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Bone Conduction System Comparison

Transcutaneous Bone Conduction Systems

What are the differences between direct and indirect bone conduction systems? Does it make a difference?

Actually, while the names are similar, direct and indirect bone conduction systems are completely different concepts. Bone conduction systems can be divided into those that directly stimulate the bone versus those where the vibration is applied to the skin. Passive bone conduction systems are actually more similar to hearing glasses as they share the same way of stimulation. The difference to hearing glasses is that passive bone conduction systems are held by an implanted magnet rather than by the arm of a spectacle.

Active vs. Passive Bone Conduction Systems

Advantages of the BONEBRIDGE

  • The BONEBRIDGE provides more output, making it more suitable for mixed hearing loss and single-sided deafness.
  • The BONEBRIDGE provides stable output, independent of skin thickness and hair growth.
  • The BONEBRIDGE does not require skin pressure for stimulation.
  • The BONEBRIDGE is comfortable to wear, leading to 50% longer wearing time per day (extra 3.5 hrs/day). This adds up to over 1250 hours more aided hearing per year.
  • The BONEBRIDGE audio processor has a much lower profile and is therefore more inconspicuous.
  • Published and presented clinical experience shows excellent results and high user satisfaction. Very low complication rates have been confirmed. 

Comparing the Systems

Comparing the Systems: Active Bone Conduction
Comparing the Systems: Passive Bone Conduction

Implant generates vibrational stimulation that is directly applied to the bone ("direct drive bone conduction stimulation"). Optimum BC sound transmission.

Sound processor generates stimulation that is applied from outside onto the skin (like hearing glasses or BC-head-bands). Skin attenuates sound before it reaches the bone.

Audio processor picks up sound and generates signal that is transmitted to the implant. Implant accepts signal and BC-FMT generates vibration ("active implant") that is applied directly to bone. Transducer ("BC-FMT") is part of the implant and is directly attached to the bone.

Sound processor picks up sound and generates vibration that is applied onto the skin. Sound processor needs transducer and plate that adds to the sound processor size and weight. Implant's main function is to hold vibrating sound processor in place and generate skin pressure ("passive implant"). The plate is held by an implanted magnet.

Average output up to 14.5 dB higher (average of 500 Hz, 1 kHz, 2 kHz and 4 kHz). In the higher requencies, output 43 dB – 55 dB higher (6 kHz and 8 kHz, respectively)1

Lower output due to skin attenuation.

Wearing Comfort
Low pressure on skin, enough to hold the audio processor in place. Low weight audio processor: 8 g (incl battery) High wearing comfort and longer daily use most likely due to low skin pressure. 50% longer wearing time (an extra 3.5 hrs per day) compared to passive systems3.

Necessary skin pressure around 4 times higher than for active system2. Sound processor weight: 15 g – 23 g (incl. plate and battery, depending on system). Limited wearing time.

1 OFL-60 data (6 mm skin, no hair). BONEBRIDGE: MED-EL internal measurements. (Baha Attract data: Cire and Flynn, presentation at AAA, Orlando, Florida, March 2014)

2 Skin pressure of the BONEBRIDGE audio processor SAMBA* of typically 0.1  N/cm2 (MED-EL internal measurements). For the Baha Attract, a skin pressure range of 0.4 – 0.6 N/cm2 has been reported (Wigren, Osseo 2013, Newcastle, June 2013).

3 Average wearing time in the BONEBRIDGE clinical study was 10.6 hrs/day. For the Baha Attract an average wearing time of 7 hrs was reported (Cochlear product presentation, LION Broadcast, 10 December 2013
 *SAMBA is pending regulatory approval

Home TECHNOLOGY LEADER Active vs. Passive
© 2018 MED-EL
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