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Hearing Aids versus Bone Anchored Hearing Aids (BAHA): Understanding your options

Kimberley Bradshaw - Head of Marketing
Written By:
Kimberley Bradshaw

Head of Online Medical Content

David - Audiologist for Hearing Aid UK
Audiologically Reviewed By:
David

Audiology Expert at Hearing Aid UK

Updated: 28th November 2025
Updated and medically reviewed: 28th November 2025 in: Hearing Aid Technology
Hearing aids vs bone anchored hearing aids (BAHA)

Hearing Aids vs Bone-Anchored Hearing Aids (BAHA)

What's the difference between the two?

 

Last Hearing Aid UK Update:  28/11/2025

Overview

If you've been told that conventional hearing aids might not work for you, or if you have certain types of hearing loss that make traditional aids problematic, you've probably come across something called a bone-anchored hearing aid, or BAHA.

The choice between standard hearing aids and bone-anchored systems can feel rather daunting, so let's break down what each option actually involves and who might benefit from which approach.

 

How standard hearing aids work

Traditional hearing aids do exactly what the name suggests: they amplify sound and deliver it through your ear canal to your eardrum.

The sound travels the conventional route through the outer ear, vibrating the eardrum, then moving through the tiny bones in your middle ear, and finally reaching the inner ear, where it's converted into signals your brain can understand.

Modern hearing aids are remarkably sophisticated devices that can process millions of calculations per second, distinguish speech from background noise, and automatically adapt to different listening environments.

They come in various styles, from tiny devices that sit deep in your ear canal to discreet Behind-the-Ear (BTE) models, and they work brilliantly for the vast majority of people with hearing loss.

Related reading:  BTE hearing aids

 

How bone-anchored hearing aids work

Bone-anchored hearing aids take a completely different approach. Rather than sending sound through your ear canal, they bypass the outer and middle ear entirely and send vibrations directly to your inner ear through the bones of your skull.

This might sound rather unusual, but it's actually based on how we naturally hear some sounds. You've probably noticed that your own voice sounds different when you hear a recording of it, and that's partly because you normally hear yourself through bone conduction as well as through the air.

A BAHA system typically consists of a small titanium implant that's surgically placed in the bone behind your ear, with a sound processor that attaches to this implant. The processor picks up sound, converts it to vibrations, and transmits these directly through your skull bone to your inner ear.

 

When standard hearing aids are the right choice

For most people with hearing loss, particularly age-related hearing loss or noise-induced hearing loss, conventional hearing aids are the obvious and best solution.

If your ear canals are healthy, your eardrums work properly, and your middle ear bones can transmit sound effectively, there's really no reason to consider anything more invasive.

Standard hearing aids are also the clear winner if you value simplicity and non-invasive solutions. There's no surgery involved, no healing period, and if you decide hearing aids aren't for you during the trial period, you simply stop wearing them.

They're also typically less expensive than bone-anchored systems, though this varies depending on the technology level you choose.

 

When bone-anchored systems make sense

BAHAs are specifically designed for people who cannot use conventional hearing aids effectively. This typically includes three main groups:

  • People with chronic ear conditions - If you have persistent ear infections, a constantly draining ear, or a condition that makes wearing anything in your ear canal problematic or impossible, a BAHA bypasses all of these issues entirely.

You're not putting anything in your ear canal, so there's no risk of trapping moisture or bacteria.

  • Those with conductive or mixed hearing loss - If your inner ear (cochlea) works reasonably well but sound isn't reaching it properly due to problems with your outer or middle ear, BAHAs can be remarkably effective.

They deliver sound directly to the functioning part of your hearing system, sidestepping the problematic bits.

  • People with single-sided deafness - If you have no usable hearing in one ear but normal hearing in the other, a BAHA can pick up sounds from your deaf side and transmit them through your skull to your working ear.

This helps with sound localisation and hearing in noisy environments when someone's speaking from your deaf side.

 

The practical differences

The surgical aspect of BAHAs is probably the most significant consideration. You're looking at a minor surgical procedure, a healing period of several months before the processor can be fitted, and a permanent titanium implant in your skull.

For some people, this feels like a big commitment, but for others who've struggled for years with conventional aids that don't work for them, it's absolutely life-changing and worth every bit of the process.

Daily maintenance differs, too, as with BAHAs, you need to keep the implant site clean, which becomes a simple daily routine. Standard hearing aids require regular cleaning of the devices themselves and occasional replacement of domes or wax filters. Neither is particularly onerous once you're used to it.

Battery life and costs are fairly comparable between modern hearing aids and BAHA processors, though the initial cost of a BAHA system is typically higher due to the surgical component.

Related reading:  Hearing aids with long battery life

 

Conclusion

The good news is that this isn't usually a difficult decision to make because the circumstances tend to make it fairly obvious which option suits you. If conventional hearing aids work well for you, there's no reason to consider anything more invasive.

If they don't work, whether because of chronic ear conditions, the type of hearing loss you have, or because you have single-sided deafness, then a BAHA might be exactly what you need.

Your audiologist and, if necessary, an ear, nose and throat (ENT) specialist will be able to assess your specific situation and recommend the most appropriate option. Many people try conventional hearing aids first (if suitable) simply because they're less invasive, and only move to considering a BAHA if traditional aids prove problematic.

Both technologies have helped countless people hear better and reconnect with the world around them. The right choice depends entirely on your individual hearing loss, ear health, lifestyle, and personal circumstances. Whatever route proves right for you, the important thing is addressing your hearing loss rather than leaving it untreated.

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Bone-Anchored Hearing Aids Vs Hearing Aids

Our network of over 200 qualified, registered audiologists across the UK can provide expert advice on all types of hearing solutions, including both conventional hearing aids and guidance on bone-anchored systems.

If you'd like to discuss your hearing concerns or aren't sure whether conventional aids have worked as well as they should, get in touch.

Sometimes all it takes is a conversation with someone who understands the options to make everything considerably clearer.

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Written by Kimberley Bradshaw

Meet Kimberley Bradshaw, Head of Online Medical Content

Kimberley Bradshaw started her love of content creation, as a freelancer for many well-established medical brands.  She has written about hearing healthcare for several UK and US online health and wellness publications since.  Connect with Kimberley on LinkedIn.

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FAQs

What is the best hearing aid model for me?

In general, any audiologist will always recommend to you the hearing aid model that best suits your needs. Here is a useful checklist to make sure that is the case.

  • Audiologist's level of knowledge: The audiologist you have seen will hopefully have a wide knowledge of all available hearing aids; however, some will only be familiar with a small number of brands and, therefore, may not really be in a position to know which model is the best for you. It is OK to challenge their recommendation and ask them to justify why this particular brand is the one for you.
  • Do research: Read about the hearing aid that was recommended. Does it seem like it will suit your lifestyle? Does it have more or fewer features than you need? 
  • Be aware of sales targets: Many high street retailers have specific tie-ins to a particular manufacturer/brand. The hearing aid they have suggested may still be the correct one for you, but do your research so that you know why they might have recommended it.
Do I need one hearing aid or two?

If you have significant hearing loss in both ears, you should be wearing two hearing aids. Here are the audiological reasons why:

Localisation: The brain decodes information from both ears and compares and contrasts them. By analysing the minuscule time delays as well as the difference in the loudness of each sound reaching the ears, the person is able to accurately locate a sound source. 

Simply put, if you have better hearing on one side than the other, you can't accurately tell what direction sounds are coming from.

Less amplification is required: A phenomenon known as “binaural summation” means that the hearing aids can be set at a lower and more natural volume setting than if you wore only one hearing aid.

Head shadow effect: High frequencies, the part of your hearing that gives clarity and meaning to speech sounds, cannot bend around your head. Only low frequencies can. Therefore, if someone is talking on your unaided side, you are likely to hear that they are speaking, but be unable to tell what they have said.

Noise reduction: The brain has its own built-in noise reduction, which is only really effective when it is receiving information from both ears. If only one ear is aided, even with the best hearing aid in the world, it will be difficult for you to hear in background noise as your brain is trying to retain all of the sounds (including background noise) rather than filtering them out.

Sound quality: We are designed to hear in stereo. Only hearing from one side sounds a lot less natural to us.

Fancy some further reading on this topic?  You can read about why two hearing aids are better than one in our article, hearing aids for Both Ears, here

What are the benefits of rechargeable hearing aids?

For most people, the main benefit of a rechargeable hearing aid is simple convenience. We are used to plugging in our phones and other devices overnight for them to charge up.  Here are some other pros and cons:

For anybody with poor dexterity or issues with their fingers, having a rechargeable aid makes a huge difference, as normal hearing aid batteries are quite small and some people find them fiddly to change.

One downside is that if you forget to charge your hearing aid, then it is a problem that can't be instantly fixed. For most, a 30-minute charge will get you at least two or three hours of hearing, but if you are the type of person who is likely to forget to plug them in regularly, then you're probably better off with standard batteries.

Rechargeable aids are also a little bit bigger and are only available in Behind-the-Ear models.

Finally, just like with a mobile phone, the amount of charge you get on day one is not going to be the same as you get a few years down the line. Be sure to ask what the policy is with the manufacturer's warranty when it comes to replacing the battery.

Are Behind-the-Ear hearing aids better than In-the-Ear hearing aids?

For most people, the answer is yes. But it's never that simple.

The majority of hearing problems affect the high frequencies a lot more than the low ones. Therefore, open fitting hearing aids sound a lot more natural and ones that block your ears up can make your own voice sound like you are talking with your head in a bucket. Therefore, in-ear aids tend to be less natural.

However, the true answer is we can't tell until we have had a look in your ears to assess the size of your ear canal, and until we have tested your hearing to see which frequencies are being affected.

People with wider ear canals tend to have more flexibility, also there are open fitting modular CIC hearing aids now that do not block your ears.

There is also the age-old rule to consider, that a hearing aid will not help you if it's sat in the drawer gathering dust. If the only hearing aid you would be happy wearing is one that people can't see, then that's what you should get.

Most people can adapt to any type of hearing aid, as long as they know what to expect. Have an honest conversation with your audiologist as to what your needs are.

What are channels, and how many do I need?

Generally speaking, six or more. Unless it's none at all.  The number of channels a hearing aid has is often a simplistic way an audiologist will use to explain why one hearing aid is better than another, but channels are complex, and it is really not that straightforward.  Here are some reasons why:

Hearing aids amplify sounds of different frequencies by different amounts. Most people have lost more high frequencies than low, and therefore need more amplification in the high frequencies. The range of sounds you hear is split into frequency bands or channels, and the hearing aids are set to provide the right amount of hearing at each frequency level.

Less than six channels, and this cannot be done with much accuracy, so six is the magic number. However, a six-channel aid is typically very basic with few other features and is suitable only for hearing a single speaker in a quiet room. The number of channels is not what you should be looking at; it's more the rest of the technology that comes with them.

As a final note, different manufacturers have different approaches. One method is not necessarily better than any other. For example, some manufacturers have as many as 64 channels in their top aids. Most tend to have between 17 and 20. One manufacturer has no channels at all.

What's covered in a manufacturer's warranty?​

Manufacturer's warranties typically last between 2-5 years, depending on the brand and model, and cover defects in materials and workmanship. This includes repairs for component failures, electronic malfunctions, and manufacturing defects, but excludes damage from misuse, accidents, or normal wear. Most manufacturers also include loss and damage insurance for the first year.

We handle all warranty claims on your behalf, liaising with manufacturers and ensuring you get replacement devices quickly when needed. This comprehensive warranty coverage, combined with our lifetime aftercare, gives you complete peace of mind.

How much does the hearing test cost?

Our hearing tests are completely free, whether at our clinics or in your home. Unlike other providers who charge £30-£100 for home visits, we believe hearing healthcare should be accessible without financial barriers. Our comprehensive assessments include examination by a registered audiologist, audiogram results, and personalised recommendations.

All testing, future adjustments, and ongoing support are included at no extra cost. While NHS tests are also free, typical 6-week waiting periods often lead people to seek immediate private testing. We provide prompt, professional assessments that fit your schedule and budget.

Do you offer home visits, and are they included in the price?

Yes, we offer completely free home visits throughout the UK, and this service is included in our prices with no additional charges. Home visits are particularly valuable for people with mobility issues, busy schedules, or those who simply prefer the comfort and convenience of their own environment.

Our audiologists can conduct full hearing tests, fit hearing aids, and provide ongoing support in your home.  This service sets us apart from many providers who either don't offer home visits or charge extra for them.

Why are your hearing aids cheaper than what I'd pay on the high street?

We can offer prices up to 40% lower than high street retailers because of our business model. As a network of 200+ independent audiologists, we don't have the massive overheads of large retail chains - no expensive high street premises, no sales targets pushing audiologists to sell the most expensive options, and no costly marketing campaigns.

However, we maintain the same buying power as the big chains because we purchase on behalf of our entire nationwide network. This means you get access to the same premium hearing aids with professional service, but at genuinely competitive prices.

How long do I have to try the hearing aids before committing to keep them?

We offer a comprehensive 60-day money-back guarantee, which gives you twice the industry standard time to properly assess whether your hearing aids are right for you. This extended period recognises that adjusting to hearing aids takes time, and your brain needs several weeks to adapt to the amplified sounds.

Unlike many providers who offer just 30 days, we believe 60 days gives you the confidence to test your hearing aids in all the situations that matter to you - from quiet conversations at home to busy restaurants and outdoor activities.

Other pages you might find useful

Audiology Home Visits - For free in the UK
View Audiology Home Visits - For free in the UK
Best hearing aids available in the UK for 2025
View Best hearing aids available in the UK for 2025
Hearing Tests at Home in the UK for free
View Hearing Tests at Home in the UK for free
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