New, affordable hearing devices for children with conductive hearing loss consist of a novel headset using bone conduction technology connected to a remote microphone, worn by the parent or teacher (figure 1).1 2 One young participant who benefited from the new technology referred to it as her ‘extendable ear’, a reference from Harry Potter3:

‘If only we could hear what they’re saying!’ said Hermione.

‘We can!’ said Ron excitedly…‘Extendable Ears, look!’

‘Fantastic!’ said Hermione… ‘Listen!’

They put their heads together and listened intently … Malfoy’s voice could be heard loud and clear’

(Harry Potter and the Half-Blood Prince)

Child using an affordable bone conduction headset (that she called her ‘extendable ear’) which can either be connected to a small microphone that can be clipped to the shirt of a teacher or parent (as shown in the first picture), or connected to a smartphone via Bluetooth to improve hearing, particularly over any background noise (as shown in the second picture).

These devices have been used in the UK to support children with the most common childhood hearing loss secondary to ‘glue ear’ (otitis media with effusion, OME). During the coronavirus pandemic, it was shown that these headsets could support children who were unable to access healthcare.2 The headset enabled self-management of hearing loss and supported children while they waited for resolution or a healthcare intervention.

In low-income countries such as Malawi, in addition to OME, chronic suppurative otitis media (CSOM) is common: here chronic inflammation or infection causes visible ear discharge.4 The ear discharge prohibits the use of hearing aids, and costly healthcare is unaffordable to most, with 90% of deaf children …