Auditory Brainstem Implants
Lin, Herrmann, and Lee (2012) report that cochlear implants (CIs) have been successfully implanted in more than 200,000 people worldwide. However, there are many deaf people who are not CI candidates, such as people with neurofibromatosis type 2 (NF2), which often causes bilateral acoustic neuromas. The auditory brainstem implant (ABI) was developed in the 1970s and first implanted in 1979 by Drs. WF House (neurotologist) and WE Hitselberger (neurosurgeon) in Los Angeles. ABI candidates include NF2 patients, as well as patients with totally ossified cochlea(s), or patients with other cochlear nerve pathology or anomalies. In the United States, NF2 patients 12 years old and older with “reasonable expectations” have been FDA approved for ABI implantation.
Surgical approaches for ABI implantation include tranlabyrinthine craniotomy and the retrosigmoid suboccipital craniotomy. Lin, Hermann, and Lee report intraoperative monitoring of the electrically evoked auditory brainstem response (EABR) are an essential part of ABI surgery to confirm optimal anatomic placement of the ABI electrode. Lin and colleagues report some 1,000 ABIs have been implanted globally to date. Further, they note that early ABIs were implanted directly on the cochlear nucleus. However, more recently in Europe, the inferior colliculus has become the anatomic site for implantation, in an effort to improve speech perception via the ABI.
For More Information, References, and Recommendations
Coletti V, Shannon R, Carner M, Veronese S, Coletti L. (2009) Outcomes in Non-Tumor Adults Fitted with the Auditory Brainstem Implant—10 Years Experience. Otology & Neurotology (30)5:614–618.
Lin, HW., Herrmann, BS and Lee, DJ. (2012): Auditory Brainstem Implants. Chapter 18, pages 317–348.
O'Driscoll M. (2009) New Frontiers: Auditory Brainstem Implant Results in Adults and Children. ENTNews (18)3:84–88.
Otto SR, Shannon RV, Wilkinson EP, Hitselberger WE, McCreery DB, Moore JK, Brackmann DE. (2008) Audiologic Outcomes With the Penetrating Electrode Auditory Brainstem Implant. Otology & Neurotology 29(8).
Otto SR, Waring MD, Kuchta J. (2005) Neural Response Telemetry and Auditory/Non-Auditory Sensations in 15 Recipients of Auditory Brainstem Implants. Journal of the American Academy of Audiology 16:219–227.
Ruckenstein M. ed. (2012) Cochlear Implants and Other Implantable Hearing Devices, Plural Publishing.
Sanna M, De Lella F, Guida M, Merkus P. (2012) Auditory Brainstem Implants in NF2 Patients. Results and Review of the Literature. Otology & Neurotology 33:154–165.
Sennaroglu L, Colletti V, Manrique M, Laszig R, Offeciers E, Saeed S, Ramsden R, Sarac S, Freeman S, Andersen HR, Zarowski A, iyal I, Sollmann WP, Kaminsky J, Bejarano B, Atas A, Sennaroglu, G, Yucel E, Sevinc S, Coletti L, Huarte A, Hendersdon L, Wesarg T, Konradsson K. (2011) Auditory Brainstem Implantation in Children and Non-Neurofibromatosis Type 2 Patients – A Consensus Statement. Otology & Neurotology 32(2):198–191.