The Baha® 6 Max Sound Processor, released in 2021, is the newest bone anchored hearing solutions speech processor from Cochlear™. Cochlear is a worldwide leader in cochlear implants and bone anchored hearing aids (BAHA). Based in Australia, but with a worldwide presence, Cochlear currently leads in market share with approximately 60% of the global sales of auditory implant devices. They have, in the last 2 years, released 9 new products with FDA approval including new bone anchored hearing solutions such as the Baha 6 Max and the Osia® 2 products (reviewed here), as well as new cochlear implant processors, a new electrode array, and smart phone applications.
The Cochlear Baha 6 Max Sound Processor in action.
The Baha 6 Max Sound Processor replaces the Baha 5 speech processor that was first introduced in the U.S. market in 2015. A long-awaited speech processor upgrade for those with Baha bone implants, the new processor has several advantages over its predecessor. Let’s take a look at some of those improvements as well as provide a brief overview of bone anchored hearing solutions.
What are Bone Anchored Hearing Aids (Baha)?
Bone anchored hearing aids do not work like typical hearing aids which pick-up sound, process and amplify it, and then deliver an acoustic signal to the ear canal. Instead, Baha systems rely on the fact that sound can be transmitted to the inner ear (cochlea) by vibrating bone (skull or teeth). This is done in cases where medical or hearing contraindications exist for a traditional hearing aid.
For example, Baha is indicated in cases of chronic ear infections, outer or middle ear malformations, or significant conductive or mixed hearing losses (topics covered in the article “How Do I Read a Hearing Test?”). Baha is also approved for single-sided-deafness (SSD) where the device is used on the deaf ear and sound is then transmitted via bone conduction to the better cochlea. Essentially, Baha works by bypassing the usual conduction of sound through the outer and middle ear and, instead, conducts sound via the bone directly to the inner ear.
The Cochlear Baha system uses a small abutment to provide a direct connection between the implant and sound processor, which is designed to maximize your hearing performance. The way the system works is: 1) The Baha 6 Max Sound Processor picks up sound vibrations from the environment; 2) The sound vibrations are transferred through an abutment to a small titanium implant inserted in the bone behind the ear; 3) Sound vibrations are then sent directly through the bone to the inner ear (cochlea) which transfers the signals to the brain, allowing you to perceive sound naturally.
With Cochlear devices, the bone vibration can be achieved two ways:
- Non-surgically by placing a speech processor that vibrates against the head or
- Surgically via a titanium implant and processor.
The non-surgical option is achieved by a cloth headband or malleable headpiece which holds the processor against the skin of the head. The vibrations transfers through the skin to the bone and then to the cochlea. The non-surgical options allow for trialing bone conduction hearing without the need for surgery. This is advantageous, for example, when a child is too young for surgery, surgery is otherwise contraindicated, or for anyone who simply wants to see how effective the device may be for them before committing to surgery.
Cochlear Baha non-surgical options include the Start (top left), Softband (bottom left), and SoundArc.
The surgical option requires that a titanium implant, which resembles a small screw, be surgically placed in the bone of the skull near the ear. It acts as the vibration point for the Baha speech processor, as well as Cochlear’s Osia 2 device. After healing, the implant becomes osseointegrated (integrates with bone) into the skull and allows for a more efficient transfer of sound compared to vibrating the bone through the skin.
The speech processor attaches to an abutment on the bone implant (Baha Connect system) or magnetically via a surgically placed magnet under the skin and a magnet on the processor (Baha Attract system). So, the same Baha speech processor is used, regardless of surgical approach.
The Baha Connect, which connects the speech processor to an abutment on the implant, requires that the implant be percutaneous—meaning that a portion of the implant remains above the skin. This method provides one of the most efficient methods of transduction of sound, but also comes with obvious cosmetic and post-operative care concerns including infection around the abutment.
The Baha Attract allows for a magnetic connection of the speech processor to the implant and the implant is entirely under the skin. While this provides better cosmetic outcomes and less concern over issues with the exposed implant, the skin dampens sound transduction and may not provide the best hearing performance. In addition, the pressure of the magnet against the skin can for some recipients lead to soreness or skin irritation.
Cochlear also offers the Osia 2 system which, likewise, is indicated for those with outer and/or middle ear issues or SSD and has a similar fitting range of the Baha 6 Max Sound Processor. The Baha system uses a mechanical vibration method, while the Osia 2 system utilizes a piezoelectric transducer which vibrates the implant. Piezoelectric means that certain materials (like quartz) will convert electrical energy to mechanical energy (or vice versa).
The Osia 2 system, other than the sound processor, is completely surgically implanted. This provides a more stable and cosmetically appealing outcome, and for new candidates for bone conduction hearing solutions, it’s likely that Osia or another company’s similar technology, would be chosen over Baha.
However, Osia is only indicated for persons 12 years and older in the U.S., and the Baha approach may be required for some people. Keep in mind that some surgeons will still implant “off label” if they believe the Osia is a better choice in the long term. If you believe you are a candidate for a bone anchored hearing solution, discuss all of your options with your hearing care provider (HCP) and otolaryngologist.
Cochlear Baha 6 Max sound processors come in 6 different colors.
Baha 6 Max Sound Processor At-A-Glance
- 6 color choices including new mint color
- Programmable LED
- Up to 4 listening programs
- Improved IP rating
- New coupling system and smaller size
- New processing chip—Xidium™ platform
- Extended frequency bandwidth
- Improved feedback reduction system
- New impulse noise reduction
- Improved battery life
- Direct streaming with both Apple® and Android™ compatible devices
Baha 6 Max Sound Processor Key Features
Cochlear’s new bone conduction sound processor features multiple improvements compared to its predecessor, the Baha 5 Sound Processor. For example, the Baha 6 Max Sound Processor is available with an additional color option and has an improved IP rating of 68 compared to Baha 5 with its IP 63 rating. The improved IP rating may help to improve overall durability of the device as it should be more resistant to dust and moisture compared to its predecessor. This does not mean Baha 6 Max is waterproof and waterproof wearing options do not appear to be available.
Cochlear also notes a new LowPro™ coupling system. The coupling system is the connection point between the sound processor and either the implant’s abutment or the external magnet. The new system lessens the projection of the processor, and it now sits approximately 2 mm closer to the head. While 2 mm may not seem like much it can help to improve the overall cosmetics of the device. However, this may not work for all wearers; if needed, your HCP can order an extended snap coupling.
The biggest change, though, is its new internal chip, called the Xidium platform. This new chip allows for faster processing speeds, increased frequency range, and the ability to stream both Apple and Android devices.
Let’s take a deeper dive into what the Baha 6 Max Sound Processor has to offer.
Fitting range for single-sided deafness (SSD), conductive and mixed hearing losses
The Baha 6 Max Sound Processor is appropriate for those with a conductive or mixed hearing loss and for those with SSD. The new Baha 6 Max Sound Processor will fit up to a 55 dB HL (Hearing Level as shown on your audiogram) sensorineural hearing loss. This value is obtained by averaging your thresholds across 500-3000 Hz of the frequency range for your bone conduction scores. Sensorineural simply means a cochlear or “nerve” hearing loss.
Keep in mind, with conductive and mixed losses, you may have additional conductive hearing loss beyond the 55 dB HL and still be a candidate for the device. This is referred to as a “mixed” loss. Also, keep in mind that Cochlear offers the Baha 5 SuperPower Sound Processor which can accommodate up to a 65 dB HL sensorineural hearing loss. Of course, this older generation device will not have the same features as the new 6 device but may be a better option for those with a more significant hearing deficit.
For those with SSD, candidacy guidelines require a profound loss in one ear and normal air conduction thresholds in the same 500-3000 Hz range. In other words, no useful hearing in one ear and normal or near-normal hearing in the better ear.
It’s also notable that although the new Baha 6 Max Sound Processor has the same fitting range as the Baha 5 Power, it is lighter and smaller. In fact, it’s the same size as the older Baha 5, though slightly heavier. The smaller size, improved power, and new connection system likely will be appreciated by wearers.
The Baha 5 Power and Baha 5 sound processors are being discontinued by Cochlear as of September 30th, 2022, with the Baha 6 Max sound processor replacing the older devices. The new Baha 6 Max Sound Processor boasts 7 dB more maximum power output than the Baha 5 Sound Processor, is within 1 dB of the Baha 5 Power Sound Processor, and has improved technology making these 2 older devices obsolete.
The Baha 5 SuperPower is still available at the time of this writing. Please contact Cochlear for additional information regarding repair and support of the discontinued products. As always, you should consult with your HCP and physician regarding your candidacy and options for better hearing.
Updated scene classifier, extended frequency range, and noise reduction features
Baha 6 Max Sound Processor incorporates and updated SmartSound® iQ scene classifier as well as updated noise reduction features and directional microphones. The scene classifier is designed to sample your listening environment up to 300 times per second and align the processor’s technology, such as noise reduction and directional microphones, and provide the best possible listening for your environment. This is all done automatically and is consistent with how today’s digital hearing aids are designed.
The new processor also has an extended frequency range compared to its predecessor. That is, the Baha 6 Max Sound Processor amplifies within a possible bandwidth of 200-9850 Hz compared to Baha 5 which is tested at 250-7000 Hz. This extended bandwidth may be perceived by the wearer as improved depth of sound and improved clarity. For some, the extended bandwidth and higher available output may also translate into improved speech understanding, even in noisy situations.
You’ll note that we say “possible” bandwidth as your device may not be programmed to amplify across the full bandwidth for various reasons. For example, you may experience feedback—that annoying squealing we sometimes hear from amplified devices—and the high pitch volume (also called “high-frequency gain”) may need to be reduced to keep this from happening. However, Cochlear reports an improved feedback reduction system compared to the older device, so the need to reduce the high frequencies due to feedback may be less than with Baha 5.
Baha 6 Max Sound Processor also now incorporates an impulse sound noise reduction system. Although not new to hearing aids, the impulse noise reduction is new to Cochlear’s Baha devices. Impulse noise reduction systems are intended to minimize the annoyance of sharp sounds. This means sudden and brief amplified noises like silverware on a plate or clanking glasses should be perceived as less bothersome, though they will still be heard. The intent, of course, is to improve overall hearing comfort.
Your HCP can also program up to 4 listening programs into the device, depending on your preferences and listening needs. For example, you may prefer to have a separate music program or noise program.
You can change the program by the onboard program button at the top of the processor or via your smartphone app or other accessory such as the Baha Remote Control. Volume cannot be changed directly on the device; instead, your smart app or other accessory can be used. Alternatively, the program slots can be used as volume adjustments if the use of an accessory isn’t practical or wanted.
Longer battery life
Baha 6 Max Sound Processors utilize a non-rechargeable, size 312 hearing aid battery. The new processor boasts an 87% average longer battery life than Baha 5 Sound Processor. Remember that battery life will depend on how your processor is programmed, your listening environments, and by how much time you spend streaming from other devices. According to Cochlear, the improved battery life is due to a more efficient electromagnetic transducer than previous devices.
The reported battery life for Baha 6 Max is 44-136 hours. This is a wide range and, again, is dependent on how your device is programmed and how it’s used. Even so, you are likely to get, at a minimum, 3-4 full days of use before needed to replace the battery.
Android and MFi Streaming and Connectivity
For the first time with Cochlear’s Baha products, both Android and Apple connectivity are an option. Using Bluetooth, Made for IPhone (MFi) and the Android Streaming for Hearing Aids (ASHA) protocols, you can stream audio directly to your Baha 6 Max Sound Processor from your Apple or Android smart phone, or other compatible devices such as tablets.
Of course, not all devices are compatible, so be sure to check compatibility on the Cochlear website. You’ll see on the compatibility page that your iPhone will require iOS 15 or later and your Android phone will require Android 11 or later. (The earlier Baha 5 products are compatible with some Apple devices but not Android.)
It should be noted that hands-free calling is not an option for Baha sound processors without the use of an accessory. The Phone Clip accessory is available for hands-free calling and can also be used to stream audio from Bluetooth devices that are not otherwise compatible with the Baha 6 Max. The Phone Clip can be included as part of your original system as an accessory, or it can be ordered after the fact at a cost of $295.
Other accessories are also available including the Mini Microphone 2/2+, a TV Streamer, and a simple Baha Remote Control 2.
Cochlear Baha Smart App.
Device Control with Baha Smart App
The Baha Smart App is available for both Apple and Android smart phones. The app allows for additional control beyond the simple program change with the button on the device itself.
Controls include program change, volume change, streaming (de)activation, and sound adjustment for bass, mid and treble levels. If you use an Apple Watch® you can also use it to control your Baha 6 Max.
Within the Smart App, you can check your battery status and there’s a feature to locate a lost sound processor. A “Hearing Tracker” allows you and/or your HCP or a caregiver to view what programs are used the most and also view total wearing time. This information can be useful in setting wearing and listening goals and/or for programming adjustments by your HCP.
Compared to some hearing aid apps, the Smart Phone App provides limited control. For example, you can’t directly adjust noise reduction within a program or how the directional microphones behave, and although Cochlear does offer remote care, it also is not available within this app.
Significant improvements over Baha 5 processor
The Baha 6 Max Sound Processor is a significant improvement over its much older predecessor, the Baha 5 processor, and is a welcome upgrade for those already wearing the older Baha devices. For many who are not a candidate for conventional hearing aids, but are a candidate for bone conduction hearing devices, Baha 6 can provide excellent hearing.
However, the Osia system or another active bone conduction implant may be a better option for new recipients. It’s likely that the Baha 6 Max Sound Processor will be chosen mostly by those who are already utilizing a Baha 5 system and not by new bone conduction solution candidates.
The Baha 6 and the Osia system are considered medical devices, and unlike traditional hearing aids, are often covered by healthcare insurance including Medicare and Medicaid in some states (check with your insurance carrier). It can be worn without surgery via a soft head band or head retention band called the SoundArc™.
Alternatively, the processor can connect to a surgically implanted titanium screw and abutment or magnetically via an implant and under-skin magnet. The non-surgical options provide the opportunity to try the device before committing to surgery.
The Baha 6 Max sound processor’s improved design features—and the added Android and Apple direct streaming capability—can help improve overall cosmetics, listening comfort, utility, and ease of use. HearingTracker strongly recommends that you discuss all of your treatment options with your HCP and/or physician to make an informed decision about any hearing healthcare product you might choose.