Congenital Aural Atresia: Hearing Rehabilitation by Bone-Anchored Hearing Implant (BAHI)

Auris atresia (AA) is a congenital pathology characterized by aplasia or hypoplasia of the external ear with associated middle ear malformation. The AA has a different degree of severity, and the severe form of the disorder presents no identifiable ear canal (complete atresia) and absence or significative underdevelopment of the middle ear structures. Sometimes AA is associated with a malformation of the ear called “microtia.” The alterations of the external auditory canal and of the middle ear structures are responsible for the conductive hearing loss which affects the patients. The hearing restoration procedures may recreate a normal external and middle ear anatomy to favor the recovery of the hearing function, or the surgeon may simply restore the hearing capacity through bypassing the malformed structures by bone-anchored hearing implants (BAHIs). The restoring of normal anatomy is generally associated with episode of restenosis of the external ear canal due to bony regrowth. The formulation of a therapeutic strategy may be supported by using Jahrsdoerfer classification to identify the severity of malformation. In the chapter we discuss various bone anchoring prostheses currently used (Baha, Ponto, Alpha2 by Sophono, Bonebridge) and the results that can be obtained by the use of these implants.