title: An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Otolaringology, Hospital De Reabilitacao De Anomalias Craniofaciais (HRAC), Universidade De Sao Paulo, Bauru, Brazil. rbritoneto@gmail.com.
authors.forename: Rubens de
authors.initials: R
authors.lastname: Brito
authors.forename: Luzia Maria
authors.initials: LM
authors.lastname: Pozzobom Ventura
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Jorge
authors.forename: Eduardo Boaventura
authors.initials: EB
authors.lastname: Oliveira
authors.forename: Luiz Fernando
authors.initials: LF
authors.lastname: Manzoni Lourencone
mesh_terms: D000293:Adolescent; D000328:Adult; D000013:Congenital Abnormalities / Q000534:rehabilitation / Q000601:surgery*; D065817:Congenital Microtia / Q000150:complications* / Q000601:surgery; D004423:Ear / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009998:Ossicular Prosthesis; D019933:Ossicular Replacement; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult