Adult Bone Conduction Hearing Systems (BCHS)

The Team

Amanda Collett – Senior Chief Audiologist and BCHS Team Lead.

Maureen Chapman – Senior Audiologist

Karen Foxall – Senior Audiologist


What is a bone conduction hearing system?

A bone conduction hearing system is a type of hearing aid which sends sound straight to the hearing organ in the inner ear, bypassing any blockages of the middle or outer ear.

Bone conduction hearing systems are designed to use your body’s natural ability to transfer sound through bone conduction. The sound processor converts sounds into vibrations, which are then sent through your skull bone and directly in to your inner ear.

Bone conduction systems consist of three parts:

  1. A small (3 or 4mm) titanium implant that sits in the bone behind the ear.
  2. Attached to the implant is a titanium post (an abutment) that juts out through the skin.
  3. A sound processor which clips on to the abutment.


Common examples of when a bone conduction hearing system may be beneficial include:

  • absent or malformed ears (called microtia or atresia),
  • perforated eardrum(s)
  • problems with the middle ear bones
  • recurrent ear infections
  • ear canals too small for “behind the ear” hearing aids
  • hearing loss in one ear

The titanium implant

The abutment without the sound processor

The abutment with the sound processor attached.


The sound processor connects easily to the abutment with a simple click. Whenever you need to remove it – before showering and sleeping etc. – just click it off again.

The abutment is fixed into the skull via minor surgery. The surgery for this is likely to be carried out under local anaesthetic (i.e. while you are awake) in the Day Procedure Unit.

You will have the opportunity to discuss this with your ENT Consultant.

some examples of Bone Conduction sound processors

Pictured below is a magnetic version of sound processor. It requires slightly more invasive surgery and is not suitable for all patients.

The surgery to implant the magnet leaves a scar and requires more stitches and healing time. The surgery for this system requires a general anaesthetic (i.e. you will be asleep).

You will be able to discuss this with your ENT Consultant.

How can you be referred?

New patients are referred by their GP to ENT, who can then refer into the BCHS clinic for an assessment, if appropriate. An Audiologist can also refer current hearing aid users into the service if they feel a BCHS may be beneficial. If you are already a BCHS user then you can refer yourself into the clinic at any time by contacting the Audiology department. Telephone 01603 287284 (Monday to Friday 8.00am until 5.00pm)


The Appointment Pathway


This is usually a two hour appointment which involves assessing your suitability for a BCHS. This will include testing your hearing ability with a BCHS on a headband. Following this appointment, if suitable, you will have the chance to trial this for two to three weeks at home. You will be asked to fill in a trial log during this time.

 Post-Trial appointment 

This is to discuss with the audiologist how helpful you found the device during the trial and to hand in your trial log. You will be required to hand in your trial device at this appointment.

The multi-disciplinary team meeting

If you wish to be considered for a bone conduction hearing system, your case will be taken to a multi-disciplinary team meeting, where surgeons and audiologists will decide whether you are likely to benefit sufficiently from a bone conduction device.

You will receive a letter informing you of the decision. If suitable, you will be put onto the waiting list for surgery.

Your appointment with the Oral and Maxillofacial Department

This appointment is to plan the siting of the fixture for the bone conduction hearing system. A technician will take an impression of the ear to be aided and the surrounding area. This is made into a template which is marked with the position for the fixture. The template will be taken to the operating theatre when you have the surgery.

Surgery to implant the fixture

This is usually done in the Day Procedure Unit by your ENT surgeon and takes around half an hour, so you will be able to go home on the same day. The surgery uses no stitches and leaves no scarring. Following the surgery a dressing and a healing cap is put onto the abutment for approximately 10 days. This protects the surgery site and encourages the healing process.

Healing cap over abutment

Abutment 1 week post-op

Abutment 3 weeks post-op


Ear, Nose and Throat (ENT) Clinic appointment

This usually follows approximately ten to fourteen days after surgery. The ENT surgeon will assess the progress of the post-surgical healing. They may also measure the stability of the implant using a special machine. This is quick and contact-free. If all is well, your next appointment will be to have your sound processor fitted at the Audiology Department.

The bone conduction sound processor fitting appointment

At this appointment, the audiologist will program your sound processor to your hearing loss. You will be shown how to operate the device and have the chance to practise putting it on and taking it off correctly. You will be given information about how to care for your device and clean the abutment site. You will be given a follow up appointment with the audiologist for approximately three months later.

An annual review appointment will be put in place following this.


BCHS repairs

If your BCHS processor is faulty please book a repair appointment at the Norfolk & Norwich Hospital or Cromer Hospital,  you can scan the QR code below.

If you cannot use the online system, you can ask someone to book an appointment on your behalf; alternatively please telephone 01603 287284 (NNUH) or 01603 646204 (Cromer) or email: