Inclusion Criteria:  Geographically and physically able to return to the investigational site for scheduled evaluations and follow-up appointments  Fluent in the German language Persons of 18 years of age or older Signed and dated informed consent before the start of any study-specific procedure The physician must fully assess the potential risks and benefits for the patient prior to the decision to implant the RW-Precision-Coupler. The physician must exercise medical judgment and consider the patient's complete hospital record (also called medical history) No previous active middle ear implant surgery performed in the implanted ear  The following indication for VORP503:  For a patient with sensorineural hearing loss, pure-tone air conduction threshold levels at or within the levels listed below: For a patient with conductive or mixed hearing loss, pure tone bone-conduction threshold levels at or within the levels listed below: A patient shall present with an ear anatomy that can facilitate positioning of the FMT in contact with a suitable vibratory structure of the ear. A patient with sensorineural hearing loss shall be a current user of an acoustic hearing aid and have used this aid for at least 4 hours (average) per day for at least 3 months prior to evaluation, or shall not be able to wear or benefit from conventional hearing aids for medical reasons. A patient shall be psychologically and emotionally stable with realistic expectations of the benefits and limitations of the Soundbridge  Exclusion Criteria:  Simultaneous participation in another clinical trial (on device or on drug) which would interfere with the results of the study  Pregnancy or lactation  Contraindication for RWP-Coupler Sizer:  if a patient is known to be intolerant of the materials used in the RWP-Coupler. if a patient is known to be intolerant of the materials used in the RWP-Coupler Sizer. in case of a fixed stapes footplate.  Contraindication for VORP503:  A patient is known to be intolerant of the materials used in the implant (medical grade silicone elastomer, medical grade epoxy and titanium). A patient with retrocochlear, or central auditory disorders. A patient with nonresponsive active ear infection and/or chronic fluid in or about the ear. A patient whose hearing loss has demonstrated an improving and decreasing fluctuation over a two-year period of 15 dB in either direction. A patient with any physical, psychological, or emotional disorder that would interfere with surgery or the ability to perform on test and rehabilitation procedures. A patient with a skin or scalp condition that may preclude attachment of the audio processor with a magnet.