Bone conduction treatment determination and care pathway

Treatment determination and care pathway

Follow these steps for a consistent and streamlined candidacy and treatment process. For more details, please go to the Resources section to download the Bone Conduction Protocol.

 

 

Cochlear Bone Conduction Solutions candidacy, evaluation and fitting protocol

Candidacy identification

Assess audiological status, medical etiologies and impact to daily life to determine if bone conduction may be an appropriate solution. Consider the following:

• Type of hearing loss (conductive or mixed hearing loss, single-sided deafness)
• Common etiologies (microtia/atresia, chronic otitis media, middle ear dysfunction/ossicular disease, or conditions contraindicating reliable use of conventional hearing aids)
• Daily interactions (struggle with communication, need for reliable and consistent hearing, and quality of life)

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Demonstration and evaluation

Allow patients to experience hearing through bone conduction, providing patients with confidence in positive outcomes and appropriate expectations with a bone conduction solution.

• Conduct a demonstration to allow patients to experience hearing through bone conduction.
• Conduct a bone conduction evaluation to assess hearing and speech outcomes to assist with treatment determination, help predict outcomes, and collect a baseline for continued monitoring.
• Set appropriate expectations for patient outcomes through counseling.

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Treatment determination

Develop an audiological treatment plan in conjunction with medical treatment, to meet patient lifestyle needs.

Patient qualification Conductive or Mixed Hearing Loss (CHL or MHL) with PTA bone conduction threshold ≤55 dB (500, 1000, 2000, 3000 Hz) Meets age requirement*† Motivated to proceed with a surgical hearing implant solution

Recommendation Cochlear™ Osia® System

Patient qualification Single-sided deafness Poor ear – Non-functional hearing (i.e. profound hearing loss) Good ear – PTA air conduction threshold ≤ 20 dB SNHL (i.e. normal hearing, 500, 1000, 2000, 3000 Hz) Meets age requirement*† Motivated to proceed with a surgical hearing implant solution

Recommendation Cochlear Osia System or Conduct a cochlear implant evaluation for a Cochlear Nucleus® System: Learn more

Patient qualification Conductive or Mixed Hearing Loss (CHL or MHL) with PTA bone conduction threshold ≤55 dB (500, 1000, 2000, 3000 Hz) No age requirement Motivated to proceed with a non-surgical hearing solution

Recommendation Cochlear™ Baha® Start with Baha 6 Max Sound Processor worn with a SoundArc™ or Softband

Additional recommendations for specific cases

Patient with factors that preclude an Osia System

Recommendation Cochlear™ Baha® Connect with Baha 6 Max Sound Processor

Patient with bone conduction PTA threshold between 55-65 dB

Recommendation Cochlear Baha Connect with Baha 5 SuperPower Sound Processor or Conduct a cochlear implant evaluation for a Cochlear Nucleus® System: Learn more

Patient suitable for a Baha Solution and requires additional clearance between the skin and the Baha 6 Max Sound Processor

Recommendation Consider the Baha 6 Max Sound Processor with the 2mm Extended snap coupling, instead of the LowPro™ snap coupling

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Patient treatment, fitting and monitoring

Provide improved sound quality and speech intelligibility with comfortable wear for the recipient to use the device to their maximum potential.

• Cochlear Fitting Software allows for customization of the bone conduction fitting prescription and configuration of the sound processor to match the patient’s thresholds, profile, and individualized listening needs.
• Complete site checks as appropriate for the bone conduction solution at every visit and counsel the patient to perform regular site checks at home and report any issues immediately.
• The same outcomes measures used for candidacy can be used post-fitting to validate the fitting and allow comparison to the pre-treatment baseline and previous post-fitting intervals to monitor performance.
• Setting appropriate expectations is not only important in the candidacy process, but on an ongoing basis in order to help patients see their successes, identify their challenges, and continue to make progress.
• Consider utilizing available Remote Care solutions to provide quality care without the need for patients to visit the clinic.