title: Amplification options in unilateral aural atresia: an active middle ear implant or a bone conduction device?
abstract: BACKGROUND
  There is no consensus on treatment of patients with congenital unilateral aural atresia. Currently, 3 intervention options are available, namely, surgical reconstruction, application of a bone-conduction device (BCD), or application of a middle ear implant.
  
  
  OBJECTIVE
  The present study aims to compare the BCD with the application of a middle ear implant. We hypothesized that cross-hearing (stimulating the cochlea by means of bone conduction contralateral to the implanted side) would cause BCD users to have difficulty performing localization tasks.
  
  
  METHODS
  Audiologic data of 4 adult patients with a middle ear implant coupled directly to the cochlea were compared with data of 4 adult patients fitted with an osseointegrated BCD. All patients were fitted during adulthood. The emphasis of this study is on directional hearing.
  
  
  RESULTS
  The middle ear implant and the BCD improved sound localization of patients with congenital unilateral aural atresia. Unaided scores demonstrate a large variation.
  
  
  CONCLUSIONS
  Our results demonstrate that there was no advantage of the middle ear implant over the BCD for directional hearing in patients who had no amplification in childhood. The BCD users had the best bandwidth.
authors.affiliation: Departments of *Otorhinolaryngology and †Biophysics, Radboud University Nijmegen Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; ‡Department of Otorhinolaryngology and Plastic Operations, University Hospital Schleswig-Holstein, Lübeck, Germany; and §Department of Otorhinolaryngology-Head and Neck Surgery, St. Augustinus Hospital, Wilrijk, Antwerp, Belgium.
authors.forename: Martijn J H
authors.initials: MJ
authors.lastname: Agterberg
authors.forename: Henning
authors.initials: H
authors.lastname: Frenzel
authors.forename: Barbara
authors.initials: B
authors.lastname: Wollenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Somers
authors.forename: Cor W R J
authors.initials: CW
authors.lastname: Cremers
authors.forename: Ad F M
authors.initials: AF
authors.lastname: Snik
mesh_terms: D000293:Adolescent; D000328:Adult; D001844:Bone Conduction; D000013:Congenital Abnormalities / Q000503:physiopathology / Q000601:surgery*; D004423:Ear / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D006310:Hearing Aids; D046088:Hearing Loss, Unilateral / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016348:Osseointegration; D009998:Ossicular Prosthesis; D013017:Sound Localization / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult