia active transcutaneous piezoelectric bone conduction implant. Eur Arch Otorhinolaryngol. 2020;277(11):2995-3002.
  8. Mylanus EAM, Hua H, Wigren S, et al. Multicenter clinical investigation of a new active osseointegrated steady-state implant system. Otol Neurotol. 2020;41(9):1249-1257.
  9. Goycoolea M, Ribalta G, Tocornal F, et al. Clinical performance of the Osia™ system, a new active osseointegrated implant system. Results from a prospective clinical investigation. Acta Otolaryngol. 2020;140(3):212-219.
  10. Briggs R et al. Clinical performance, safety and patient reported outcomes of an active osseointegrated steady-state implant system. Otol. Neurotol. 2022 Aug;43(7):827-834.
  11. de Wolf MJ, Hendrix S, Cremers CW, Snik AF. Better performance with bone-anchored hearing aid than acoustic devices in patients with severe air-bone gap. Laryngoscope. 2011;121(3):613-6.