Introduction
Hearing loss is among the most common congenital conditions at birth. Early auditory stimulation and hearing rehabilitation are essential for normal auditory and language development in affected children. A range of bone conduction hearing systems (BCHS) are currently available for the management of conductive and mixed hearing loss.

Objective
To evaluate audiological benefit and subjective satisfaction in children with conductive hearing loss implanted with an active BCHS.

Methods
Audiological outcomes were assessed by comparing pre- and postoperative conditions, using functional gain (FG) calculated from the PTA4 (average of 500, 1000, 2000 and 4000 Hz), speech thresholds and speech recognition in noise using the HINT test, and subjective benefit through the SSQ-12 and GBI questionnaires.

Results
Thirty-one children (mean age 7.7 years) underwent unilateral implantation with an active BCHS using the J-flap surgical technique. Of these, 67.7% had unilateral microtia/atresia, 25.8% bilateral, and 6.5% had cholesteatoma sequelae. Average FG was 30.5 dB compared to unaided condition, and 7.4 dB over preoperative aided testing with a passive BCHS. Speech-in-noise testing showed a mean improvement of 8.3 dB in signal-to-noise ratio and 40.2 percentage points in word recognition over the unaided condition, and 2.7 dB and 18.1 points over the passive BCHS condition. GBI results showed a mean perceived quality of life improvement of +34.8. Between 9% and 18% of caregivers reported no perceived change in mood, behavior, or attention.

Conclusion
Active bone conduction systems provide significant audiological and subjective benefit in children with conductive hearing loss due to microtia, atresia or cholesteatoma.

Introduction:
In the past, transcutaneous bone conduction implants with implantation of magnets were often used to treat conductive hearing loss in cases of auditory canal atresia. Current bone conduction implants offer improved treatment options for patients. The question arises as to how to optimize treatment through implant replacement.

Materials and Methods:
Patients with a Sophono Alpha magnet (Sophono GmbH) underwent an explantation procedure due to inadequate audiological supply, followed by implantation of an alternative bone conduction implant (Bonebridge, MED-EL Elektromedizinische Geräte Gesellschaft m.b.H.) according to current standards.

Results:
The results show an improvement in all frequencies. The standardized treatment process and the surgical procedure were well tolerated by the patients.

Conclusion:
Replacement of bone conduction implants can lead to improved patient supply and should be considered in cases of subjective and objective complaints.

Background:
Congenital atresia of the external auditory canal (EAC) occurs in approximately 1 in 10,000–20,000 live births and is bilateral in about one-third of cases. Due to the separate embryological development of the inner and external/middle ear structures, cochlear and sensorineural elements are typically unaffected. Nevertheless, the resulting conductive hearing loss, often around 60 dB, can impair auditory and social development even when unilateral. In many cases, the severity of middle ear deformity precludes safe reconstruction, making bone-conduction hearing devices the first-line treatment.
Methods:
This study included children with unilateral complete atresia of the EAC. Preoperative high-resolution CT with 3D reconstruction was used to assess middle ear anatomy and assist surgical planning. Reconstruction was performed via a retroauricular approach with maximal enlargement of the tympanic and mastoid cavities. The reconstructed canal was covered using sculpted conchal cartilage or cortical bone.
Results:
Hearing improved above the socially functional threshold. The reconstructed canals remained stable and patent. No facial nerve dysfunction or major complications occurred.
Conclusion:
EAC reconstruction is a viable and safe option in selected cases. With detailed anatomical evaluation, accurate imaging, and intraoperative nerve monitoring, the procedure can offer stable audiological outcomes and improved quality of life. Where reconstruction is not feasible, bone-conduction hearing aids remain an effective alternative.

VACTERL association, previously named VATER in 1970s is defined as presence of three components of these birth defects: vertrebal anomalies, anal atresia, cardiac anomalies, esophageal atresia/tracheoesophageal fistula (EA/TEF), renal anomalies and limb defects. Galarreta et.al. studied craniofacial (CF) findings in 409 with and incidence of microtia 5.9% in patients with VACTERL and 5% in patients with pVACTERL (partial) saying it might be considered as part of the phenotypic diversity of VACTERL association. Microtia/anotia is well described in literature (SCHRAW et.al.), but not more than 20% of patients are diagnosed with genetic or chromosomal syndromes; Botto et al reported severe ear defects in 2.1% of infants with VACTERL association. We present a case report, of a masculine seven year old boy, with bilateral anotia, with previous use of ADHEAR, proper speech and language therapy since one year old, funding was made to complete the surgery due to lack of government funding, implanting bilateral BCI-602 located with OTOPLAN, with two SAMBA 2, becoming the first ever VACTERL association with microtia/anotia implanted in Mexico in 2024.

Background
This study compares the efficacy of Vibrant Soundbridge (VSB) and Bonebridge (BB) implants in patients with unilateral aural atresia, focusing on spatial hearing, masking release, sound localization, and patient-reported satisfaction.

Methods
In this ongoing study, six VSB and two BB recipients with unilateral aural atresia, all active implant users for ≥6 months, served as their own controls. Audiological assessments included pure-tone audiometry, vibrograms, and word recognition in quiet (WRS; Freiburger monosyllabic test). Spatial hearing was evaluated using the Oldenburg Sentence Test (OLSA) in three spatial configurations. Sound localization was assessed via the Beephonix setup. Patient satisfaction and quality of life were measured using the Spatial and Qualities of Hearing Scale 12 (SSQ12).

Results
All patients exhibited normal inner ear function bilaterally. The VSB group (n=6) achieved a mean WRS of 80% (SD ± 13) and demonstrated significant improvements in OLSA performance (ipsilateral signal/contralateral noise: -8.6 dB SNR) compared to unaided conditions. Sound localization accuracy improved significantly, with median absolute error decreasing from 11.94° (unaided) to 8.06° (aided) and localization success (LS) increasing from 94.44% to 100% with VSB. SSQ12 scores averaged 76,4%, reflecting high satisfaction. The BB results remain under evaluation.

Conclusion
VSB significantly improves auditory outcomes in unilateral aural atresia, particularly in spatial hearing and localization. Comparative efficacy between implants is being further investigated through continued recruitment. These results highlight the critical role of device-specific counselling in achieving optimal patient outcomes.

Introduction: Getting to know the importance of auditive rehabilitation. Bone conduction hearing devices have expanded the treatment options for unilateral sensorineural hearing loss, demonstrating their clinical efficacy. Nevertheless, the assessment of quality of life (QoL) allows to establish the patient’s improvement in daily activities and their satisfaction with the treatment.
Objective: To determine the QoL and treatment adherence of patients with sensorineural hearing loss treated with bone conduction hearing devices at Hospital Universitario Clinica San Rafael in Bogota D.C., Colombia, between 2012 - 2017.
Study design: Cross-sectional observational cohort study.
Methods: After the review of the medical history from the eligible patients who attended the hospital’s otology clinic, a validated QoL questionnaire (Glasgow Benefit Inventory – GBI) and an adherence questionnaire were completed. The score of QoL questionnaire and percentage of adherence were analyzed by nonparametric tests in relation to sociodemographic and clinical variables.
Results: A total of 38 patients were included in the study. The median of the total GBI score was +36.1 (range 0 to +61) and the global reported adherence was at least 5 times per week. We did not identify a statistically significant difference between these variables and the type of bone conduction hearing device.
Conclusions: The use of bone conduction hearing devices is associated with an improvement in QoL, high adherence rate and low prevalence of complications, without identifying statistically significant differences between those devices currently available in the market (Baha®, Bonebridge®, Cros® or Sophono®).
Keywords: Hearing Loss, Bone Conduction, Osseointegration, Quality of Life, Treatment Adherence and Compliance

Background:
Permanent unilateral conductive hearing loss (UCHL) in children can significantly affect language and auditory development. Although international evidence supports the benefits of bone conduction devices, their indication remains limited. This may be due to audiological assessments typically conducted in quiet, which do not reflect real-life environments. Functional evaluations, such as speech-in-noise tests, are increasingly considered the gold standard, emphasizing the need for more realistic clinical protocols.

Methods:
This cross-sectional, non-experimental, quantitative study compared auditory performance in noise between children and adolescents with normal hearing and those with UCHL using the OSIA bone conduction implant. A total of 20 participants were divided into two groups: Control (normal hearing) and Study (UCHL with OSIA). All participants underwent the Hearing In Noise Test (HINT) under fixed and adaptive noise conditions. Free-field audiometry was used for calibration in the study group; conventional audiometry in the control group.

Results:
In fixed noise (speech at 0°, noise at 180°), average scores were: Control 92.2%, UCHL unaided 90.9%, and OSIA 98.9%. In a spatially separated condition (speech at 270°, noise at 90°): Control 99.2%, unaided 78.3%, OSIA 96.4%. ANOVA showed significant differences (F = 142.37, p < 0.00001). Adaptive noise testing also showed significant effects (F(2,20) = 48.55, p < 0.001). No significant difference was found between OSIA and normal hearing (p = 0.101).

Conclusion:
OSIA significantly improves speech-in-noise recognition in children with UCHL, achieving outcomes comparable to those with normal hearing, supporting its clinical indication for functional auditory rehabilitation.