The Xomed Audiant(tm) Bone Conductor(tm) is an implantable hearing device for conductive hearing impairments not adequately relieved by surgical methods or hearing aid amplification. It has now been used long enough for analysis of its present position in our management armamentarium. Data obtained from respondents from the United States and Canada are presented and indicate that this device, properly prescribed and used, almost eliminates the conductive elements of the hearing impairment. During the early years of its use, the device was frequently implanted in patients outside the manufacturer's guidelines for use. Some of the reasons for this discrepancy, as well as evidence that this misapplication is lessening, are presented. When proper guidelines were used, however, the results presented here indicate that socially adequate hearing can be restored to patients with conductive loss by the Audiant(tm). Complications have been few and appear to be diminishing. The results indicate that this device has, in its present state of development, a narrow and restrictive application, but a well-defined and efficient role to play in the management of conductive hearing impairment.