A 2-year-old boy has bilateral congenital aural atresia with microtia. CT shows normal inner ear structures and ABR confirms normal cochlear function bilaterally. His parents want rehabilitation that does not wait for surgical canal reconstruction. Which intervention is most appropriate now?

• A Conventional behind-the-ear air conduction hearing aid with a custom earmould
• B Bone conduction implant on a softband, with plans for implantation once skull thickness permits ✓
• C Cochlear implantation in the better hearing ear
• D Delay all rehabilitation until atresiaplasty is performed at school age

Explanation

In bilateral aural atresia with normal cochlear function, sound bypasses the absent canal via bone conduction. A bone conduction device worn initially on a softband provides amplification during the critical language period, and the titanium fixture is placed later when the temporal bone is thick enough, usually around 4 to 6 years. Air conduction aids cannot be retained without a canal, and cochlear implantation is inappropriate because the cochlea is normal.

Reference: Cummings Otolaryngology Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.