An important piece of information for patients is that if they for whatever reason are not satisfied with the BAHA solution, removing the implant is easy.

[citation needed] By bypassing the outer or middle ear, BAHA can increase hearing in noisy situations and help localise sounds.

In addition to improved speech understanding, it results in a natural sound with less distortion and feedback compared with conventional hearing aids.

If the hearing loss is significant an air conduction aid may have difficulty overcoming the dysfunction of the eardrum and middle ear bones.

Bone conduction hearing device bypassing the middle ear may be a more appropriate treatment for these patients.

Conventional ear surgery involves a risk of hearing loss due to the surgical procedure.

An extended trial of a BAHA system with a headband prior to surgery led to more realistic expectations.

[14] Irritation in the external ear canal due to inflammation or eczema may be a condition for which a conventional air conduction aid is not an appropriate treatment.

Treacher Collins syndrome patients may have significant malformations with ossicular defects and an abnormal route of the facial nerve.

[15][16][needs update] Children with certain syndromes may have a slighter build, thinner bone, or unusual anatomy.

In the U.S., the Food and Drug Administration only approves BAHA implantation of children aged five years or older.

[3] Other drawbacks of BAHA include accidental or spontaneous loss of the bone implant, and patient refusal for treatment due to stigma.

[17] The bone behind the ear is exposed through a U-shaped or straight incision or with the help of a specially designed BAHA dermatome.

The hole is widened and the implant with the mounted coupling is inserted under generous cooling to minimize surgical trauma to the bone.

The rationale for this is to reduce the mobility between implant and skin to avoid inflammation at the penetration site.

The infections seen early during the development of the surgical procedure could perhaps be explained by the lack of seal between implant and abutment allowing bacteria to enter the space.

Direct bone conduction through a vibrator attached to a skin-penetrating implant addresses these disadvantages.

In 1977, the first three patients were implanted with a bone-conduction hearing solution by Anders Tjellström at the Ear, Nose, and Throat Department at Sahlgrenska University Hospital in Gothenburg, Sweden.

Osseointegration has been defined as the direct contact between living bone and an implant that can take a load, with no soft tissue at the interface.

Most common are the BAHA from Australian company Cochlear, and the Ponto from Danish manufacturers Oticon Medical.