title: Application of the Vibrant Soundbridge in bilateral congenital atresia in toddlers.
abstract: CONCLUSIONS
  The Vibrant Soundbridge offers an excellent audiologic rehabilitation for toddlers with microtia and atresia. It provides direct stimulation of the cochlea and straightforward adaption to the given anatomical structures. The 'posterior atresia incision' preserves the physical integrity of the tissue layers around the ear remnant, which is essential for an aesthetic auricular reconstruction.
  
  
  OBJECTIVE
  Patients with bilateral aural atresia require immediate auditory stimulation to ensure normal speech development. We present an operative technique that allows safe restoration of hearing before aesthetic reconstruction.
  
  
  METHODS
  A 6-year-old boy presented with bilateral microtia and osseous atresia. A hairline incision was performed through all layers and was followed by a subperiostal preparation towards the atresia plane. The fused malleus-incus-complex was removed and the transducer was crimped to the stapes suprastructure on both sides.
  
  
  RESULTS
  Speech performance is nearly normal in both quiet and noise conditions. The surgery did not affect the tissues that are important for the later ear reconstruction.
authors.affiliation: Department of Otorhinolaryngology and Plastic Operations, University Hospital Schleswig-Holstein, Lübeck, Germany. henning.frenzel@uk-sh.de
authors.forename: Henning
authors.initials: H
authors.lastname: Frenzel
authors.forename: Frauke
authors.initials: F
authors.lastname: Hanke
authors.forename: Millo
authors.initials: M
authors.lastname: Beltrame
authors.forename: Barbara
authors.initials: B
authors.lastname: Wollenberg
mesh_terms: D002648:Child; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery; D004432:Ear, Middle / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008297:Male; D019933:Ossicular Replacement; D013063:Speech Discrimination Tests