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With great interest we read the recently published article by Bianchin et al. describing a case report of a child with Van Maldergem Syndrome causing severe craniofacial dysmorphism and bilateral congenital conductive hearing loss due to microtia and external auditory canal atresia [1]. Auditory restoration with a conventional skin-drive bone-conduction device, attached to a steel spring headband, was not optimal causing a speech development delay. Therefore, it was decided to implant Vibrant Soundbridge. The workup to this decision and postoperative outcomes are being discussed. We agree to the statement of the author that the best solution should be provided after careful multidisciplinary assessment about risk and benefits of all possible treatments. But with this letter we would like to express our concerns regarding the incomplete considerations about the BAHA, further described as bone implant (BI), and Vibrant Soundbridge made in the article especially in such a young child with complex needs.

Comment on “Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism”