The ability of sound to be conducted through bone was hypothesised as early as ancient Greece. Italian physician Girolamo Cardano in the 15th century invented the first bone conduction hearing aid by placing a rod between a patient’s teeth and attaching it to a musical instrument. This was the rumoured method Ludwig van Beethoven used towards the end of his career suffering from hearing loss by placing a rod in his mouth and resting the other end on the rim of his piano. French physician Jean Marc Gaspard Itard in the early 1800’s improved on this device by attaching the other end of the rod not to a musical instrument but to the mouth of another speaker, with the device known as the “Rod of Itard”. During the early 1900’s hearing via bone conduction evolved thanks to technological advances including development of the carbon microphone. These devices were designed to convert sound into mechanical signals to vibrate the mastoid. These devices were beneficial however cumbersome due to having to be worn on headbands or eyeglasses with often sub optimal sound transmission. Anders Tjellstrom and colleagues implanted the first percutaneous titanium device in Sweden using bone-anchored hearing principles and the process of osteointegration. These first devices were known as bone-anchored hearing aids or BAHA. The late 20th and early 21st centuries have seen innovations in implantable systems, with devices like the Cochlear’s Baha and MedEl Bonebridge emerging. These offer more discrete, effective and evolving sound processing. 1.Mudry A, Tjellström A. Historical background of bone conduction hearing devices and bone conduction hearing aids. In: Implantable bone conduction hearing aids. Karger Publishers; 2011. p. 1–9. 2.Hagr A. BAHA: bone-anchored hearing aid. Int J Health Sci. 2007;1(2):265. 3.Tjellström A, Lindström J, Hallén O, Albrektsson T, Brånemark PI. Osseointegrated titanium implants in the temporal bone: a clinical study on bone-anchored hearing aids. Otol Neurotol. 1981;2(4):304–10.