from Osia to Bonebridge?

[Maud]

Hello,

I have been wearing a BAHA for nearly 15 years, and I have 9 months of experience using the OSIA system before the implant was extracted due to skin retractation leaving the implant visible. Meanwhile I had a series of painful infections remediated with antibiotics. I am now considering a MEDEL Bonebridge implant.

Below is a background of my journey with the OSIA

While the audiologist where I lived had mentioned that I had the choice between MEDEL Bonebridge and COCHLEAR OSIA; the hospital I was allocated to after moving to a new region did not provide me with a choice, only the OSIA system. I mistakenly thought that the OSIA was chosen because I had advocated the need to use the processor in water (mom of 2/water safety), and I knew the OSIA could be worn with a water kit. I was given no medical nor technical information about the OSIA, except that there would be “a little bump” under the skin (I thought it would be where the magnet is located!). I then received a letter with an operation date.

The OSIA adventure came with many shocks.

The implant was protruding much more than I had been prepared for (the audiologist had shown me a mannequin head with the Medel Bonebridge which provides a ‘flat surface’, something that I had remembered!).

The OSIA implant had been placed too close to the ear with a stretched-out skin that created an unreachable and unmanageable crater, perfect for infections.

Two days after activation with the processor, I thought that the processor was defective when it stopped working. I replaced the battery and carried on. Again, the same story. After visiting the OSIA FB group, I discovered that the battery lasted on average 2 days. The water kit for the OSIA allows the processor to function…an hour! Pretty useless in my opinion.

A slight bumping om the protruding OSIA implant when, for example cuddling with/carrying my child, was very painful.

I could barely wear the OSIA with a bike helmet and this with the processor not sitting entirely on the magnet and the helmet slightly pushed on the side. I cycle a lot (to work/with kids on the back) and I really like (mostly for safety reasons) to cycle and hear!

Between moving house, settling the kids into a new life, studying and starting a new job I felt pressured into saying yes to the OSIA surgery (“if you say ‘no’ 2 times we will remove you from our patient list to get the OSIA”). I went to my surgery not knowing what I was saying yes to.

As of today, there are 3 alternatives for a transcutaneous bone implant: Medel Bonebridge, Cochlear OSIA and Oticon Sentio. I consider it important to assess which implant is potentially best for you from both a medical and practical point of view (user experience /different needs), rather than trying to find which one is best in the absolute. And this is the most difficult part. This is not that you can bring back the product to the shop, if unsatisfied. It is now part of you.

As far as I am concerned, the OSIA was an extremely bad choice from a medical perspective. I had had several cholesteatoma operations with resulting scare tissue and very thin skin. Stretching a thin skin with a lot of scar tissue on the OSIA implant was a recipe for disaster, which it was.

Because the OSIA sits on the skull and protrudes, it is much more prone to shock and damage especially if one is a kid playing football, or an active adult. This is something that should be also considered.

On a practical level, the lack of flexibility of the OSIA implant at the time of operation leaves little maneuver to position the implant to accommodate, for ex. a bicycle helmet, without even mentioning the protruding implant. For me the transcutaneous bone implant had/has the opportunity to improve my quality of life. This meant having the possibility to be in water and hear. This meant having the possibility to wear a bike helmet and hear while cycling. And of course, better hearing all around. Medel Bonebridge implant is much more flexible and therefore can allow for an informed placement at the time of surgery (of course, if the surgeon understands that this is important and tries to cater for your needs, which is another story). That the battery lasts significantly longer, as well as with the water kit, is also an important plus, as far as I am concerned.

By the way, I would be happy to get feedback on the water kit for samba 2 from a user perspective!

Last but not least, Medel Bonebridge seems to have much more medical and practical information released for the potential patient than what is available for Cochlera OSIA. It may have changed since, but nowhere could I see a photo of how the OSIA protrudes (the photos shown are very forgiving) nor information on the battery life for the processor.

The newly released Oticon Sentio is even smaller allowing for easy surgery. The processor is thin, light and may allow for less pressure on the skin due to a bumpy surface. As of today, it does not come with a water kit.