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  • Auditory Brain Stem Implant

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    Suprit Sn
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    An auditory brainstem implant is a surgically implanted electronic device that provides a sense of sound for people who are profoundly deaf due to damage to the cochlea or auditory nerve. It stimulates the brainstem instead of the cochlea like a cochlear implant. Only about 1000 people have received an ABI due to the invasive brain surgery required and reduced effectiveness compared to a cochlear implant. The ABI was first implanted in humans in 1979 and has undergone improvements, but most recipients can only detect sound rather than understand speech or music. It is an approved treatment for adults with Neurofibromatosis Type II who are deaf.

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    An auditory brainstem implant is a surgically implanted electronic device that provides a sense of sound for people who are profoundly deaf due to damage to the cochlea or auditory nerve. It stimulates the brainstem instead of the cochlea like a cochlear implant. Only about 1000 people have received an ABI due to the invasive brain surgery required and reduced effectiveness compared to a cochlear implant. The ABI was first implanted in humans in 1979 and has undergone improvements, but most recipients can only detect sound rather than understand speech or music. It is an approved treatment for adults with Neurofibromatosis Type II who are deaf.

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    Attribution Non-Commercial (BY-NC)
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    638 views2 pages

    Auditory Brain Stem Implant

    Uploaded by

    Suprit Sn
    An auditory brainstem implant is a surgically implanted electronic device that provides a sense of sound for people who are profoundly deaf due to damage to the cochlea or auditory nerve. It stimulates the brainstem instead of the cochlea like a cochlear implant. Only about 1000 people have received an ABI due to the invasive brain surgery required and reduced effectiveness compared to a cochlear implant. The ABI was first implanted in humans in 1979 and has undergone improvements, but most recipients can only detect sound rather than understand speech or music. It is an approved treatment for adults with Neurofibromatosis Type II who are deaf.

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    Dr.

    Supreet Singh Nayyar, AFMC

    2012

    Auditory Brain Stem Implant (ABI) (for more ENT topics & presentations, visit www.nayyarENT.com)
    Surgically implanted electronic device that provides a sense of sound to a person who is profoundly deaf, due to sensorineural hearing impairment (due to illness or injury damaging bilateral cochlea or auditory nerve, and so precluding the use of a cochlear implant) The auditory brain stem implant uses similar technology as the cochlear implant, but instead of electrical stimulation being used to stimulate the cochlea, it is instead used to stimulate the brain stem of the recipient Only about a thousand recipients have been implanted with an auditory brain stem implant, due to the nature of the surgery required to implant the device (as it requires brain surgery to implant the device) and the reduced effectiveness of the implant (most auditory brain stem implant recipients only have an awareness of sound - recipients won't be able to hear musical melodies, only the beat) In the United States ABIs are only approved for adults (18 & over) and only for patients with Neurofibromatosis type II (NF2). In Europe, ABIs have been used in children and adults, and in patients with NF2 as other auditory complications, such as auditory nerve aplasia and cochlea ossification. Speech perception in non-NF2 patients on average has been reported to be higher than that of NF2 patients.

    Implant history The auditory brainstem was first implanted in humans in 1979 at the House Ear Institute, CA, USA. This original ABI consisted of two ball electrodes which were implanted near the surface of the cochlear nucleus. A change from a percutaneous connection to a wireless transcutaneous connection, and from ball electrodes to flat electrodes were the only changes to the implant until 1991, where 25 people had received the ABI . In the US in 1992 an eight electrode implant developed by Cochlear Limited, the House Ear Institute and Huntington Medical Research Institute . An electrode array with 21 electrodes developed by Cochlear Limited was developed for the European market at the same time. The processor for both the eight and 20 electrode implants used Nucleus 22 ABI (Cochlear Limited) external speech processors. Since 1999 a 21 electrode array implant has been used with the Nucleus 24 ABI (Cochlear Limited) speech processor. A 12 electrode array implant with a speech processor based on the C40+ cochlear implant (Med-El) and a 16 electrode array implant with the Clarion-1.2 cochlear implant (Advanced Bionics) have also been developed.

    Note on the auditory brainstem implant in NF II The auditory brainstem implant is increasingly used to rehabilitate patients with neurofibromatosis type 2 (NF2) who are totally deaf and have no cochlear nerves as a result of their bilateral VS or the surgery to remove them They are thus unsuitable for cochlear implants Auditory brainstem implant electrode array comprises 21 small disc electrodes
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    www.nayyarENT.com

    Dr. Supreet Singh Nayyar, AFMC

    2012

    mounted on a silastic carrier, which is placed onto the surface of the cochlear nucleus This is found in the floor of the lateral recess of the fourth ventricle, which is entered through the foramen of Luschka This is usually done at the end of the operation to remove the tumour through either a translabyrinthine or retrosigmoid approach The foramen is located by following the glossopharyngeal nerve upwards and the stump of the eighth nerve if present downwards The choroid plexus is seen emerging from the foramen The taeniae of the fourth ventricle may have to be divided and there is often an arterial loop that has to be moved to one side The cochlear nucleus is identified by its very white colour and by a fairly constant thin vein that runs over its surface

    (for more ENT topics & presentations, visit www.nayyarENT.com)

    www.nayyarENT.com

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