There are multiple methods of hearing improvement. These range from use of hearing aids in the elderly or surgical reconstruction of hearing mechanism using either of these methods: . Ossiculoplasty: Reconstruction of middle ear ossicles/bones using titanium implants. b. Bone anchored hearing implants: For patients with open cavities or radical mastoidectomies on both sides. c. Active middle ear implants (Vibrant Soundbridge): For patients with mixed hearing loss with both conducive and sensorineural hearing loss component and when patients are not comfortable wearing hearing aids. d. Cochlear implants: To correct severe to profound hearing loss not amenable to any other non-surgical or surgical modality.