Cochlear™ Bone Conduction Solutions Now is the Time to Experience a Life of Better Hearing Cochlear gives you more than hearing. We give you hope. The journey you are about to embark on is an exciting one, and the decision Hope to hear the birds singing. to get a bone conduction solution can be life-changing. Our goal is to make sure you feel confident about your future with a Cochlear™ Bone Conduction Hope to hear your grandchild’s voice. Solution. As part of our promise to help you “Hear now. And always,” we are committed to helping you achieve your personal best hearing experience every day. This means providing you with innovative hearing solutions and Hope to hear your favorite song unsurpassed support throughout your entire hearing journey—today and into that takes you back. the future. Hope to connect with those you love the most. Hope to experience the joy of hearing. We provide this hope through innovative hearing solutions and personalized service to help you

1 Contents

Chapter 1: Hearing Loss and Solutions ...... 4

Chapter 2: Cochlear™ Osia® System ...... 24

Chapter 3: Cochlear™ Baha® 5 Systems ...... 46

Chapter 4: System Accessories ...... 64

Chapter 5: Service and Support ...... 76

Chapter 6: Steps and Resources ...... 94

Meryl C. – Baha recipient 2 3 Hearing Loss & Solutions Loss Hearing

Chapter 1: Hearing Loss and Solutions

How Hearing Works ...... 6

Types and Degrees of Hearing Loss ...... 8

Understanding the Audiogram ...... 12

Possible Hearing Loss Solutions ...... 14

Advantages of a Bone Conduction Implant System ...... 19

Tiffany S. – Baha recipient 4 5 Hearing Loss & Solutions Hearing Loss and Solutions Outer Ear Hearing Nerve

The fi rst step in understanding treatment options available to you is to understand how hearing works and the types and degrees of hearing loss. The most appropriate treatment option for you is based on your type and degree of hearing loss. 4

How Hearing Works 2 3

Hearing is the process of sound traveling through the outer, middle and inner 1 ear. Although sound enters through the ear, it is interpreted by the brain. So you actually hear with your ears and your brain. Each part of the ear plays an important role in transmitting sound. If there is a problem anywhere in the Cochlea process, the result may be hearing loss. Middle Ear

Inner Ear How natural hearing works

1 Sound travels down the ear canal to the eardrum.

2 The movement of the eardrum makes the tiny bones in the middle ear vibrate.

3 These vibrations are transmitted to the inner ear (cochlea).

4 Tiny sensory hair cells in the inner ear pick up the vibrations and transmit signals to the hearing nerve that sends the signals to the brain where they are interpreted as sound.

6 7 Types of Hearing Loss

Sensorineural hearing loss – occurs when the inner ear or hearing nerve is damaged or not working properly. This type of hearing loss is permanent and can be genetic or caused by diseases, exposure to noise, certain kinds of Sensorineural Hearing Loss medication or the aging process.

Sensorineural hearing loss can occur in one or both ears. If the loss is in one ear, it is often referred to as unilateral hearing loss or single-sided deafness. This is when there is little or no hearing in one ear, but normal hearing in the other ear.

Common causes include: • Aging • Adverse reaction to medications • Viral infections • Head or ear injuries • Ménière’s disease • Many other unknown reasons

Conductive hearing loss – occurs when sound is not passing through the outer or middle ear to reach the inner ear. This can be due to a blockage such as wax build up, an ear infection or other factors.

Common causes include: • Malformations at birth such as • Skin growth or cyst Microtia and Atresia (cholesteatoma) • Syndromes such as Down, • Draining or runny ears Goldenhar and Treacher Collins • Chronic ear infections • Chronic mastoiditis or middle • Previous ear surgeries ear infections • Benign tumors Conductive Hearing Loss

Mixed hearing loss – a combination of conductive and sensorineural hearing loss.

8 9 Degrees of Hearing Loss

Mild hearing loss – you may hear conversations, but soft sounds are hard to hear, such as a whisper or the consonants on the end of words like “shoes” or “fi sh.”

Moderate hearing loss – you may be able to hear another person talking at a normal level, but will have diffi culty understanding what is said. You might hear the vowels within a sentence but not the consonants. This makes sentence comprehension diffi cult because words can sound muffl ed.

Severe hearing loss – you may hear some or none of what a person is saying at a normal level. You may hear only a very loud sound, such as a car horn, but it might not be startling in the same way it may be to a person with normal hearing.

Profound hearing loss – you will not hear conversations, only very loud sounds. You will likely feel the vibrations of only the loudest sounds.

Cindy M. – Baha recipient 10 11 Hertz (Hz) measures pitch or frequency Understanding the Audiogram 125 250 500 1000 2000 4000 8000 Normal 0-25 dB HL 10 An audiogram is a chart that shows Hertz (Hz) measures pitch or frequency 20 p the softest sounds you hear, called 125 250 500 1K 2K 4K 8K f th h s -10 Mild 30 z v g k hearing thresholds, when you have 0 26-40 dB HL ch 10 sh a hearing test. Pitch, also known as 20 40 j m d b i Moderate n a frequency, is measured in hertz (Hz) 30 ng o r 40 41-55 dB HL 50 e and the volume of sound is measured 50 u l 60 Moderately 60 in decibels (dB). 70 Severe

Hearing level (dBHL) 80 56-70 dB HL 90 70 The audiologist will plot your hearing 100 Severe 110 71-90 dB HL loss using X or > for the left ear in 120 80 blue, and O or < for the right ear in Conductive hearing loss – Right ear 90 red. If you are a candidate for a bone Profound

Decibels (dB) measure volume of sound 91 dB HL+ 100 conduction implant, your audiogram Hertz (Hz) measures pitch or frequency

may look like one of the examples to 125 250 500 1K 2K 4K 8K 110 the right. -10 0 120 10 Normal hearing is the ability to 20 30 detect sound across a range of high 40 50 and low pitches at a volume level of 60 20 dB or better. 70 Hearing level (dBHL) 80 Reading the audiogram 90 100 110 120 • The pictures represent sounds at typical volume Mixed hearing loss – Right ear and frequency levels. • The yellow highlighted area is known as the “speech banana”; Hertz (Hz) measures pitch or frequency consonants and vowels are spoken at frequencies that fall 125 250 500 1K 2K 4K 8K within this area. -10 0 10 • Access to “speech banana” sounds is required to hear and 20 understand conversations. 30 40 50 60 70

Hearing level (dBHL) 80 90 100 110 120 Single-sided deafness (SSD) Left ear (normal hearing), Right ear (hearing loss)

12 13 Bone conduction implants (Cochlear™ Baha® 5 Systems) Possible Solutions for Hearing Loss Bone conduction implants help those with mixed or conductive hearing loss or single-sided deafness. They work by bypassing the damaged middle and outer ear and sending clearer and more crisp sound directly to the inner ear The type and degree of hearing loss is determined through hearing tests using bone conduction.1 The sound vibrations are captured and sent through conducted by an audiologist. Only then is it possible to discuss the best the skin to the implant located in the skull bone, then onto the inner ear. treatment approach. Below are typical solutions for certain types of hearing Bone conduction implants are a stable, long-term, yet flexible solution loss. The appropriate solution can depend on other clinical factors as well. compared to non-surgical options.2-4

Traditional hearing aids Active OSI system (Cochlear™ Osia® System) Hearing aids are electronic devices that make sounds louder through With an osseointegrated, steady-state implant system, the implant and the amplification. Typically, a hearing aid helps those with mild to moderate transducer (the part of the implant that creates vibrations) are completely hearing loss in one or both ears. Some people are not able to wear hearing under the skin. It uses bone conduction to send sound vibrations naturally aids due to conditions like outer or middle ear malformations, or if the through the bone to the inner ear. An active OSI System can provide more hearing aids aggravate existing conditions such as draining ears. power with the sound vibrations being sent directly through the bones in the skull versus through the skin. The Cochlear™ Osia® System is the world’s first Cochlear implants implant system of this kind and can help those with mixed or conductive Cochlear implants help people with moderate to profound sensorineural hearing loss or single-sided deafness. hearing loss in both ears. They work by bypassing the damaged inner ear (cochlea) and stimulating the hearing nerve directly.

CROS hearing aids Contralateral Routing of Signal (CROS) hearing aids are designed to help those who are deaf in one ear. They require the user to wear two hearing aids behind or inside each ear and work by picking up sound on the “bad side” and transmitting it with a wire or wireless signal to the normal hearing ear.

Middle ear surgery Middle ear surgery is a reversible treatment option that may be considered to address problems with the tiny bones in the middle ear or to address chronic middle ear fluid that can cause conductive hearing loss. If you are considering middle ear surgery, you can try a bone conduction system, beforehand, risk- free. That way, you’ll know the options before making the final decision.

14 15 Cochlear Bone Conduction Solutions

Baha® 5 Sound Processors Osia® 2 Sound Processor The Cochlear portfolio of bone conduction solutions offers implantable and non-surgical options that are designed to meet your individual needs and provide unparalleled hearing performance.

Our bone conduction solutions all work by bypassing the damaged or missing parts of the outer or middle ear and sending sound vibrations directly through the bone to the inner ear.

Our bone conduction solutions include the following main components: processors External sound

• External sound processor – our sound processors provide different levels of power to best fi t your hearing needs throughout their lifetime. Osia Implant • Connection between sound processor and implant – we offer magnetic connections as well as a connection through an abutment. • Internal implant – all of our bone conduction solutions use the stable foundation of our BI300 Implant with proven long-term reliability and 5 sound transmission. Baha Connect Baha Attract Connection between between Connection sound processor and implant and processor sound

BI300 Implant implant Internal Internal

16 17 Are You a Candidate Advantages of a Bone Conduction Implant System for a Bone Conduction Solution?

Cochlear bone conduction solutions are approved for those with conductive Research and decades of experience demonstrate that a bone conduction and mixed hearing loss or single-sided deafness. implant system may help you:6-10 Ask yourself the following questions. If you answer “yes” to any of them, • Hear better, even in noisy situations then schedule an appointment with a Hearing Implant Specialist who can • Enjoy a clean, more natural sound because bypassing the damaged part help determine whether you are a candidate. of your ear may reduce the amount of amplification needed to help them • Can you only hear from one side? hear better • Do you have trouble getting sufficient loudness when using • Hear sounds as if they are coming from both sides hearing aids? • Become more aware of your surroundings, increasing your ability • Do you battle feedback or distorted sound quality when using to hear important sounds hearing aids? • Engage in conversations more easily because you no longer need • Do you suffer from sore or irritated ears due to your hearing aids? to keep turning to use your ‘good’ ear • Do you have draining ears? • Do you have malformed ears or ear canals? Baha SoundArc a Non-Surgical Solution

Hear Your Best in Both Ears If you are not yet ready to move forward with a surgical solution, you can experience better hearing with the Baha® SoundArc.™ The SoundArc System is a non-surgical bone conduction solution. It works with one or two of any Bilateral bone conduction solutions - a bone conduction solution of the Baha 5 Sound Processors. Once you are comfortable with the Baha on each ear 5 SoundArc System, you can work with your Hearing Implant Specialist to If the hearing loss has progressed in both ears to where a hearing aid in one determine which solution is best for you. ear and bone conduction solution in the other ear, or a bone conduction solution in one ear alone, is not helping you understand sound and speech, bilateral bone conduction solutions may be beneficial. Whether it is with one solution or two, hearing sounds in both ears is important to provide your brain with enough stimulation to understand conversations and communicate effectively.

18 19 Insurance Coverage for a Bone Conduction Solution

Unlike hearing aids, bone conduction solutions are typically covered by most insurance plans.* Contact your insurance company or local Hearing Implant Specialist to determine coverage as well as your estimated out-of-pocket expenses. The cost of the implant will vary from person to person based on their specific health plan.

Private Insurance Medicaid Medicare

Bone Conduction Covered by most Typically Covered.† Solutions insurance plans.* covered.**

Typically Typically By law are not Hearing Aids not covered. covered.** covered.

With the Baha System, you have the unique advantage of TRYING IT FIRST BEFORE YOU MAKE ANY DECISIONS.

* Contact your insurance company or local Hearing Implant Specialist to determine your eligibility for coverage. ** Coverage for adult Medicaid recipients varies according to state-specific guidelines. † Covered for Medicare beneficiaries who meet CMS criteria for coverage. 20 21 About Bone Conduction Solution Surgery

Even though surgery is required for a bone conduction solution, the long- lasting benefits can be life-changing. The procedure is fairly routine and simple and is typically outpatient. A few important things about surgery: • The surgery generally takes between half an hour to an hour and a half, depending on the type of bone conduction solution that is being implanted • There will be additional time in the preparation and recovery areas • Patients typically go home the same day • After a couple of days for recovery, most people are back to their normal routine

The procedure is considered safe, but like with any surgery, there are risks. For more information on what happens during bone conduction solution surgery, visit www.Cochlear.com/US, or speak with your Hearing Implant Specialist.

“The surgery was absolutely nothing. I think when I heard the word ‘surgery,’ I just got nervous.” Andria L. -Baha recipient

Andria L. – Baha recipient 22 23 Chapter 2: Osia System Cochlear™ Osia® System

The Cochlear Osia System ...... 26

How the Osia System Works ...... 28

Understanding Piezo Power™ Technology ...... 30

The Reliability of BI300 Implant ...... 32

About the Osia Implant Surgery ...... 33

Osia 2 Sound Processor Features ...... 35

24 25 Cochlear Osia System

Osia System Osia You’ve Never Heard Anything Like It The Cochlear™ Osia® System is the world’s fi rst osseointegrated, steady- state active system. The system utilizes innovative technologies specifi cally designed to work in and with the body. We call this approach Human Design.™ The Osia System uses the body’s natural ability to conduct sound through bone conduction, and could help you hear speech better, particularly in noisy situations where you can struggle the most.

Osia System

26 27 External Sound Processor A New Way to Hear Through Bone Conduction

1 3 Rather than trying to reconstruct the outer or middle ear, the Osia System 2 uses bone conduction to send vibrations directly to the inner ear through the implant placed under the skin. Traditional bone conduction implants are designed to transfer vibrations externally through the skin to the bone. We have innovated bone conduction technology with the Osia System so that the vibrations are created by the transducer located under the skin, creating direct bone conduction to the inner ear. This state-of-the-art design helps create optimal sound transmission to the inner ear. Clinical evidence shows that 30% of middle ear surgery cases result in remaining hearing loss, and repeat 4 surgeries are common.1

The Osia System uses a small, one-unit sound processor placed off the ear, which leaves the ear canal free. The Osia Implant features the Piezo Power™ transducer that is placed under the skin and is attached to our BI300 Implant.

Internal Implant

How the Osia System works

1 The sound processor captures sound in the air and digitally analyses the signal.

2 The processed signal and power are sent through to the implant.

3 The Piezo Power transducer vibrates, sending vibrations through the implant to the bone.

4 The vibrations travel to the inner ear where they are converted into electrical impulses and sent to the brain to be interpreted as sound.

28 29 Understanding More About Piezo Power™ Technology

The new Osia System uses a special Piezo Power transducer that has a component that expands and contracts to create powerful vibrations. Piezoelectricity has been used for years in many products like microphones, high-end speakers and medical equipment, but Cochlear is pioneering its’ use in hearing implants. One of the many advantages of our Piezo Power transducer is its ability to vibrate at high frequencies, the area of sound most important for speech understanding. Piezo Power™ transducer Cochlear Osia 2 Sound Processor An implant built to last The Piezo Power transducer is built to be very durable and provide long- term performance. There are no movements between parts that can cause wear over time. Instead, the piezoelectric layers inside the transducer fl ex to create the power needed to provide optimal hearing performance, especially in high frequencies. Attached to the very reliable BI300 Implant is the Osia

Implant, which is designed to provide your best hearing for years to come. Stable osseointegrated foundation A digital sound experience To help optimize the transfer of power and deliver optimal sound quality, the Osia System uses a digital link between the sound processor and the implant. Cochlear Osia This robust connection provides smart, two-way communication that OSI200 Implant transfers 100% of the signal without risk of interference.*

Lifetime testing shows that Piezo Power technology PROVIDES POWERFUL AND CONSISTENT PERFORMANCE OVER TIME.2

* The unique implant ID ensures data integrity between sound processor and implant. 30 31 The Importance of Reliability Minimally Invasive Surgery

The Cochlear™ Baha® BI300 Implant set the industry standard for long-term The Osia Implant has a very thin profi le on a stable foundation. This design reliability and hearing performance. allows for a short, straightforward and minimally invasive procedure. Typically most people are back to their normal activities within a few days. The BI300 is Cochlear’s latest titanium implant featuring TiOblast™ surface technology. The implant is designed to promote faster and stronger integration to the bone (through a natural process known as Thin p r o fi l e osseointegration) to provide a stable foundation. Our state-of-the-art implant has an exceptional reliability rate of 99% and is backed by years of clinical research, which ensures that your implant may remain stable for Monolithic design BI300 years to come.3-6 The BI300 Implant lays the essential foundation for our bone conduction implant systems which includes: the Osia Implant System as well as the Baha Connect and Baha Attract Systems. It also provides Designed for safe MRIs better sound transmission when compared to any other system.7,8 The Osia implant is approved for MRIs at 1.5 and 3.0 Tesla with the internal magnet removed with a simple procedure.*

*This study was based on the implant survival rate. Multiple factors contribute to rates of survival, including but not limited to implant design and surgical technique. * Prior to receiving an MRI, please consult with your clinician about proper precautions. 32 33 High Power, More Sound Osia 2 Sound Processor - Designed for Comfort

The more power a sound processor has, the greater the opportunity you The slim, off-the-ear Osia Sound Processor is light and comfortable to wear. have to hear more sounds. Additional power capacity can be critical if your As a one-piece unit that includes the magnet and battery, you can simply hearing loss declines over time, which is why the Osia System is designed to place it on your head and you’re ready to go. It’s that easy. Its small size is help those with a hearing loss up to 55dB SNHL.* The Osia System can help designed to allow you to wear it all day. In fact, you may even forget it’s there. you better understand speech by creating a contrast between soft and loud sounds, allowing a more natural hearing experience.

In a clinical trial, Osia System users showed a signifi cant improvement in Osia 2 Sound Processor 1 2 their ability to hear in both noisy and quiet environments compared to 1 Indicator LED Light unaided conditions before being implanted. The Osia System also provided signifi cant improvements in reported health-related quality of life compared 2 Control Button to before the Osia System.9,10

3 Dual Microphones 4 Speech in noise9,10 Speech in quiet9,10 4 Battery Door 3 93.3%

59.9% 12 dB

Increasing noise Increasing 25.5% % correctly repeated words 2.63%

Ability to understand speech Soft speech Normal speech at normal conversation level in noise (50 dB) in quiet (65 dB) in quiet

Before Osia System (unaided) With Osia System

* SNHL means sensorineural hearing level. 34 35 Connect Without Compromise from a Smartphone Convenient Control With the Osia Smart App

The Osia System features direct, Made for iPhone technology so you can The Osia Smart App lets you control and adjust your hearing experience stream sound directly from a compatible Apple® device* without the need for easily and discreetly from your smartphone or Apple Watch.® You can control any intermediary device worn around your neck. This means you can talk on your volume and programs to your preferences and manage settings, all the phone, enjoy music, entertainment, stream GPS directions and more, all from your smartphone that acts as a remote control. You can even get help to your Osia Sound Processor, hands and cord-free, without sacrificing size, locating the sound processor if it goes missing.* comfort or battery life.

For Android™ and other smartphone users, sound can be streamed directly to the Osia 2 Sound Processor using our True Wireless™ Phone Clip.

Osia Smart App Control and adjust compatible with Apple Watch your settings

* The Cochlear Osia 2 Smart App is available on App Store and Google Play. For compatibility information visit * For compatibility information visit www.Cochlear.com/Compatibility. www.Cochlear.com/Compatibility. 36 37 Advanced True Wireless™ Technology

Compatible with the Osia Sound Processor, our True Wireless technology can help you hear more clearly in challenging situations by streaming sound to your sound processor. Cochlear True Wireless accessories connect to your sound processor using Bluetooth® technology, without any cords, neck loops or wires required.

Our True Wireless accessories utilize the same 2.4 GHz wireless protocol that Bluetooth® and Wi-Fi devices depend on. It’s a robust, time-tested, dependable technology that sets the standard for wireless connectivity. You can enjoy the benefit of True Wireless technology when watching TV with the TV Streamer, talking on the phone with the Phone Clip and hearing in noisy environments with the Mini Microphone 2+.

38 39 Osia 2 Sound Processor Adapts to Your World, Automatically Data Logging Tracks Device Usage and Provides Key Information to Your Audiologist The Osia System features our innovative SmartSound® iQ that adjusts automatically to the environment. It is designed to replicate natural hearing Our sound processors include innovative data logging technology that by monitoring sound and automatically adapting the sound processor to your records detailed usage information. Your audiologist can pull this information surroundings, from the softest sounds to a noisy party with friends. and make adjustments to make sure you are hearing your best.

SmartSound® iQ Programs:

The seven SmartSound iQ environments help you hear better Soft Speech Loud Speech in all situations:

Quiet Speech in Soft Noise Baha® SmartSound® iQ Speech in loud noise Speech in soft noise Have a conversation Chat after dinner while in noisy surroundings the dishwasher is running Loud Noise Speech in Loud Noise

Soft Noise

Loud speech Soft speech Quiet Time in noise and speech: Make lively conversations Enjoy a child’s Appreciate soft sounds more comfortable soft whispers in quiet environments Soft Speech .75hrs

Quiet 1.5hrs Loud Speech 2.25hrs

Speech in Soft Noise 3.25hrs Loud Noise 3.75hrs Soft noise Loud noise Reduce the hum of Hear comfortably Total background noise in noisy situations Usage Soft Noise 2.25hrs

Speech in Loud Noise 10.25hrs

40 41 Designed to Be Durable

The Osia 2 Sound Processor is designed to sit securely and comfortably against your head so you can wear it throughout all your daily activities. It is dust and moisture resistant* and has been thoroughly drop tested for durability. The Osia System comes with colored covers for the sound processor, so you can change the color based on your preference and mood.

Sandy Blonde Chocolate Brown

Slate Grey Silver Grey Black

Osia System Battery The Osia 2 Sound Processor uses one power 675 disposable battery. Depending on how often you stay on air, use direct streaming or True Wireless accessories, battery life typically lasts 22-35 hours.**

Disposable Battery

* The Osia 2 Sound Processor is IP57 rated with battery compartment excluded. ** Battery life may vary by individual. 42 43 Soak, Splash and Swim

With the Aqua+ accessory, designed specifi cally for the Osia 2 Sound Processor, you can enjoy swimming, surfi ng and snorkeling.* The Aqua+ accessory covers the Osia 2 Sound Processor and makes it waterproof up to almost ten feet, so you won’t miss out on the water activities you enjoy.

Osia 2 with Aqua +

* The Osia 2 Sound Processor with Aqua+ is water resistant to level IP68 of the International Standard IEC60529 when used with LR44 alkaline or nickel metal hydride disposable batteries. Refer to the relevant User Guide for more information. The Osia 2 Aqua+ may not be available in all markets and is subject to regulatory approval and product availability. Chris W. – Osia recipient 44 45 Chapter 3: Baha Implants and Systems

Baha Connect System ...... 50 & Systems Implants Baha

Baha Attract System ...... 51

Cochlear Baha 5 Sound Processors ...... 52

Tiffany S. – Baha recipient 46 47 Baha Implants and Systems

Today, Cochlear offers a choice of different systems using the same implant. The Baha Connect System is an abutment connection, and the Baha Attract System is a magnetic connection. Both the Baha Connect and the Baha Attract System utilize the same advanced implant technology, the Cochlear™ BI300. Each system is designed using Cochlear’s innovative technology, so you can benefi t from better hearing today and into the future. Baha Implants & Systems

Baha 5 Baha 5 Power Baha 5 SuperPower

48 49 Baha Attract System - An Invisible Connection Baha Connect System - A Direct Connection to Better Hearing to Better Hearing The Baha Attract System uses internal and external magnets that attract The Baha Connect System uses a small abutment to provide a direct to one another, thus creating an invisible link between the implant and connection between the implant and sound processor, which may maximize sound processor. Depending on the thickness of your hair and skin, there are your hearing performance. The sound processor simply snaps onto the different strengths of magnets available to ensure that the processor stays abutment which comes in different lengths to fit your needs. The Baha firmly in place. The sound processor simply connects to the magnet which Connect System is easy to use and requires little daily care. transmits the sound. The Baha 5 Attract System is comfortable, discreet, and requires no daily care. Dermalock™ Technology ™ Unlike conventional systems, the Baha Connect abutment features The Baha SoftWear Pad innovative Dermalock™ technology with a unique surface coating and For added comfort and performance, we developed the Baha SoftWear™ concave shape, preserving the hair and skin around the abutment. These Pad. Our unique SoftWear pad sits on the external magnet and adapts abutments are designed specifically for better cosmetic outcomes and can comfortably to the shape of your head, distributing pressure evenly across reduce the overall time in surgery.1 the surface. This provides an additional level of comfort and prevents the skin from breaking down over time. Easy Access to MRI Since an MRI (magnetic resonance imaging) can be an important medical Safe Access to MRI tool, rest assured you will be able to safely access this diagnostic test if If you ever need an MRI, the Baha Attract System’s internal magnet is needed. The Baha 5 Connect System is designed for a high level of MRI approved for up to 1.5 Tesla,* but you must remove your sound processor compatibility. Always remove the sound processor prior to the MRI; the before the scan. For MRI scans above 1.5 Tesla,* a simple procedure to remove implant as well as the abutment can stay in place. the magnet may be necessary.

* Prior to receiving an MRI, please consult with your clinician about proper precautions. * Prior to receiving an MRI, please consult with your clinician about proper precautions. 50 51 Cochlear™ Baha® 5 Sound Processors

Our Baha 5 Sound Processors are designed to provide you with an optimal hearing experience. The Baha 5 System offers three head-worn sound processors, each one designed to meet a different level of hearing loss up to 65 dB SNHL.* You can choose the best one for you today and you have options if your hearing loss changes over time.

All Baha 5 Sound Processors feature the most advanced technology to help you hear your best, including: • Dual microphones that help you filter out background noise • Automatic sound processing automatically adapts to your environment, without the need for manual adjustments • Made for iPhone compatibility** so you can stream phone calls, music and entertainment • Baha 5 Smart App† allows you to easily control your settings or find a misplaced sound processor • Data logging to help provide your key usage information to the audiologist • Built in 2.4 GHz True Wireless™ technology to help you hear more clearly in challenging situations without neck-worn loops or wires • Compatible with all our True Wireless accessories

* SNHL means sensorineural hearing level. ** For compatibility information visit \www.Cochlear.com/Compatibility. † The Cochlear Baha 5 Smart App is available on App Store and Google Play. For compatibility information visit www.Cochlear.com/Compatibility. Randi L. – Baha recipient 52 53 Baha 5 Sound Processor—Small and Smart

The Baha 5 Sound Processor is our smallest bone conduction solution that helps those with a hearing loss of up to 45 dB SNHL.* Although it is small, the Baha 5 Sound Processor provides advanced connectivity with Made for iPhone direct streaming and built-in True Wireless technology to help you hear better than ever before.

Baha 5 Sound Processor 1

1 Program/Streaming Button 2 2 Dual Microphones

3 Battery Door 3

* SNHL means sensorineural hearing level. Debra B. – Baha recipient 54 55 Baha 5 Power Sound Processor—More Power When You Need It

The Baha 5 Power Sound Processor may be a solution for you if you have a higher degree of hearing loss—up to 55 dB SNHL.* It is designed to provide a greater level of amplifi cation and can help you hear better in challenging listening environments. While the Baha 5 Power Sound Processor features all of our innovative technology on the inside, it also features the convenience of on-device functionality that allows for volume changes.

Baha 5 Power Sound Processor 1

1 Program/Streaming Button 2

2 Volume Rocker

3 Indicator Light 3 4 4 Battery Door

* SNHL means sensorineural hearing level. Dennis K. – Baha recipient 56 57 Baha 5 SuperPower Sound Processor—Providing Maximum Amplifi cation

Created for those with a substantial degree of hearing loss—up to 65 dB SNHL*—the Baha 5 SuperPower Sound Processor is the industry’s fi rst head- worn super power bone conduction solution.2 The actuator, which holds the part that provides sound vibrations to the implant, is separated from the microphones by a cable to provide the maximum sound power potential with reduced risk of feedback. The Baha 5 SuperPower Sound Processor rests comfortably and securely behind your ear.

Baha 5 SuperPower Sound Processor

1 Actuator with Transducer 2 1

2 Dual Microphones 5

3 Sound Processor 3

4 Battery 4 5 Program/Streaming Button

* SNHL means sensorineural hearing level. Lois D. – Baha recipient 58 59 Made for iPhone Connectivity—A Seamless Visual Confi rmation Your Processor is Working Connection to Life

The Baha 5 Sound Processors can stream sound directly from your favorite Just like you refer to the lights in your car to verify all the key components Apple® devices.* Created for outstanding sound quality, Made for iPhone are functioning, our Baha 5 Power and SuperPower Sound Processors have hearing devices are designed to provide outstanding sound quality while lights that tell you and other caregivers if certain features are working. These fi tting easily into your lifestyle. visual indicators are easy to notice, provide important diagnostic information about your sound processor, and give you peace of mind that the equipment Enjoy direct streaming to your sound processor for: is working properly. • Music • FaceTime® calls The Baha 5 Sound Processor does not include indicator lights due to its • Apps • Movies and TV shows small size.

Take control with the Baha 5 Smart App Baha Test Rod If you prefer to monitor your sound processor information from your The Baha Test Rod easily attaches to your sound processor and, when placed smartphone, the Baha 5 Smart App is designed for just that. against your head, allows you to confi rm the sound processor is working properly. The Test Rod is included with your Baha System. From your compatible Apple or Android™ device, the Baha 5 Smart App** helps you: • Locate a lost sound processor† • Monitor battery life • Change programs and settings • Start wireless streaming

* For compatibility information visit www.Cochlear.com/Compatibility. ** The Cochlear Baha 5 Smart App is available on App Store and Google Play. Control and adjust For compatibility information visit www.Cochlear.com/Compatibility. your settings Baha 5 Power Baha 5 SuperPower Baha Test Rod † Not available with the Baha 5 Smart App on Google Play. 60 61 Personalizing Your Sound Processor Batteries

Colors Each sound processor requires a different type of battery in order to keep you * Baha 5 and Baha 5 Power Sound Processors come in a range of color options. on air all day. Typically, battery life is determined by battery size, listening Choose the color that is best for you. environments, streaming and the use of accessories. Baha 5 Sound Processor: • Battery type 312 zinc air • Battery life usually lasts 60-72 hours

Black Brown Copper Silver Blonde Baha 5 Power Sound Processor: Disposable Batteries • Battery type 675 zinc air • Battery life usually lasts 135-220 hours The Baha 5 SuperPower Sound Processor comes in four colors. Choose the color that is best for you. Baha 5 SuperPower Sound Processor: We offer a choice of rechargeable batteries for the Baha 5 SuperPower Sound Processor so you have the fl exibility to manage your power use throughout the day.* • Compact and Standard rechargeable battery choices Compact and Standard • Battery life usually lasts 60-80 hours Rechargeable Batteries

Carbon Mocha Maize Smoke

* Battery life may vary by individual. 62 63 Chapter 4: Accessories

True Wireless™ Accessories ...... 66

Remote Control...... 73

Retention Options ...... 74 Accessories

Dennis K. – Baha recipient 64 65 Accessories

Cochlear’s True Wireless™ accessories are compatible with the Osia® 2 Sound Processor or any of the sound processors in the Baha 5® portfolio. These accessories can help you hear better whether you are in a noisy environment, talking on the phone, or watching TV. In addition, there are remote control options to manage your sound processor settings if your phone is not compatible with the Baha® 5 Smart App. With every new Osia System or Baha Implant System, you will receive one complimentary accessory of your choice. Accessories Mini Microphone 2+ TV Streamer Phone Clip

66 67 True Wireless™ Accessories—No Strings Attached

Wireless freedom, reliable connection Cochlear’s True Wireless accessories can help you hear more clearly in challenging situations by streaming sound directly to your sound processor. Our True Wireless technology utilizes the same 2.4 GHz wireless protocol that Bluetooth® and Wi-Fi devices depend on. It’s a robust, time-tested, and trustworthy technology that sets the standard for wireless connectivity. Our range of easy-to-use accessories provides you with the best hearing experience possible without the need for any additional devices—no cables, cords or necklaces.

Easy to pair, easier to use To use the accessories, simply press the pairing button and power up your sound processor. Within seconds, they’re connected. That’s it! Once paired, you can easily stream sound from your True Wireless accessories with the push of a button.

Shelly S. – Baha recipient 68 69 Mini Microphone 2+ Phone Clip With the Mini Microphone 2+, you can hear more clearly in any listening Talking on the phone is important for both work and connecting with situation, especially noisy environments. It works by streaming speech and loved ones. The Phone Clip can be used when you are not using the direct music to your sound processor. Simply clip the Mini Microphone 2+ to your streaming feature with a compatible Apple® or Android™ smartphone.* It uses companion’s collar when you are dining at a restaurant, riding in a car, in a Bluetooth®-enabled technology to give you control using your smartphone, presentation at work, or while shopping. It’s lightweight and portable, so it and a hands-free connection to family and friends. You can also use the can be used anywhere. Phone Clip to stream sound to your sound processor while using your GPS navigation or when listening to music and watching movies from your phone Key features: or tablet. • Directional microphone for one- on-one conversations and omni- Key features: directional microphone for use in • Up to six hours of talk time and • Simultaneous connection to large groups 80 hours of standby time two Bluetooth® devices • Up to 11 hours of talk time on • Call reject, transfer, last number • Quality stereo sound when a single battery charge dialed, and voice-dial functions streaming music • Recharges in three hours with • Range of up to 23 feet • Private and secure connection included charger Mini Microphone 2+ • Connects with other personal * For compatibility information, visit www.Cochlear.com/compatibility. electronics via plug-in • Range of over 80 feet with clear line of sight • FM connectivity • Built-in telecoil • Pairing button status indicators • Low battery light indicator

Julie P. – Baha recipient 70 71 TV Streamer Remote Control 2 Enjoy stereo sound streamed from your TV right into your sound processor The Remote Control 2 allows you to effortlessly manage your hearing without having the volume too high for other people in the room. You get experience with a push of a button. With its small size, you can attach it to a balanced experience of sound from the TV while still being able to hear your keychain or put it in your pocket. It is especially useful for those without what’s going on around you. Unlike other loop systems, you’ll enjoy a robust a smartphone. Instead of using your smartphone to adjust the settings on wireless connection so you can hear the TV as you move about the room. the sound processor, you can conveniently use the Remote Control. Plus, it’s easy to set up! Key features: Key features: • Simple way to adjust program or • Range of up to 23 feet • Pair with as many Baha or Osia volume setting without touching or Sound Processors as desired • Set so you can hear audio removing the sound processor devices in addition to the • Install and forget it—always • Monitor battery status sounds around you stays paired • Start streaming from other wireless accessories • Control multiple sound processors • Easy to read, large LCD display

Remote Control

72 73 Retention Options for Osia 2 Sound Processor Retention Options Give You Added Peace of Mind • Long Safety Line with Alligator Clip* – can attach to your clothing. While You Stay Active • Short Safety Line with Hair Clip – a more discreet retention option. • Cochlear Headband – an optional accessory that holds the sound Retention options help keep your sound processor securely on your head processor in place and is available in a variety of fun colors. so you can stay active and enjoy physical activities and sports.

Retention Option for Baha 5 and Baha 5 Power Hair Clip Sound Processors • Long Safety Line with Alligator Clip – can attach to your clothing.* Safety Line* Brown White Black

Retention Options for Baha 5 SuperPower Sound Processor • Earhook+ – secures the sound processing unit in place behind your ear Long Safety Line with Alligator Clip Short Safety Line in an under the ear confi guration. The Earhook+ comes in one size and is adjustable. • S n u g fi t – helps to tighten the sound processor on the ear. The Snugfi t comes in three convenient sizes to fi t your ear (small, medium and large). • Litewear™ – provides more comfort and less weight on the ear by having the sound processor worn on the body instead of behind the ear. Vanilla Pink Dark Blue Purple Black • Mic Lock – this secures the sound processor comfortably on your ear with a light, clear band.

Cochlear Headband

Earhook+ S n u g fi t Litewear Mic Lock

* Retention lines longer than the Safety Line (standard length) are not recommended for use by children as they may present * Retention lines longer than the Safety Line (standard length) are not recommended for use by children as they may present a risk of strangulation. a risk of strangulation. 74 75 Chapter 5: Service and Support

Our Story ...... 80

Upgrading Your Device ...... 82

Support When and Where You Need It ...... 84

The Cochlear Community ...... 86

Recipient Stories ...... 88 Service &Service Support

Adriane S. – Osia recipient 76 77 Service and Support We help people hear and be heard.

Cochlear strives to be your partner for a lifetime of hearing. With almost 40 years of experience within the industry, you can feel confident that you are We empower people to connect getting the best support. We are committed to developing new technologies and providing personalized services to guide you to better hearing. with others and live a full life. There are hundreds of thousands of recipients world wide who have made this We help transform the way people life-changing decision. They are waiting to share their unique and inspiring stories and help you in your own journey. Connect with someone who has understand and treat hearing loss. been in your shoes; ask questions and get answers. We are committed to helping you Hear now. And always. We innovate and bring to market a range of implantable hearing solutions that deliver a lifetime of hearing outcomes.

Cochlear’s Mission Service & SupportService &

78 79 It All Started with a Very Personal Story

Over 40 years ago, Dr. Graeme Clark set out to help those who couldn’t hear. This became his life’s passion for a very personal reason—his father was deaf. Dr. Clark grew up experiencing fi rsthand the challenges of hearing loss and dreamed at a very early age of “fi xing ears.” And that’s exactly what he accomplished when he invented the world’s fi rst multi-channel cochlear implant in 1978. Since that fi rst small miracle, more people have chosen Cochlear than all the other hearing implant companies combined.1,2

Since 1978, Cochlear has evolved and expanded hearing implant solutions through bone conduction with the Cochlear Baha System. Dr. Anders Tjellström and his team pioneered the world’s fi rst bone conduction implant over 40 years ago. This discovery opened up a whole new world of hearing to those suffering from conductive hearing loss, mixed hearing loss and single- sided deafness.

Today, we work with over 2,000 hearing professionals around the world and with more than 100 research partners in 20 counties to continue to make breakthroughs. From creating the world’s fi rst Hearing Hub campus to developing revolutionary new products, our commitment and mission never stray from our main focus—to help you or your loved one Hear now. And always.

Dr. Graeme Clark Dr. Anders Tjellström 80 81 As Technology Continues to Improve, Baha® So Can Your Hearing 1993 Classic 300

In the same way that technology continues to evolve in smartphones, cars, computers and TV’s, Cochlear is continuously innovating to improve your Cordelle II 1999 hearing solution for comfort, performance and usability. As part of our Baha promise to help you “Hear now. And always,” we design our hearing implant 2000 systems to allow access to technological upgrades as they become available Compact without the need for additional surgery. Baha ® 2005 As the global leader in implantable hearing solutions and with our large Divino investment in research and development, our priority is to continue to bring Baha advanced technology to you for a lifetime. 2007 Intenso®

Baha 3 2009

2011 Baha 3 Power (BP110)

Baha 4 2013

2015 Baha 5

Baha 5 Power 2016

Baha 5 2017 SuperPower

Baha SoundArc 2018 (Wearing Option)

2019 Osia® 2

82 83 Support When and Where You Need It Insurance Process Support Cochlear is committed to answering your questions, providing fast and You will have access to our specialized team who can help you obtain convenient service, and helping you get the most from your bone conduction insurance approval if you experience a denial in coverage. implant today and into the future. Here’s how: Visit www.Cochlear.com/US/Insurance

Enjoy personalized services and information with Cochlear Family Cochlear Family is a program designed to help guide your family on this Fast service for repairs and replacements with Hear Always amazing hearing journey. By activating your free account, you’ll have Your clinic and Cochlear want to make sure you experience sound personalized access to tips, tools and resources to help you get the most uninterrupted, which is why we partnered on the exclusive Hear Always out of your hearing experience. You’ll connect with other Cochlear Family program. Hear Always ensures expedited replacement of your sound members and enjoy the peace of mind that comes from knowing we’re with processor if you are ever without sound. you every step of the way.

Visit www.Cochlear.com/US/CochlearFamily

Robust hearing therapy resources on the Communication Corner The Communication Corner is our extensive rehabilitation website that Anytime, anywhere access to important information with myCochlear provides materials and activities for all levels and ages to help improve your listening and communication skills. It includes a range of practice tools, as As part of the Cochlear Family, you will have access to a convenient online well as an assessment that provides guidance on where to start and which resource called myCochlear. Your family’s myCochlear account provides program is best for you. information about your specific device, including warranty and upgrade information, troubleshooting tips, and special promotions. It’s a one-stop Visit www.Cochlear.com/US/CommCorner shop for all things Cochlear and is available 24/7.

Cochlear Concierge can answer your questions A team of experts is ready to answer your questions and assist you in learning about the process, our products, technology and company.

Call 1 877 897 4474 or email [email protected]

84 85 You’ll Never Be Alone on Your Journey

Connect with others who have been exactly where you are and want to help

At any point during your journey, you may want to connect with others who have gone through the process. There is a large community of families who have been exactly where you are and want to support you and share their stories.

www.Cochlear.com/US/Connect-with-a-Mentor

What it means to be a part of the Cochlear Family We are a family. One that’s united by sound. Bound by a common experience that is anything but common. We are the people who can now hear what we couldn’t hear before, thanks to a company founded almost 40 years ago. We are the people who place our trust in Cochlear. We share our dreams with the surgeons, audiologists and therapists who help make them come true. We look out for one another. We support one another. We are united by sound and connected by Cochlear. We are the Cochlear Family.

86 87 Recipient Stories

Adrian S. I first learned of my hearing loss during a particularly difficult personal period in my life, and knowing that one of my five senses was failing, I felt even more separated from people. I struggled to find my place not only with my partner, but also with my friends and coworkers. Once I made the decision to move forward with the Osia system, my life changed. Upon activation, I teared up because I felt such an indescribable sense of relief and completeness. All the little, everyday things became so much easier. A great passion of mine is music, and after losing my hearing in my right ear, I lost all confidence in myself as a singer. But with Osia, my confidence is back and I’m in front of the microphone again. Other aspects of my life have seen improvements as well, both socially and at work. My partner and I enjoy trying out new restaurants, and the Mini Mic has been a valuable accessory to the Osia system. It has made it possible for me not just to hear, but to connect eye to eye with people, which is so meaningful to me. Also, as a psychiatric nurse, I have seen such a difference in how I connect with people. I have more honest, direct, and normal communication which sets a positive tone for conversations with my patients. It may sound cliché, but Osia has been a godsend, and it has truly changed my life for the better—I am eternally grateful for it.

Adrian S. - Osia recipient 88 89 Chris W. I was diagnosed with hearing loss when I was six years old, and although my hearing was perfect on the right side, I can remember feeling so isolated in social situations for much of my life. Since having the Osia device fitted, my confidence in social situations has completely changed. I am able to interact and play with my grandchildren, and hear them properly and clearly, which is one of my great joys in life. I am even able to carry on with all my favorite activities like swimming and singing in a choir. I can keep the device on while I’m swimming, thanks to the waterproof case, and it causes me no discomfort at all. I have always participated in and appreciated music—it is a major aspect of who I am, and having the Osia device has helped me to continue my involvement in this passion. Another accessory that I use quite often is the Mini Mic, and I can place it on the table at noisy restaurants which enables me to pick up sound far easier. Honestly, I can do everything that I want to do because the Osia® 2 Sound Processor feels very comfortable, normal, and natural. I’m living much more effectively; Osia has changed my life to such a high degree that I can hardly imagine what it would be like not having it.

Chris W. - Osia recipient 90 91 Anne S. From a very early age, I faced challenge after challenge when it came to hearing loss. I was born with a fused stapes bone in both ears, and a non- functional eardrum on my right side. Over the years, spanning from the age of 3 to 30, I underwent middle ear surgery five different times. Each time, I had hope that the latest middle ear surgery would work, but sadly, my story never changed. My next step was trying hearing aids which did help, but I knew they weren’t going to be enough and wouldn’t be a long-term solution. When I heard about the Cochlear Baha Bone Conduction Implant System, I was interested, yet hesitant. I didn’t know if I could handle yet another disappointment if it didn’t work. But eventually, I decided I had nothing to lose, so I just went for it. The Baha Implant procedure was easier than I had anticipated; I was in and out within a day and back to work within a couple of days. Since then, I feel like I have come out of my “cocoon.” With my Baha 5 System, I finally enjoy talking to people again! My family and professional life has improved, and most importantly, my self-confidence has increased dramatically. I fell so in love with how well I was hearing that I decided to go bilateral and got a second Baha Implant for the other side. So many people don’t realize what an asset it is to be able to hear from both ears. When you hear out of one ear, it’s harder to hear people call you if they’re standing on the wrong side of you. Now, it doesn’t matter what side people are on. I’m happier. I’m out more. I’m active. I’m enjoying other people and living my best life.

Anne S. – Baha recipient 92 93 Chapter 6: Steps and Resources

Steps to Getting a Bone Conduction Implant ...... 96

Resources ...... 100

References ...... 108 Steps & Resources & Steps

94 95 Steps to Getting a Bone Conduction Implant System Steps and Resources 1 Visit a Hearing Implant Specialist for a hearing test You may be as excited as you are hesitant. The idea of a surgical procedure If you haven’t already met with a Hearing Implant Specialist, then now is the would worry anyone and that’s completely understandable, but remember time. You will complete a hearing test to find out if you can benefit from a how much you could benefit from this technology. We want you to feel bone conduction system. If it’s determined you are a good candidate, you’ll comfortable every step of the way. And, we will be right there with you. get to test the sound processor and hear the difference this technology can make. That’s the unique advantage of a bone conduction solution—you can try it first before deciding to move forward.

To find a Hearing Implant Specialist in your area, visit www.Cochlear.com/US/Appointment

2

Obtain insurance approval Unlike hearing aids, bone conduction implant systems are typically covered by Medicaid, Medicare and most insurance plans.* The hearing implant team or your audiologist may submit the necessary paperwork to your insurance company to start the approval process.

For more information, visit www.Cochlear.com/US/Insurance

Once qualified and while insurance approval is pending, your hearing implant team will discuss the risks and benefits with you and schedule surgery. If you need assistance navigating the insurance approval process or help with an appeal if the claim has been denied, we offer individual insurance support.

Contact Cochlear Insurance Support at 800 633 4667 option 4 or email [email protected]

* Covered for Medicare beneficiaries who meet CMS criteria for coverage. Coverage for adult Medicaid recipients varies according to state specific guidelines.

Steps & Resources 96 97 3 6 Choose the best bone conduction solution for you All bone conduction solutions are designed to restore access to sound in a Ongoing care similar fashion, yet there are noticeable distinctions between the devices. To help ensure you are hearing your best every day, take good care of the device. We have many “how to” videos available on myCochlear, a 24/7 online Make sure to ask the right questions before choosing the right device for you. service portal, and our Customer Service team will be happy to answer any Think beyond today and consider what you want for the future. You may questions you have along the way. also want to think beyond the product itself and remember that Cochlear will provide support to you for a lifetime. Throughout your entire journey, We understand, though, that things can happen. And when they do, keep in you can always connect with other Cochlear bone conduction recipients and mind, we offer a one-time loss replacement. families who can share their personal experiences.

Visit www.Cochlear.com/US/Connect-with-a-Mentor 7

Hearing therapy 4 Just as with any surgery, rehabilitation is critical to your success and will continue to be important while growing up. For additional support, we offer Outpatient surgery robust rehabilitation programs through the Communication Corner that We understand the thought of surgery is intimidating, but it’s necessary can be tailored to your needs at every learning level and age group. Register to provide you with access to sound with a bone conduction implant. for the Communication Corner and share the information with your speech Fortunately, the procedure is fairly routine, typically lasting less than an hour, therapist and audiologist. and is performed under general anesthesia. The risks of the implant surgery are typically low, and most people are back to their normal activities within a Visit www.Cochlear.com/US/CommCorner few days.

5

Activating your bone conduction system After the initial healing period of up to 12 weeks, you will have an appointment with your audiologist to receive your new sound processor. This is the day you will start to hear sound through your new device. Your audiologist will adjust the settings to match your needs and show you how it works. Just like that, your world will open up through sound.

98 99 Baha 5 Sound Processor Features Baha 5 System Features Feature Benefit Why It Matters Feature Benefit Why It Matters

The Baha 5 System is the first The Baha Connect System Your hearing needs may bone conduction system to offer Unique surface coating abutment features state of the Dermalock™ Sound Processor change over time and will three head-worn sound and concave shape that art Dermalock™ technology, Abutment Options need options for today and processors, each one designed preserves the hair and skin which helps reduce surgery time, Technology the future. to meet a different level of around the abutment. and most people heal in just a hearing loss. few days.3

Made for iPhone technology The Baha Connect System is Easily control and stream Made for provides the convenience designed for a high level of MRI sound to your sound iPhone of direct streaming to the compatibility. The Baha Attract processor from your Connectivity sound processor from your System is conditionally approved Apple® device. Apple device. for an MRI at 1.5 Tesla, with the MRI Providing a safe and sound processor removed and the You can personalize and Compatibility* effective MRI image. magnet in place. For stronger MRI, Control and manage Baha 5 monitor your hearing experience the magnet can be temporarily your hearing using Smart App conveniently with devices you removed. Both the Baha Connect your smartphone. use every day. and Attract Systems sound processors need to be removed The sound processor blocks before any MRI scan.* Innovative technology background noise to help SmartSound® iQ for better hearing you hear your best in performance. noisy environments.

The automatic scene classifier analyzes your current Automatic Easier hearing in noise. surroundings and identifies the Scene Classifier listening environment as one of seven common scenes.

Records how the sound Tracks how you use the processor is being used in Data Logging sound processor every day. order to provide information to your audiologist.

Confirmation that your Visual Alert Baha 5 Power or Baha Lets you know if everything is Lights 5 SuperPower Sound working as it should be. Processor is working.

A Hearing Implant Specialist You have the unique Try it First, can help you demo a sound advantage of hearing Then Decide processor with a Softband the difference. or SoundArc.

* Prior to receiving an MRI, please consult with your clinician about proper precautions. 100 101 Osia 2 Sound Processor Features Osia 2 System Features Feature Benefit Why It Matters Feature Benefit Why It Matters

Provides you with a powerful Provides you with a hearing solution Because the transducer Sound It's important to know that you hearing loss solution for up to now, and in the future if your has no movement in the Processor Piezo Power™ have consistent and powerful 55 dB SNHL.* hearing loss progresses. inner parts, it gives you Technology hearing performance to hear powerful and reliable your best. Easily control and stream Made for iPhone technology access to hearing.4 Made for sound to your sound provides the convenience of direct iPhone processor from your streaming to the sound processor The Baha BI300 is Cochlear’s Connectivity Improves the transmission Apple® device. from your Apple device. latest titanium implant featuring of sound and ensures TiOblast™ surface technology, you can benefit from You can personalize and BI300 Implant which is designed and tested for Control and manage consistent and reliable Osia monitor your hearing experience long-term reliability and better your hearing using access to hearing Smart App conveniently with devices you sound transmission compared to your smartphone. throughout your life.5 use every day. other systems.5,6

The sound processor blocks back- The Osia Implant is designed to Innovative technology for SmartSound iQ ground noise to help you hear your MRI MRI Access be MRI conditional at 1.5 and 3.0 better hearing performance. best in noisy environments. Tesla with the magnet removed.

The automatic scene classifier Automatic Accessories analyzes the surroundings and Scene Easier hearing in noise. identifies the listening environment Feature Benefit Why It Matters Classifier as one of seven common scenes. Having speech and sound wirelessly streamed directly to Records how the sound processor is Tracks how you use the True Wireless Wireless streaming to your your sound processor without Data Logging being used to provide information sound processor every day. Technology sound processor. the need to wear anything to your audiologist. around the neck can allow you to hear more clearly. Confirmation that your Visual Alert Lets you know if everything is sound processor Lights working as it should be. Manage settings and programs is working properly. Remote management without the need to touch the Remote Control of you hearing. sound processor so you don’t go Sound You have the unique Gives you the opportunity to without sound. Processor advantage of having five color choose if you want your sound Personalization cover options to choose from. processor to blend in or stand out.

The Osia 2 Sound Processor is water You can hear while Aqua+ resistant and can be waterproof swimming or spending Accessory** when used with the easy-to-use time underwater. Aqua+ accessory.

* SNHL means sensorineural hearing level. ** The Osia 2 Sound Processor with Aqua+ is water resistant to level IP68 of the International Standard IEC60529 when used with LR44 alkaline or nickel metal hydride disposable batteries. Refer to the relevant User Guide for more information. The Osia 2 Aqua+ may not be available in all markets and is subject to regulatory approval and product availability. 102 103 Services Feature Benefit Why It Matters

Comprehensive Your family will have access Cochlear Family personalized online to personalized tips, tools resources. and resources.

Your family will have access to convenient online Access to important resources including warranty myCochlear information anytime and upgrade information, and anywhere. troubleshooting tips, as well as special promotions.

Cochlear You will feel supported Concierge and Questions answered by knowing there is a team of Engagement Cochlear experts. local experts to help you when Managers you have questions.

Provides confidence that you'll have support and help navigating Insurance Insurance payment process the insurance process. We also Support made easier. offer direct billing services for parts and accessories to your insurance company.

The Hear Always program Fast repair and ensures expedited replacement Hear Always replacement services. of your sound processor if you are ever without sound.

You will have confidence in Comprehensive Robust hearing therapy our rehabilitation support Rehabilitation resources for all ages with the Communication Resources and abilities. Corner, our extensive hearing therapy website.

104 105 Glossary of Important Terminology

Acquired deafness: A severe to profound hearing loss that develops later Frequency: The pitch of a sound is measured in Hertz (Hz). in life. Hearing threshold: The softest sound that a person can hear at a specific Active osseointegrated implant system: An osseointegrated, steady- frequency. Hearing thresholds are displayed on an audiogram to show an state implant system that has the implant with the transducer (the part individual’s hearing loss. of the implant that creates vibrations) completely under the skin and uses Localization: The ability to determine where a sound comes from. bone conduction to send sound vibrations naturally through the bone to the inner ear. Mixed hearing loss: Refers to a combination of conductive and sensorineural hearing loss. This means there may be damage in both the outer or middle Audiogram: A graph obtained during a hearing test that illustrates a person’s ear, as well as the inner ear. hearing in each ear, indicating the degree and type of hearing loss. Otolaryngologist: A physician that treats ear, nose, sinus and throat Audiologist: A professional who treats individuals with a hearing disorders and diseases. loss impairment. Otologist: A physician who specializes in treatment of ear problems. Auditory: Relating to hearing. Post-lingual deafness: Deafness that occurs after language acquisition. Bilateral hearing: Using the same hearing technology in both ears, either with two hearing aids or two hearing implants. Rehabilitation: Specialized training for people with hearing loss to help them learn to speak and understand language through listening. Bimodal hearing: Using a hearing aid in one ear and a hearing implant in the other ear. Residual hearing: The amount of remaining hearing that a person has after experiencing a hearing loss. Binaural hearing: Using both ears to hear sounds. Sensorineural hearing loss: This type of hearing loss occurs when there Binaural/Bilateral hearing loss: Hearing loss affecting both ears. is damage to the inner ear, or cochlea, or the nerve pathways to the brain. Bone conduction implant system: A hearing implant system where the This type of hearing loss is the most common and is usually permanent. osseointegrated implant is in the skull bone and the transducer is included Single-sided deafness: Sensorineural hearing loss can occur in one or both in a sound processor outside of the head. ears. If the loss is in one ear, it is often referred to as unilateral hearing loss or Conductive hearing loss: Sound cannot travel through the outer or middle single-sided deafness. This is when there is little or no hearing in one ear, but ear because of malformation, chronic ear infections, benign tumors or other normal hearing in the other ear. factors. This condition may be treatable depending on the cause. Speech frequencies: The range of frequencies most important for hearing Congenital hearing loss: A hearing loss that is present at birth. and understanding speech from 250 to 6,000 Hz.

Intensity: The loudness of a sound measured in decibels (dB). Sudden deafness: Hearing loss that occurs seemingly overnight. Often times, it may be difficult to identify a specific cause.

106 107 References

Chapter 1: Chapter 2: 1. Sennerby L, Gottlow J, Rosengren A, Flynn M. An experimental evaluation of a new craniofacial implant using the 1. Lewis AT, Vanaelst B, et al. Clinical success rates in restoring hearing loss among adult and pediatric patients with rabbit tibia model. Part II. Biomechanical findings. Otology and Neurotology (accepted). chronic otitis media: a systematic review. 2. Lin LM, Bowditch S, Anderson MJ, May B, Cox KM, Niparko K. “Amplification in the rehabilitation of unilateral 2. Goh J. OSI200 Implant Accelerated Life Test Report. D1439967. Cochlear Bone Anchored Solutions AB, Sweden 2019. deafness: speech in noise and directional hearing effects with bone-anchored hearing and contralateral routing of 3. den Besten CA, Stalfors J, Wigren S, Blechert JI, Flynn M, Eeg-Olofsson M, Aggarwal R, Green K, Nelissen RC, Mylanus signal amplification.” Otology & Neurotology. 2006;27(2):172-82. EA, Hol MK. Stability, Survival, and Tolerability of an Auditory Osseointegrated Implant for Bone Conduction Hearing: 3. Niparko JK, Cox KM, Lustig LR. Comparison of the bone-anchored hearing aid implantable hearing device with Long-Term Follow-Up of a Randomized Controlled Trial. Otol Neurotol. 2016;37(8):1077-1083. contralateral routing of offside signal amplification in the rehabilitation of unilateral deafness. Otology & 4. Felton M, Hill-Feltham P, Bruce IA. The role of stability measurements of the Baha(R) system in children. Int J Pediatr Neurotology, 2003 Jan;24(1):73-78. Otorhinolaryngol. 2014;78(3):513-516. 4. in LM, Bowditch S, Anderson MJ, May B, Cox KM, Niparko K “Amplification in the rehabilitation of unilateral deafness: 5. Marsella P, Scorpecci A, D’Eredita R, Della Volpe A, Malerba P. Stability of osseointegrated bone conduction systems speech I noise and directional hearing effects with bone-anchored hearing and contralateral routing of signal in children: a pilot study. Otol Neurotol. 2012;33(5):797-803. amplification.” Otology & Neurotology.2006;27(2):172-82. 6. Wilkie MD, Lightbody KA, Salamat AA, Chakravarthy KM, Luff DA, Temple RH. Stability and survival of bone anchored 5. Cochlear Bone Anchored Solutions AB, Mölnlycke, Sweden. Long term stability, survival and tolerability of a (novel) hearing aid implant systems in post-irradiated patients. Eur Arch Otorhinolaryngol. 2015;272(6):1371- 1376. Baha implant system. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). [Cited 2016 7. Sennerby L, Gottlow J, Rosengren A, Flynn M. An experimental evaluation of a new craniofacial implant using the Jan 6]. Available from: https://clinicaltrials.gov/ct2/show/NCT02092610. NLM Identifier: NCT02092610. rabbit tibia model. Part II. Biomechanical findings. Otology and Neurotology (accepted). 6. Flynn MC, Sadeghi A, Halvarsson G. Baha solutions for patients with severe mixed hearing loss. Cochlear Implants Int 8. Dun, C.A.J. , de Wolf, M.J.F , Wigren, S., Eeg Olofsson, M., Granstrom, G.,Green, K., Flynn, M.C., Stalfors, J., Rothera, 2009;10 Suppl 1:43-7. M., Mylanus, E.A.M., & Cremers, C.W.R.J. (2010) Development and Multi centre Clinical Investigation of a Novel Baha 7. Hol MK, Snik AF, Mylanus EA, Cremers CW. Long-term results of bone anchored hearing aid recipients who had Implant System. Technical and 6 Month Data. Paper presented at CI 2010, Stockholm, Sweden. previously used air-conduction hearing aids. Arch Otolaryngol Head Neck Surg 2005 Apr;131(4):321-5. 9. Karaca CT, Akçay SS, Toros SZ, et al. External auditory canal microbiology and hearing aid use. Am. J. Otolaryngol. 8. Watson GJ, Silva S, Lawless T, Harling JL, Sheehan PZ. Bone anchored hearing aids: a preliminary assessment of the 2013;34(4): 278-281. impact on outpatients and cost when rehabilitating hearing in chronic suppurative otitis media. Clin Otolaryngol 10. Clinicaltrials.gov. (2019). 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108 109 We would like to give a special thank you to all the recipients and their families who have shared their pictures and stories in an effort to help others who are going through their own hearing journey.

Bob Y. – Baha recipient 110 As the global leader in implantable hearing solutions, Cochlear is dedicated to helping people with moderate to profound hearing loss experience a life full of hearing. We have provided more than 550,000 implantable devices, helping people of all ages to hear and connect with life’s opportunities.

We aim to give people the best lifelong hearing experience and access to innovative future technologies. We have the industry’s best clinical, research and support networks.

That’s why more people choose Cochlear than any other hearing implant company.

Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always read the instructions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information. Views expressed are those of the individual. Consult your health professional to determine if you are a candidate for Cochlear technology. ©Cochlear Limited 2019. All rights reserved. Hear now. And always and other trademarks and registered trademarks are the property of Cochlear Limited or Cochlear Bone Anchored Solutions AB. The names of actual companies and products mentioned herein may be the trademarks of their respective owners. The Cochlear Baha 5 Smart App is available on App Store and Google Play. For compatibility information visit www.Cochlear.com/Compatibility. Cochlear Baha 5 sound processors are compatible with iPhone, iPad and iPod touch. For compatibility information visit www.Cochlear.com/Compatibility. Android and Google Play are registered trademarks of Google Inc. ©2019. Apple, the Apple logo, FaceTime, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc. and any use of such marks by Cochlear is under license. www.Cochlear.com/US Follow us on

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BUN324 ISS7 DEC19