An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results.

OBJECTIVE To demonstrate the surgical technique and audiological results of a middle ear implant for restoring hearing in patients with bilateral aural atresia and microtia with conductive or mixed hearing loss. MATERIALS AND METHODS In this prospective study, 12 subjects aged 12 years and older presenting with hearing loss and bilateral congenital aural atresia underwent surgical insertion of a middle ear implant. The patients underwent tympanomastoidectomy with a wide opening of the attic and preservation of the roof of the atresic tympanic bone to expose the middle ear and position the floating mass transducer of the implant. RESULTS There were no intraoperative or postoperative complications. The hearing threshold averages in a free field were 53.5 dB preoperatively and 25.6 dB postoperatively. Monosyllabic word recognition averaged 61% preoperatively and 91.3% postoperatively. The average speech perception in quiet conditions during the hearing in noise test improved from 67.11 dB to 45.99 dB, and the signal-to-noise ratio improved from 5.64 to 1.31. CONCLUSION The tested system is an excellent option for auditory rehabilitation of conductive hearing loss due to bilateral ear atresia. The surgery is well structured and safe and provides several alternatives to the surgeon, which is valuable in difficult cases.