An assembly comprising a sound transducer can be implanted in the middle ear in a manner that simplifies surgery. The assembly may comprise a narrow cross-sectional profile such that the assembly can be positioned in the middle ear through an incision in the eardrum, for example without cutting bone. The incision can be closed and electromagnetic energy transmitted through the closed incision to a transducer configured to vibrate the ear in response to the electromagnetic energy. In many embodiments, the sound transducer comprises a speaker positioned in the middle ear, and the sound transducer can couple to vibratory structure of the ear with air so as to simplify surgery. The assembly may be affixed to a substantially fixed structure of the ear, for example the promontory, so as to inhibit user perceivable occlusion and inhibit motion of the assembly, such that the user can perceive clear sound with little occlusion.