Objectives: Atresia auris affects 1 in every 10,000 - 20,000 live births, with prevalence in Latin America much higher at 5 to 21 of every 10000 newborns. The important conductive hearing loss is crucial for the development of children.
There are aesthetic and functional aspects of treating these patients. For functional treatment, there are surgical and non-surgical alternatives like rigid and softband systems. The disadvantages of these prostheses include limited functional gain, cosmetic unattractiveness, and pain due to pressure on skin. Active transcutaneous bone conduction implants (BCI) achieve better sound transmission stimulating the bone directly. In 2016, an adhesive bone conduction device (aBCD) was introduced. The main objective of study was to assess the audiological performance and subjective satisfaction of children implanted with an active transcutaneous BCI over one year and to compare the outcomes with a non-surgical aBCD in the same users.
Methods: Prospective, multicentric study. Audiological performance and subjective satisfaction were evaluated at 1, 6 and 12 months post-implant activation, and after a 1-month trial with the non-surgical device. Tests: sound field audiometry; sound field speech in quiet and in noise; hearing-specific and audio processor-specific questionnaires.
Results: 10 patients completed all tests. The average PTA4 in the unaided condition was 65 dB HL and improved significantly to 20 dB HL after using the BCI for 12 months; with the aBCD an average PTA4 of 33 dB HL was measured. The speech recognition in quiet in the unaided condition was on average 33 %, which improved significantly using the BCI or aBCD. A mean WRS of 99 % with the BCI and 91 % with the aBCD could be achieved. The daily wearing time was 11 hours per day with the BCI and 9 hours using the aBCD. Overall, the BCI showed better results than the aBCD regarding subjective satisfaction.
Conclusions: The aBCD demonstrated sufficient hearing improvement and subjective satisfaction and thus is a good solution for hearing rehabilitation if surgery is not desired or not possible. If surgery is an option, the bone conduction implant is better device in terms of hearing outcomes, and subjective satisfaction.

**Objectives:** Atresia auris affects 1 in every 10,000 - 20,000 live births, with prevalence in Latin America much higher at 5 to 21 of every 10000 newborns. The important conductive hearing loss is crucial for the development of children.
There are aesthetic and functional aspects of treating these patients. For functional treatment, there are surgical and non-surgical alternatives like rigid and softband systems. The disadvantages of these prostheses include limited functional gain, cosmetic unattractiveness, and pain due to pressure on skin. Active transcutaneous bone conduction implants (BCI) achieve better sound transmission stimulating the bone directly. In 2016, an adhesive bone conduction device (aBCD) was introduced. The main objective of study was to assess the audiological performance and subjective satisfaction of children implanted with an active transcutaneous BCI over one year and to compare the outcomes with a non-surgical aBCD in the same users.
**Methods:** Prospective, multicentric study. Audiological performance and subjective satisfaction were evaluated at 1, 6 and 12 months post-implant activation, and after a 1-month trial with the non-surgical device. Tests: sound field audiometry; sound field speech in quiet and in noise; hearing-specific and audio processor-specific questionnaires.
**Results:** 10 patients completed all tests.** **The average PTA4 in the unaided condition was 65 dB HL and improved significantly to 20 dB HL after using the BCI for 12 months; with the aBCD an average PTA4 of 33 dB HL was measured. The speech recognition in quiet in the unaided condition was on average 33 %, which improved significantly using the BCI or aBCD. A mean WRS of 99 % with the BCI and 91 % with the aBCD could be achieved. The daily wearing time was 11 hours per day with the BCI and 9 hours using the aBCD. Overall, the BCI showed better results than the aBCD regarding subjective satisfaction.
**Conclusions:** The aBCD demonstrated sufficient hearing improvement and subjective satisfaction and thus is a good solution for hearing rehabilitation if surgery is not desired or not possible. If surgery is an option, the bone conduction implant is better device in terms of hearing outcomes, and subjective satisfaction.

Comparison of audiological performance and subjective satisfaction between surgical and non-surgical bone conduction hearing aids in children with atresia auris

It is with great pleasure and enthusiasm, that on behalf of the Cochlear Implant centers of the Radboud UMC in Nijmegen and Erasmus MC Sophia Children’s Hospital in Rotterdam to invite you to attend the 16th European Symposium on Pediatric Cochlear Implantation to Rotterdam, the Netherlands in 2023.

Yours sincerely, on behalf of the CI Centers at Radboud UMC and Erasmus MC,