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In our experience B.A.H.A. (Bone Anchored Hearing Aid) with its direct bone conduction brings a better hearing rehabilitation for patients with draining ear and further more with major aplasia. 23 patients were tested, 12 have got a bilateral hearing aid, 5 unilateral. They reported a better comfort, a more natural sound and a better discrimination in noise. A bilateral application brought them a stereoacousy with a special directivity, we also note improvement of hearing by different hearing tests.

The osteofixtures developed by P.I. Branemark are pure titanium screws implanted percutaneously and intraosseously in the mastoid region. The mechanical properties and biocompatibility towards bone and soft tissues of these titanium fixtures were studied after 80,000 cases of human application, essentially in the field of dentistry. The authors present their preliminary results in the otological field: firstly, the auditory prosthesis with a mean gain of 20 dB over classical prostheses via air and bone transmission and, secondly, the epiprosthesis of the external ear in cases of aplasia with scarred skin.

Principles underlying reconstructive surgery of external ear for major aplasia are described and results presented for 65 patients treated using a cartilaginous framework of a costal autograft as described by B. Brent. Possibilities are discussed of combining this technic with auditory function surgery and the wearing of an auditory prosthesis within the framework of general care of major aplasias.

Hemifacial microsomia and Treacher Collins syndrome are the most frequent among the first and second branchial arch syndromes to include anomalies of the facial skeleton. Hemifacial microsomia is almost always unilateral and is characterised by hypoplasia or agenesis of the mandibular ramus. Treacher Collins syndrome is always bilateral and involves specifically the zygomatic bones. The treatment of skeletal anomalies is seldom started before 10-12 years of age, except in severe form with major aesthetic impairment. Such cases are treated at the beginning of school age, on and after 6-8 years. Several operations, including osteotomies of the jaws and bone grafts, are usually necessary to achieve an acceptable result.