Clinical and scientific innovations in auditory brainstem implants

Auditory brainstem implantation (ABI) is a recent innovation in pediatric hearing restoration in children with a sensorineural hearing impairment. Only limited information is available on the spontaneous speech development of severe-to-profound congenitally hearing-impaired children who received an ABI. The purpose of this study was to investigate longitudinally the accuracy of ABI children’s word productions in spontaneous speech in comparison to the accuracy of children who received a cochlear implant and children with normal hearing. The data of this study consist of recordings of the spontaneous speech of the first three Dutch-speaking children living in Belgium who received an ABI. The children’s utterances were phonemically transcribed and for each word, the distance between the child’s production and the standard adult phonemic transcription was computed using the Levenshtein Distance as a metric. The same procedure was applied to the longitudinal data of the children with CI and the normally hearing children. The main result was that the Levenshtein Distance decreased in the three children with ABI but it remained significantly higher than that of children with typical hearing and cochlear implants matched on chronological age, hearing age, and lexicon size. In other words, the phonemic accuracy increased in the children with ABI but stayed well below that of children without hearing loss and children with cochlear implants. Moreover, the analyses revealed considerable individual variation between the children with ABI.

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Auditory brainstem implants: past, present and future prospects

Operative Neuromodulation - Acta Neurochirurgica Supplements ◽

10.1007/978-3-211-33081-4_50 ◽

2007 ◽

pp. 437-442 ◽

Cited By ~ 11

Author(s):

Francisco Javier Cervera-Paz ◽

M. J. Manrique

Keyword(s):

Auditory Brainstem ◽

Future Prospects ◽

Auditory Brainstem Implants

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Ipsilateral Cochlear Implantation in the Presence of Observed and Irradiated Vestibular Schwannomas

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420935482 ◽

2020 ◽

Vol 129 (12) ◽

pp. 1229-1238

Author(s):

Matthew J. Urban ◽

Dennis M. Moore ◽

Keri Kwarta ◽

John Leonetti ◽

Rebecca Rajasekhar ◽

...

Keyword(s):

Hearing Loss ◽

Cochlear Implantation ◽

Neurofibromatosis Type ◽

Auditory Brainstem ◽

Observation Time ◽

Vestibular Schwannomas ◽

Open Set ◽

Pubmed Database ◽

Auditory Brainstem Implants ◽

Hearing Outcomes

Objectives: Historically, eventual loss of cochlear nerve function has limited patients with neurofibromatosis type 2 (NF2) to auditory brainstem implants (ABI), which in general are less effective than modern cochlear implants (CI). Our objective is to evaluate hearing outcomes following ipsilateral cochlear implantation in patients with NF2 and irradiated vestibular schwannomas (VS), and sporadic VS that have been irradiated or observed. Methods: Multi-center retrospective analysis of ipsilateral cochlear implantation in the presence of observed and irradiated VS. MESH search in NCBI PubMed database between 1992 and 2019 for reported cases of cochlear implantation with unresected vestibular schwannoma. Results: Seven patients underwent ipsilateral cochlear implantation in the presence of observed or irradiated vestibular schwannomas. Four patients had sporadic tumors with severe-profound contralateral hearing loss caused by presbycusis/hereditary sensorineural hearing loss, and three patients with NF2 lost contralateral hearing after prior surgical resection. Prior to implantation, one VS was observed without growth for a period of 7 years and the others were treated with radiotherapy. Mean post-operative sentence score was 63.9% (range 48-91) at an average of 28 (range 2-84) months follow up. All patients in this cohort obtained open set speech perception. While analysis of the literature is limited by heterogenous data reporting, 85% of implants with observed schwannomas achieved some open set perception, and 67% of patients previously radiated schwannomas. Furthermore, blending literature outcomes for post implantation sentence testing in quiet without lip-reading show 59.0 ± 35% for patients with CI and observed tumors and 55.7 ± 35% for patients with radiated tumors, with both groups ranging 0 to 100%. Conclusion: This retrospective series and literature review highlight that hearing outcomes with CI for VS patients are superior to those achieved with ABI. However, important considerations including imaging, delayed hearing loss, and observation time cannot be ignored in this population.

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