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Cochlear Implants and Auditory Brainstem Implants
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Rajeev Mathew, Deborah Vickers, Patrick Axon, Manohar Bance
Auditory brainstem implants (ABIs) are used for hearing restoration in patients with severe to profound hearing loss when a CI is not possible. Potential candidates include Adults with bilateral vestibular schwannoma due to neurofibromatosis type 2 (NF2), undergoing tumour resection, in whom cochlear nerve preservation is not possible; the function of the cochlear nerve can be checked during surgery with electrically evoked ABR/compound action potentialAdults with cochlear ossification due to meningitis, labyrinthitis, fractures or otosclerosisChildren with bilateral cochlear aplasia or bilateral auditory nerve aplasia or dysplasia
Teleaudiology
Published in Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm, Advances in Audiology and Hearing Science, 2020
Piotr H. Skarzynski, Mark Krumm, Karolina Penar, Stavros Hatzopoulos
There are many goals of the NNT including: The versatile care for patients with cochlear implants, auditory brainstem implants, middle ear implants, bone conduction implants and also modern hearing aids using digital technology. Telemedicine can be used to provide complex and comprehensive health care to individuals with hearing loss permitting the highly personalized services for each client.Coordination of the hearing rehabilitation process that is necessary for development of sound perception and interpretation abilities, and, through systematic training, enhancing oral communication skills with other people.The realization of social, educational, and professional development programs based on knowledge of the multidisciplinary team of specialists in the Institute of Physiology and Pathology of Hearing.To cultivate knowledge about cochlear implants and the rehabilitation process of implanted patients.
Pendred Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Auditory brainstem implants stimulate the second-order auditory neurons (instead of the cochlear nerve) in the cochlear nucleus and may be considered for patients with severe cochlear or cochlear nerve malformations or aplasia, severe cochlear ossification, and temporal bone fractures associated with traumatic cochlear nerve avulsion.
Awake craniotomy for assisting placement of auditory brainstem implant in NF2 patients
Published in Acta Oto-Laryngologica, 2018
Qiangyi Zhou, Zhijun Yang, Zhenmin Wang, Bo Wang, Xingchao Wang, Chi Zhao, Shun Zhang, Tao Wu, Peng Li, Shiwei Li, Fu Zhao, Pinan Liu
Neurofibromatosis 2 (NF2) is an autosomal dominant disorder characterized by bilateral vestibular schwannomas. The disorder is genetically defined by a mutation of a tumorsuppressor gene on chromosome 22 coding for merlin, the lack or dysfunction of which leads to multiple nerve sheath tumors. Patients with NF2 always suffer bilateral hearing loss due to the surgical removal, progressive bilateral acoustic tumors, radiation therapy or other reasons [1]. Hearing loss is one of the main factors influencing quality of life and is difficult to handle in this condition. For bilateral auditory nerve injuries or disconnection in these patients, cochlear implant (CI) is not an appropriate option to reconstruct hearing. Auditory brainstem implant (ABI) can restore auditory function by bypassing the auditory nerve and directly stimulating the cochlear nucleus complex (CNC) in the brainstem [2–5]. However, auditory outcomes with ABIs are poor compared with those reported in CI users. Some ABI patients achieve open-set speech perception [6,7], but auditory benefits are limited to enhancing lip-reading for the majority of NF2 patients. Suboptimal placement of an ABI electrode array over the cochlear nucleus may be a crucial reason for poor auditory performance [8].
Percutaneous pedestals in cochlear implantation
Published in Cochlear Implants International, 2018
Alistair Mitchell-Innes, Richard Irving, Robert Briggs
House implanted seven patients between 1979 and 1986 with an early version of an auditory brainstem implant. The device was named a central electroauditory prosthesis. It consisted of a Dacron mesh pad integrated with electrodes placed on the cochlear nucleus. The pad was connected to electrode leads which passed out via a cortical mastoidectomy to a Pyrolite carbon percutaneous pedestal (Carbomedics) that housed the electrode connector. The pedestal was also connected to a bare platinum wire that acted as a reference electrode for monopolar stimulation (Eisenberg et al., 1987). Four of the seven patients suffered infections around the percutaneous pedestal resulting in explantation of the pedestal and three subsequently had the pedestal replaced with a transcutaneous magnetic induction coupling system.
Patient, parental and multi-disciplinary team rationale for non-implantation following the paediatric cochlear implantation assessment
Published in Cochlear Implants International, 2022
Andrew Hall, Fiona McClenaghan, Robert Nash, Azhar Shaida
Anatomical concerns in relation to the surgery itself were highlighted in only eight cases (10.8%) as the reason not to proceed. In five cases, subsequent referral for consideration of paediatric auditory brainstem implant was made owing to the absence of cochlear nerves on the MRI. Other specific cases where anatomical considerations led to a decision not to proceed with surgery included the CHARGE, labyrinthine aplasia or severe craniofacial microsomia. Perceived unrealistic parental or patient expectation from cochlear implantation as a reason not to proceed was documented in only two cases (2.7%).