About 50% of patients with the TCS have conductive hearing loss, caused by characteristic major and/or minor ear anomalies. It is also common for these patients to have microtia or severe malformation of the pinna. The results of [figure: see text] reconstructive surgery to improve hearing are usually moderate to poor, because of combinations of anomalies. In general, it is recommended to start hearing rehabilitation at the earliest possible stage. Owing to the above-described anomalies, rehabilitation usually involves fitting a BAHA, whether or not in combination with a pinna epithesis.