목적: Conventional hearing aids are only helpful in a limited number of patients with sensorineural hearing loss. Especially, Patients with sloping type hearing loss suffer from problems associated with conventional hearing aids such as occlusion of the ear canal and feedback. The aim of the study was the evaluation of rehabilitation of patients with sloping type hearing loss with the active middle ear implant (Vibrant Soundbridge). 방법:We defined sloping type patients who presenting with severe high frequency hearing loss but only mild hearing loss in the low frequencies. The Vibrant Soundbridge was surgically implanted into 34 patients from October 2011 to October 2013. Out of the 34 patients, 8 presented ski slope audiogram and the floating mass transducer(FMT) was clipped onto the long process of the incus. Main outcome measures were pure tone audiometry, speech audiometry in quiet and in noise (k-HINT). We also investigated subjective satisfaction with APHAB (Abbreviated profile of hearing aid benefit) test in patients who used previously conventional hearing aids. 결과:Residual hearing was preserved in all 8 cases and all patients were followed at least 6months. Functional hearing gain was in proportion to the individual hearing losses and was remarkably high in the high frequencies up to 8000 Hz. Mean functional gain was 34 dB in the frequencies between 1000-8000 Hz (250Hz 1.4dB, 500Hz -0.7dB, 1K 20dB, 2K 34.3dB, 3K 33.6dB, 4K38.6dB, 8K40.7dB). Speech recognition scores in quiet was improved from 73% to 81%. K-HINT score was significantly improved in all direction. APHAB was improved from 63.9018.18 to 42.522.14 (P<0.001). 결론:Active middle ear implant (Vibrant Soundbridge) has been shown to be perform extremely well especially in the high frequencies and more preferable satisfaction than conventional hearing aids. It offers a new solution for rehabilitation of sloping type hearing loss.