Deafness due to bilateral temporal bone fractures is a dramatic consequence for the injured patients. Out of more than 1000 patients in Hannover which received a cochlear implant we analyzed the medical history of 44 patients (36 male, 8 female, average age of adults: 41 years) which were implanted after posttraumatic deafness (Nucleus device n = 33, Clarion device n = 11). Postoperatively the patients underwent an auditory rehabilitation program. Most of them (84%) reached open set speech understanding. Results are different caused by additional damage of auditory nerve fibers and posttraumatic central lesions. Due to the risk of posttraumatic fibrosis of the cochlea, implantation should be performed early and can be recommended to the patient if bilateral deafness is diagnosed. In the case of auditory nerve damage brain stem implants offer new possibilities.