Vibrant Soundbridge and Porous Polyethylene Auricular Reconstruction in a Single‑Stage Procedure

Microtia with aural atresia presents a dual challenge-restoration of external ear anatomy and rehabilitation of conductive hearing loss. Multiple staged procedures are often required, increasing patient burden. This study presents a single-stage surgical approach combining auricular reconstruction using Porous High-Density Polyethylene (pHDPE, Medpor^®) with simultaneous implantation of a Vibrant Soundbridge (VSB) and intraoperative audiological evaluation. To assess the surgical feasibility, safety, and postoperative cosmetic and audiological outcomes of a combined one-stage Medpor reconstruction and VSB implantation in a patient with grade 3 microtia and congenital aural atresia. A male in his early teens with right-sided grade 3 microtia and complete external auditory canal atresia underwent simultaneous Medpor auricular reconstruction and active middle ear implantation using the VSB system. The Floating Mass Transducer was attached to the short process of the incus. Intraoperative audiological measurements confirmed appropriate device coupling. The surgery included detailed preoperative planning, use of a temporoparietal fascial flap, and full-thickness skin grafting. Postoperatively, the patient demonstrated a significant improvement in hearing thresholds with a pure-tone average of 30 dB HL. Cosmetic results were excellent, and no surgical complications were reported. The patient reported enhanced auditory perception and satisfaction with both function and appearance. This case highlights the safety and effectiveness of combining Medpor auricular reconstruction with VSB implantation in a single procedure. The approach offers functional and esthetic benefits while reducing the need for multiple surgeries. Further studies with larger cohorts and longer follow up are needed to validate patient selection criteria and optimize treatment protocols for this complex congenital condition.