A sound processor behind the ear<unk> s use a surgically implanted abutment to transmit sound by direct conduction through<unk>  to the inner ear, bypassing the external auditory canal and middle ear. A titanium prosthesis is surgically embedded into the skull with a small abutment exposed outside the skin. A sound processor sits on this abutment and transmits sound vibrations to the titanium implant. The implant vibrates the skull and inner ear, which stimulate the nerve fibers of the inner ear, allowing<unk> . The surgery is often performed under local anesthesia and as an outpatient procedure. An important piece of information for patients is that if they for whatever reason are not satisfied with the<unk>  solution, removing the implant is easy. No other ear surgical procedure is reversible like this. By bypassing the outer or middle ear,<unk>  can increase<unk>  in noisy situations and help localise sounds. In addition to improved speech understanding, it results in a natural sound with less distortion and feedback compared with conventional<unk> <unk> s. The ear canal is left open for comfort, and helps to reduce any problems caused by chronic ear infections or allergies. In patients with single-sided sensorineural deafness,<unk>  sends the sound by the skull<unk>  from the deaf side to the inner ear of the<unk>  side. This transfer of sound gives a 360° sound awareness.<unk> s may facilitate normal speech development. Chronic ear disease This fairly common condition is often associated with continuous or intermittent drainage from the ear canal. These patients may also have a<unk>  loss and need amplification. A conventional air conduction<unk>  with a mold placed in the ear canal opening may not be appropriate due to the drainage, and may even provoke drainage. If the<unk>  loss is significant an air conduction<unk>  may have difficulty overcoming the dysfunction of the eardrum and middle ear<unk> s.<unk>  conduction<unk>  device bypassing the middle ear may be a more appropriate treatment for these patients. Good transmission of sound in the<unk> , with reduced attenuation and distortion may be possible. Single-sided deafness A person with unilateral<unk>  loss may have functional difficulty<unk>  even when the other ear is normal, particularly in demanding situations such as noisy environments and when several people are speaking the same time. A complication in single-sided deafness is<unk>  impairment in the<unk>  ear. Conventional ear surgery involves a risk of<unk>  loss due to the surgical procedure. Most ear surgeons are thus reluctant to perform surgery on an only<unk>  ear. The<unk>  surgery avoids this risk and may be an appropriate treatment. An extended trial of a<unk>  system with a headband prior to surgery led to more realistic expectations. In the trial, 50% of the candidates wished to proceed to surgery. External ear canal problems Irritation in the external ear canal due to inflammation or eczema may be a condition for which a conventional air conduction<unk>  is not an appropriate treatment. Direct<unk>  conduction may be an option. Malformations Patients with malformations are not always suitable for reconstructive surgery. Treacher Collins syndrome patients may have significant malformations with ossicular defects and an abnormal route of the facial nerve. These structures, as well as the inner ear, could be in danger at surgery. Patients with Down syndrome may have a narrow ear canal and middle ear malformation leading to impaired<unk> . Some part of the cognitive delay seen in these children may be partly due to their poor<unk> . The surgery can only take place once the skull is at least 2.5 mm thick. Children who suffer certain syndromes may have a slighter build, thinner<unk> , or unusual anatomy. Other children may have a thicker skull at a younger age, so it is difficult to give a specific age for surgery. In the U.S., the Food and Drug Administration only approves<unk>  implantation of children aged five years or older. For infants and young children prior to surgery, the sound processor can be worn on a head band or soft band which the infant wears to hold it against the skull.
Bone-anchored hearing aid
Middle ear implant
Craniofacial prosthesis
Cochlear implant
Tinnitus retraining therapy
Vibroacoustic therapy
Totally implantable cochlear implant
Audio therapy