Treatments: Osia implant for hearing loss
What is osia?
Osia is a device to improve hearing in people with certain types of hearing loss. The system, shown at left, consists of a surgically implantable component (shown in silver) and an external component (shown in black at left). The external piece adheres over the skin to the side of the head by a magnet. This external piece may be removed and replaced easily, and the user may choose one of several available colors
Schematic depiction of normal air conduction hearing.
how is osia different from a hearing aid?
The Osia implant sends vibrations through the skull bone to the inner ear (cochlea), which then translates these vibrations into a nerve signal that the brain uses. Traditional hearing aids amplify the wound waves in the air, augmenting the movements of the eardrum and middle ear bones, which themselves transmit vibrations to the inner ear. Essentially, both a traditional hearing aid and an Osia send sound waves to the inner ear, but the Osia bypasses the eardrum and tiny middle ear bones, going instead straight to the inner ear.
Schematic depiction of bone conduction hearing with an Osia system. The external sound processor translates external sound waves to a digital signal, which is passed through the skin to the Osia implant, which vibrates to send sound energy through the skull bone to the inner ear. This process bypasses the auditory canal, tympanic membrane, and the middle ear bones (malleus, incus, and stapes).
Under what circumstances is Osia beneficial?
There are two situations in which one might benefit from Osia:
A patient with one deaf ear, and the other ear hears normally.
A patient in which both ears have moderate hearing loss. Hearing should not be worse than 55 dB on average across different frequencies.
How does osia work?
• Animated YouTube video by Cochlear company describing the Osia technology.
The cornerstone technology of the Osia is use of a piezoelectric material in the implant. This allows the implanted device to vibrate the skull according to signal sent by the external sound processor. These skull bone vibrations translate directly to the inner ear, which picks up the vibrations as sound.
Unlike electromagnetic transducers first designed for external use, the Osia piezoelectric transducer transducer has no movement between parts that can cause wear over time. Furthermore, the transducer has a digital link that transfers 100% of the signal with minimal risk of interference.
for patients deaf in on ear (single sided deafness), which is better, Osia or cochlear implant?
What are the activity limitations with an osia implant?
Swimming and watersports may be undertaken with the device in use, provided that the external piece is placed in the provided water-tight case, and the user stays less than 9 1/2 feet depth. Physical exertion and non-contact sports may be undertaken, though a headband is recommended to avoid accidental loss of the external piece. Activities with high impact risk are not recommended with an Osia implant. If an Osia recipient decides to undergo such activities it is recommended they wear a helmet that leaves enough space over the implant site to prevent any external pressure being applied to the implant. Such a helmet may help to reduce impact forces but not fully protect the implant system. The removable external components of the device should not be worn during such activities. If someone were to undertake contact sports, such as soccer for example, the implant company does not guarantee, warrant or promise that the implant and related equipment will continue to function as expected or as it has in the past under such circumstances.
what other surgeons should know when a patient has an osia implant
A patient with an Osia who may undergo another procedure in the head and neck area, whether it be for skin cancer, cervical spine surgery, or brain surgery should inform their surgeon of this. The surgeon needs to know that a certain type of device used to control bleeding, called monopolar electrocautery, may damage the Osia implant if it is used in the head and neck area.
Can a patient undergo medical imaging with an Osia implant?
Plain x-rays, ultrasounds, and computed tomography (CT/CAT) scans are all safe with an Osia implant in place.
After Osia implantation, you may undergo Magnetic Resonance Imaging (MRI) with use of the use the MRI Cochlear MRI kit. Depending on the generation of the implant components, the MRI magnet strength may need to be 1.5 Tesla or less. Reference for maximum MRI magnet strength based on the generation of Osia components may be found here. Alternatively, if you were to have your implant surgically removed, there would no longer be any restriction related to Osia that would prevent you from undertaking an MRI. These limitations are true regardless of the body part undergoing MRI imaging, whether brain, ankle, or elsewhere.
How long does the Osia implant last?
The Osia implant has a 10 year warranty, but is designed to last a lifetime. The Osia device is newer than cochlear implants, but the cochlear implants made by the same company that makes Osia (Cochlear) uses similar manufacturing techniques, and many of the first wave of cochlear implant recipients are still utilizing their implant from 30+ years ago. In the meantime, the manufacturing process has continued to improve. There is no internal battery in the Osia, so there is no chance of a dead battery requiring surgery.
Can a patient convert from a bone anchored hearing aid (baha) to an osia?
Yes, this can be done. The medical indications for BAHA are very similar to those for Osia, so most individuals wishing to change from BAHA to Osia may do so. This requires two separate operations, with the first removing the old BAHA and closing the skin perforation, and about a month later a second procedure to implant the Osia.
Osia implant (approximate fastest) timeline:
Audiological and ENT surgeon evaluation. Osia implant may be offered. If chosen, insurance authorization, scheduling, and pre-testing is done.
+2-4 weeks later: Surgery
+1 week later: Post-operative visit, suture removal, wound check
+3 weeks later: Programming of device. Begin usage!
+4 weeks and onwards: Audiological re-checks and adjusting programming as needed.
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