Patients born with severe dysmorphology involving the ears usually have hearing derangements as well as other areas of the craniofacial skeleton affected. To correct the functional problem, the usual and customary treatment is augmentation of the hearing with a bone conducting hearing device. The patients have to wear these devices with an external band. The new advances in osseointegrated implant allowed us today to utilize the same technology in the patient with the application of a bone anchored hearing device. The advantages are related to the obviation of the need to use a hearing band across the head, that most children object to, and the new device is much smaller than the large and cumbersome banded device. There is also an added advantage in the improvement of the hearing as the units are anchored internally in the bone. The device utilizes digital technology and can be calibrated easily. The patient can apply the device in the morning by a simple application click. The disadvantage to the patient is that the area requires consistent maintenance and care, however, this operation can be done very easily. A sleeper osseointegrated unit is kept as a spare that can be utilized if any osseo-integrated functional problem appears. The functional changes in the hearing and the audiological improvements are well documented.