■ OBJECTIVES: The goal of the presentation is to describe the advantages and disadvantages of a middle ear implant (MEI Vibrant Medel) versus a bone-anchored hearing aid (Entific/Cochlear BAHA) in patients with conductive or mixed hearing loss.

■ METHODS: Due to the frequency of minor and major cutaneous complications in 23 BAHA patients out of a total of 114, we have proposed a middle ear implant in case of mixed hearing loss where a conventional hearing aid could not be used due to external auditory canal problems.

■ RESULTS: 9 patients were implanted with an MEI; 5 on the ossicular chain and 4 on the round window. The authors will describe the surgical technique, and the intraoperative monitoring for the round window placement together with the anatomical and functional results (gain, speech discrimination in quiet and in noise).