In 1977, a new phase began in hearing rehabilitation of patients with chronic middle and external diseases and atresias. Thus far, these patients have had to rely on conventional bone conduction and air conduction devices that for various reasons give poor rehabilitation. The principle of the new treatment, made possible by the Swedish bone-anchored hearing system, is simple: sound vibrations are directly transmitted to the skull bone via a skin-penetrating titanium implant and then are further transmitted to the cochlea, bypassing the middle ear. The present paper summarizes our results in 147 patients over 10 years, including a total of 6,334 follow-up months. No significant rate of skin infections was observed. In over 93% of the observations, no sign of adverse skin reaction was seen. When herein-suggested indications for treatment with the bone-anchored sound processor HC-200 are followed, the success rate is over 90%. The improved quality of life reported by the patients is a combination of improved quality of sound, improved comfort, and relief from middle ear and ear canal disease occasioned by conventional hearing aids.