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BAŞ B, Gökay NY, Aydoğan Z, Yücel E. Do auditory brainstem implants favor the development of sensory integration and cognitive functions? Brain Behav 2024; 14:e3637. [PMID: 39099332 PMCID: PMC11298688 DOI: 10.1002/brb3.3637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/22/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Information about the development of cognitive skills and the effect of sensory integration in children using auditory brainstem implants (ABIs) is still limited. OBJECTIVE This study primarily aims to investigate the relationship between sensory processing skills and attention and memory abilities in children with ABI, and secondarily aims to examine the effects of implant duration on sensory processing and cognitive skills in these children. METHODS The study included 25 children between the ages of 6 and 10 years (mean age: 14 girls and 11 boys) with inner ear and/or auditory nerve anomalies using auditory brainstem implants. Visual-Aural Digit Span Test B, Marking Test, Dunn Sensory Profile Questionnaire were applied to all children. RESULTS The sensory processing skills of children are statistically significant and positive, and moderately related to their cognitive skills. As the duration of implant use increases, better attention and memory performances have been observed (p < .05). CONCLUSION The study demonstrated the positive impact of sensory processing on the development of memory and attention skills in children with ABI. It will contribute to evaluating the effectiveness of attention, memory, and sensory integration skills, and aiding in the development of more effective educational strategies for these children.
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Affiliation(s)
- Banu BAŞ
- Faculty of Health Sciences, Department of AudiologyAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
| | | | - Zehra Aydoğan
- Faculty of Health Sciences, Department of AudiologyAnkara UniversityAnkaraTurkey
| | - Esra Yücel
- Faculty of Health Sciences, Department of AudiologyHacettepe UniversityAnkaraTurkey
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Reddy A, Panda N, Ghai B, Panda NK, Kameswaran M, Vasudevan MC. Overcoming anesthetic challenges in a child with Michel's aplasia undergoing auditory brainstem implantation. Paediatr Anaesth 2024. [PMID: 38972016 DOI: 10.1111/pan.14962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/08/2024]
Affiliation(s)
- Ashwini Reddy
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nidhi Panda
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Babita Ghai
- Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh K Panda
- Department of Otolaryngology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohan Kameswaran
- Department of Otolaryngology, Madras ENT Research Foundation Pvt Ltd, Chennai, Tamil Nadu, India
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Odedra A, Blumenow W, Dainty J, Dasgupta S, Dominguez-Gonzalez S, Gonzalez-Martin J, Hartley H, Kelly M, McKay VH, Sharma R, Spinty S, Fattah AY. Multidisciplinary Care for Moebius Syndrome and Related Disorders: Building a Management Protocol. J Clin Med 2024; 13:3309. [PMID: 38893020 PMCID: PMC11172851 DOI: 10.3390/jcm13113309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/18/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
Moebius syndrome is a collection of orofacial anomalies with highly variable features affecting many different systems but characterised by bilateral facial palsy and absent eye abduction. We largely regard Moebius syndrome as a diagnosis of exclusion. Lack of awareness and knowledge means that children often fall between services, leading to treatment delays and difficulty interfacing with social care and schools, with long-term impact on physical health and psychosocial development. We developed a multidisciplinary team comprising core clinicians (lead physician, geneticist, speech and language therapist, psychologist and specialist nurse) and an expanded group to encompass the other affected systems. The interactions between our specialties lead to the development of a treatment protocol, which we present. The protocol harnesses the aspects of care of children with a range of other rare diseases at a specialised paediatric centre and synthesises them into a holistic approach for MBS and related conditions. Management is sequenced on an "ABC-style" basis, with airway, feeding, vision and speech taking priority in the early years. We define management priorities as airway stabilisation with swallow assessment, ocular surface protection and maintenance of nutritional support. Management principles for issues such as speech, reflux, drooling and sleep issues are outlined. In later years, psychological support has a prominent role geared towards monitoring and interventions for low mood, self-esteem and bullying.
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Affiliation(s)
- Amar Odedra
- Regional Paediatric Burns and Plastic Surgery Service, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Wendy Blumenow
- Department of Speech and Language Therapy, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK;
| | - Jennifer Dainty
- Department of Psychology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Soumit Dasgupta
- Department of Audiology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Susana Dominguez-Gonzalez
- Department of Orthodontics and Paediatric Dentistry, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Jose Gonzalez-Martin
- Department of Ophthalmology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Helen Hartley
- Therapy Department, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Maria Kelly
- Regional Paediatric Burns and Plastic Surgery Service, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Victoria H. McKay
- Department of Genetics, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
| | - Ravi Sharma
- Ear Nose and Throat Department, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Stefan Spinty
- Department of Paediatric Neurology, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
| | - Adel Y. Fattah
- Regional Paediatric Burns and Plastic Surgery Service, Alder Hey Children’s NHS Foundation Trust, Liverpool L12 2AP, UK
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Garcia A, Haleem A, Poe S, Gosh D, Christian Brown M, Herrmann BS, Lee DJ. Auditory Brainstem Implant Outcomes in Tumor and Nontumor Patients: A Systematic Review. Otolaryngol Head Neck Surg 2024; 170:1648-1658. [PMID: 38329219 DOI: 10.1002/ohn.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/03/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To elucidate the differences in auditory performance between auditory brainstem implant (ABI) patients with tumor or nontumor etiologies. DATA SOURCES PubMed, Embase, and Web of Science Core Collection from 1990 to 2021. REVIEW METHODS We included published studies with 5 or more pediatric or adult ABI users. Auditory outcomes and side effects were analyzed with weighted means for closed-set, open-set speech, and categories of auditory performance (CAP) scores. Overall performance was compared using an Adult Pediatric Ranked Order Speech Perception (APROSPER) scale created for this study. RESULTS Thirty-six studies were included and underwent full-text review. Data were extracted for 662 tumor and 267 nontumor patients. 83% were postlingually deafened and 17% were prelingually deafened. Studies that included tumor ABI patients had a weighted mean speech recognition of 39.2% (range: 19.6%-83.3%) for closed-set words, 23.4% (range: 17.2%-37.5%) for open-set words, 21.5% (range: 2.7%-48.4%) for open-set sentences, and 3.1 (range: 1.0-3.2) for CAP scores. Studies including nontumor ABI patients had a weighted mean speech recognition of 79.8% (range: 31.7%-84.4%) for closed-set words, 53.0% (range: 14.6%-72.5%) for open-set sentences, and 2.30 (range: 2.0-4.7) for CAP scores. Mean APROSPER results indicate better auditory performance among nontumor versus tumor patients (3.5 vs 3.0, P = .04). Differences in most common side effects were also observed between tumor and nontumor ABI patients. CONCLUSION Auditory performance is similar for tumor and nontumor patients for standardized auditory test scores. However, the APROSPER scale demonstrates better ABI performance for nontumor compared to tumor patients.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Sonja Poe
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Deborah Gosh
- Howe Library, Massachusetts Eye and Ear, Boston, MA, USA
| | - M Christian Brown
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Barbara S Herrmann
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Audiology, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Boston, Massachusetts, USA
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5
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Aslan F, Ertugrul G, Sennaroglu G, Sennaroglu L. Unimodal versus bimodal auditory stimulation in inner ear malformations: Cognitive, language, and motor performance. Laryngoscope Investig Otolaryngol 2023; 8:1401-1409. [PMID: 37899848 PMCID: PMC10601589 DOI: 10.1002/lio2.1153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/01/2023] [Accepted: 09/01/2023] [Indexed: 10/31/2023] Open
Abstract
Purpose New perspectives on rehabilitation options for inner ear malformations have still been studied in the literature. This study investigated the cognitive, language, and motor skills of auditory brainstem implant (ABI) users in unimodal and bimodal groups. Methods The motor competency of the participants was assessed with Bruininks-Oseretsky Motor Proficiency Test-2 Short Form (BOT2 SF). Language performance was evaluated by the test of Early Language Development-3 and Speech Intelligibility Rating. Word identification, sentence recognition tests, and Categories of Auditory Performance were used to assess auditory perception skills. To examine the cognitive performance, Cancellation Test and Gesell Copy Form were administered. All the tests were conducted in a quiet environment without any distractions. Results The participants were divided into two groups: (1) 17 children in the unimodal group and (2) 11 children in the bimodal (who used a cochlear implant on one side and ABI on the other side) group. There were significant correlations between the chronological age of participants and BOT2 SF total score, cancellation tests, auditory perception tests, and language performance. Similarly, there were significant correlations between the duration of ABI use and auditory perception tests, language performance, cancellation test, and some BOT2 SF subtests (r = -0.47 to -0.60, p < .001). There was no significant difference between the unimodal and bimodal groups in any task (p > .05). However, there were moderate-to-strong correlations among the auditory perception tests, cancellation test, language test, and BOT2 SF total score and subtests (r = 0.40 to 0.55, p < .05). Conclusion Although there were no significant differences between bimodal and unimodal groups, a holistic approach, which indicates that hearing and balance issues can have broader impacts on a person's physical, emotional, social, and psychological aspects, should be used in the assessment process. Level of Evidence Level 4.
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Affiliation(s)
- Filiz Aslan
- Department of Audiology, Faculty of Health SciencesHacettepe UniversityAnkaraTurkey
| | - Gorkem Ertugrul
- Department of Audiology, Faculty of Health SciencesHacettepe UniversityAnkaraTurkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health SciencesHacettepe UniversityAnkaraTurkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of MedicineHacettepe UniversityAnkaraTurkey
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6
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Veronese S, Cambiaghi M, Tommasi N, Sbarbati A, Galvin JJ. Ten-year follow-up of auditory brainstem implants: From intra-operative electrical auditory brainstem responses to perceptual results. PLoS One 2023; 18:e0282261. [PMID: 36862753 PMCID: PMC9980821 DOI: 10.1371/journal.pone.0282261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
The auditory brainstem implant (ABI) can provide hearing sensation to individuals where the auditory nerve is damaged. However, patient outcomes with the ABI are typically much poorer than those for cochlear implant recipients. A major limitation to ABI outcomes is the number of implanted electrodes that can produce auditory responses to electric stimulation. One of the greatest challenges in ABI surgery is the intraoperative positioning of the electrode paddle, which must fit snugly within the cochlear nucleus complex. While there presently is no optimal procedure for intraoperative electrode positioning, intraoperative assessments may provide useful information regarding viable electrodes that may be included in patients' clinical speech processors. Currently, there is limited knowledge regarding the relationship between intraoperative data and post-operative outcomes. Furthermore, the relationship between initial ABI stimulation with and long-term perceptual outcomes is unknown. In this retrospective study, we reviewed intraoperative electrophysiological data from 24 ABI patients (16 adults and 8 children) obtained with two stimulation approaches that differed in terms of neural recruitment. The interoperative electrophysiological recordings were used to estimate the number of viable electrodes and were compared to the number of activated electrodes at initial clinical fitting. Regardless of the stimulation approach, the intraoperative estimate of viable electrodes greatly overestimated the number of active electrodes in the clinical map. The number of active electrodes was associated with long-term perceptual outcomes. Among patients with 10-year follow-up, at least 11/21 active electrodes were needed to support good word detection and closed-set recognition and 14/21 electrodes to support good open-set word and sentence recognition. Perceptual outcomes were better for children than for adults, despite a lower number of active electrodes.
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Affiliation(s)
- Sheila Veronese
- Department of Neuroscience, Biomedicine and Movement Sciences, Verona University, Verona, Italy
- * E-mail:
| | - Marco Cambiaghi
- Department of Neuroscience, Biomedicine and Movement Sciences, Verona University, Verona, Italy
| | - Nicola Tommasi
- Centre of Economic Documentation (CIDE), Verona University, Verona, Italy
| | - Andrea Sbarbati
- Department of Neuroscience, Biomedicine and Movement Sciences, Verona University, Verona, Italy
| | - John J. Galvin
- House Institute Foundation, Los Angeles, California, United States of America
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Bergeron D, Iorio-Morin C, Bonizzato M, Lajoie G, Orr Gaucher N, Racine É, Weil AG. Use of Invasive Brain-Computer Interfaces in Pediatric Neurosurgery: Technical and Ethical Considerations. J Child Neurol 2023; 38:223-238. [PMID: 37116888 PMCID: PMC10226009 DOI: 10.1177/08830738231167736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/11/2023] [Accepted: 03/17/2023] [Indexed: 04/30/2023]
Abstract
Invasive brain-computer interfaces hold promise to alleviate disabilities in individuals with neurologic injury, with fully implantable brain-computer interface systems expected to reach the clinic in the upcoming decade. Children with severe neurologic disabilities, like quadriplegic cerebral palsy or cervical spine trauma, could benefit from this technology. However, they have been excluded from clinical trials of intracortical brain-computer interface to date. In this manuscript, we discuss the ethical considerations related to the use of invasive brain-computer interface in children with severe neurologic disabilities. We first review the technical hardware and software considerations for the application of intracortical brain-computer interface in children. We then discuss ethical issues related to motor brain-computer interface use in pediatric neurosurgery. Finally, based on the input of a multidisciplinary panel of experts in fields related to brain-computer interface (functional and restorative neurosurgery, pediatric neurosurgery, mathematics and artificial intelligence research, neuroengineering, pediatric ethics, and pragmatic ethics), we then formulate initial recommendations regarding the clinical use of invasive brain-computer interfaces in children.
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Affiliation(s)
- David Bergeron
- Division of Neurosurgery, Université de Montréal, Montreal, Québec, Canada
| | | | - Marco Bonizzato
- Electrical Engineering Department, Polytechnique Montréal, Montreal, Québec, Canada
- Neuroscience Department and Centre
interdisciplinaire de recherche sur le cerveau et l’apprentissage (CIRCA), Université de Montréal, Montréal, Québec, Canada
| | - Guillaume Lajoie
- Mathematics and Statistics Department, Université de Montréal, Montreal, Québec, Canada
- Mila - Québec AI Institute, Montréal,
Québec, Canada
| | - Nathalie Orr Gaucher
- Department of Pediatric Emergency
Medicine, CHU Sainte-Justine, Montréal, Québec, Canada
- Bureau de l’Éthique clinique, Faculté
de médecine de l’Université de Montréal, Montreal, Québec, Canada
| | - Éric Racine
- Pragmatic Research Unit, Institute de
Recherche Clinique de Montréal (IRCM), Montreal, Québec, Canada
- Department of Medicine and Department
of Social and Preventative Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Alexander G. Weil
- Division of Neurosurgery, Department
of Surgery, Centre Hospitalier Universitaire Sainte-Justine (CHUSJ), Département de
Pédiatrie, Université de Montréal, Montreal, Québec, Canada
- Department of Neuroscience, Université de Montréal, Montréal, Québec, Canada
- Brain and Development Research Axis,
CHU Sainte-Justine Research Center, Montréal, Québec, Canada
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Faes J, De Maeyer S, Gillis S. Speech intelligibility of children with an auditory brainstem implant: a triple-case study. CLINICAL LINGUISTICS & PHONETICS 2022; 36:1067-1092. [PMID: 35380929 DOI: 10.1080/02699206.2021.1988148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/11/2021] [Accepted: 09/25/2021] [Indexed: 06/14/2023]
Abstract
Auditory brainstem implantation (ABI) is a relative recent development in paediatric hearing restoration. Consequently, young-implanted children's productive language has not received much attention. This study investigated speech intelligibility of children with ABI (N = 3) in comparison to children with cochlear implants (CI) and children with typical hearing (TH). Spontaneous speech samples were recorded from children representing the three groups matched on cumulative vocabulary level. Untrained listeners (N = 101) rated the intelligibility of one-word utterances on a continuous scale and transcribed each utterance. The rating task yielded a numerical score between 0 and 100, and similarities and differences between the listeners' transcriptions were captured by a relative entropy score. The speech intelligibility of children with CI and children with TH was similar. Speech intelligibility of children with ABI was well below that of the children with CI and TH. But whereas one child with ABI's intelligibility approached that of the control groups with increasing lexicon size, the intelligibility of the two other children with ABI did not develop in a similar direction. Overall, speech intelligibility was only moderate in the three groups of children, with quite low ratings and considerable differences in the listeners' transcriptions, resulting in high relative entropy scores.
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Affiliation(s)
| | - Sven De Maeyer
- Department of Training and Education Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
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A Retrospective Evaluation to Assess Reliability of Electrophysiological Methods for Diagnosis of Hearing Loss in Infants. Brain Sci 2022; 12:brainsci12070950. [PMID: 35884756 PMCID: PMC9313358 DOI: 10.3390/brainsci12070950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/10/2022] [Accepted: 07/17/2022] [Indexed: 01/27/2023] Open
Abstract
Background: An electrophysiological investigation with auditory brainstem response (ABR), round window electrocochleography (RW-ECoG), and electrical-ABR (E-ABR) was performed in children with suspected hearing loss with the purpose of early diagnosis and treatment. The effectiveness of the electrophysiological measures as diagnostic tools was assessed in this study. Methods: In this retrospective case series with chart review, 790 children below 3 years of age with suspected profound hearing loss were tested with impedance audiometry and underwent electrophysiological investigation (ABR, RW-ECoG, and E-ABR). All implanted cases underwent pure-tone audiometry (PTA) of the non-implanted ear at least 5 years after surgery for a long-term assessment of the reliability of the protocol. Results: Two hundred and fourteen children showed bilateral severe-to-profound hearing loss. In 56 children with either ABR thresholds between 70 and 90 dB nHL or no response, RW-ECoG showed thresholds below 70 dB nHL. In the 21 infants with bilateral profound sensorineural hearing loss receiving a unilateral cochlear implant, no statistically significant differences were found in auditory thresholds in the non-implanted ear between electrophysiological measures and PTA at the last follow-up (p > 0.05). Eight implanted children showed residual hearing below 2000 Hz worse than 100 dB nHL and 2 children showed pantonal residual hearing worse than 100 dB nHL (p > 0.05). Conclusion: The audiological evaluation of infants with a comprehensive protocol is highly reliable. RW-ECoG provided a better definition of hearing thresholds, while E-ABR added useful information in cases of auditory nerve deficiency.
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Faes J, Gillis S. Intraword Variability in Children With Auditory Brainstem Implants: A Longitudinal Comparison With Children With Cochlear Implants. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1787-1800. [PMID: 35737893 DOI: 10.1044/2022_ajslp-21-00312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Intraword variability designates the phenomenon that a particular target word is produced variably by a child at one point in the child's development. In this study, the amount of intraword variability is studied longitudinally in children with auditory brainstem implants (ABIs). Auditory brainstem implantation is a relative recent technique in pediatric hearing restoration. Therefore, little is known about the phonological development of these children's speech. METHOD The intraword variability is investigated in three children with ABI, in comparison to children with cochlear implants, matched on lexical development. Intraword variability is measured using relative entropy in order to take into account the frequency distribution in children's productions. RESULT Results showed considerable variation between the three children with ABI. Still, all children had higher levels of intraword variability in their spontaneous speech productions as compared to children with cochlear implants. CONCLUSION It seems that children with ABI are lagging behind their phonological development in reference to children with cochlear implants.
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Affiliation(s)
- Jolien Faes
- Centre for Computational Linguistics and Psycholinguistics, University of Antwerp, Belgium
| | - Steven Gillis
- Centre for Computational Linguistics and Psycholinguistics, University of Antwerp, Belgium
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11
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Ozkan HB, Aslan F, Yucel E, Sennaroglu G, Sennaroglu L. Written language skills in children with auditory brainstem implants. Eur Arch Otorhinolaryngol 2022; 279:3937-3945. [PMID: 35352145 DOI: 10.1007/s00405-022-07359-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to assess the written language skills of children with auditory brainstem implants (ABI). METHODS In this study, 15 children (from second to eighth grades) with ABI were evaluated for their written language abilities using a written expression skill assessment form. Five different features of written expression points were scored and analyzed, yielding a composite score for written expression skills. RESULTS This study showed that all children with ABI needed more verbal cues than spontaneously written samples. Moreover, these children used short and simple sentences with limited vocabulary and repeated words and sentences. Furthermore, these children were deficient in writing an introduction, the body, and the conclusion paragraphs and could not write events in a logical sequence. CONCLUSIONS The written language skills of children with ABI depend on age at implantation, duration of implant use, and additional handicaps. Written expression skills in children with ABI are highly complex skills. The findings highlight the importance of ABI during the critical language development period and the enhancement of training programs for written language skills in children who underwent ABI.
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Affiliation(s)
- Hilal Burcu Ozkan
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Sihhiye/Ankara, 06100, Ankara, Turkey.
| | - Filiz Aslan
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Sihhiye/Ankara, 06100, Ankara, Turkey
| | - Esra Yucel
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Sihhiye/Ankara, 06100, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Sihhiye/Ankara, 06100, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Hacettepe University, Ankara, Turkey
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Behr R, Schwager K, Hofmann E. Auditory Brainstem Implants-Hearing Restoration in Congenitally Deaf Children. DEUTSCHES ARZTEBLATT INTERNATIONAL 2022; 119:135-141. [PMID: 35012707 PMCID: PMC9201461 DOI: 10.3238/arztebl.m2022.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 04/29/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Children who are born deaf can learn to hear and to speak with the aid of a cochlear implant (CI). If the implantation of a CI is not possible for anatomical reasons, an auditory brainstem implant (ABI) is the only surgical option for auditory rehabilitation. It is estimated that about 5 to 45 children could potentially benefit from this treatment in Germany each year. In this article, we present and discuss the current state of the scientific evidence. METHODS The PubMed and Embase databases were searched for relevant publications from 2010 onward. 15 articles reporting at least 10 cases with at least one year of auditory follow-up were included in the analysis. The results, including CAP ("categories of auditory performance") scores on a scale of 0 to 7, are presented and compared with the authors' own findings in a series of 38 patients. RESULTS All of the publications show that children who do not suffer from impairments of other kinds hear significantly better with an ABI than those with additional handicaps. Early implantation is advantageous, under the age of three years if possible. The results vary widely across publications and from patient to patient. The mean CAP score in all publications is 3.57 (standard deviation [SD], 1.04). 38.24% of the patients (SD 18.68) achieved the ability to understand spoken language (CAP ≥= 5), more specifically, the ability to communicate in everyday life without lip reading, in person and some even succeed in conversing over the telephone. CONCLUSION ABI is a safe and effective treatment for sensorineural deafness in congenitally deaf children who cannot be treated with a cochlear implant. In particular, children without any other impairments have a good chance of developing the ability to understand spoken language, especially if the implantation is performed early.
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Affiliation(s)
- Robert Behr
- University Medicine Marburg Campus Fulda, Clinic for Neurosurgery
| | | | - Erich Hofmann
- University Medicine Marburg Campus Fulda, Clinic for Diagnostic and Interventional Neuroradiology: Emeritus
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Yarali M, Aslan F, Çinar BÇ, Batuk MÖ, Bajin MD, Sennaroğlu G, Bilginer B, Sennaroğlu L. Revision Surgery for Pediatric Nontumor Auditory Brainstem Implant Users: Audiological, Rehabilitative, and Surgical Outcomes. Otol Neurotol 2022; 43:e50-e55. [PMID: 34699402 DOI: 10.1097/mao.0000000000003396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report the audiological, rehabilitative, and surgical outcomes of revision surgery for pediatric auditory brainstem implant (ABI) users. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS Five pediatric ABI users who had revision surgery for device malfunctions. INTERVENTIONS Revision surgery for ABI malfunctions. MAIN OUTCOME MEASURES The findings of free-field audiometry with the device, the Meaningful Auditory Integration Scale, and the pattern discrimination, word identification, sentence recognition, and expressive and receptive language tests before the device failure and after revision surgery were obtained from the patient records and compared. RESULTS The revision rate for pediatric ABI was 6.45%. The Meaningful Auditory Integration Scale and expressive-receptive language scores showed improvements following revision surgery, while the aided thresholds, pattern perception, and word identification scores did not change. Individual differences in performance for these measures were observed. CONCLUSION Equal or improved performance after the revision surgeries in the current study showed that revision surgery is successful and important for pediatric ABI users. It is essential to consider remedying the loss of auditory input in sensitive periods of pediatric development.
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Affiliation(s)
| | | | | | | | | | | | - Burçak Bilginer
- Department of Neurosurgery, Hacettepe University, Ankara, Turkey
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Faes J, Gillis S. Consonant and vowel production in the spontaneous speech productions of children with auditory brainstem implants. CLINICAL LINGUISTICS & PHONETICS 2021; 35:1132-1160. [PMID: 33427516 DOI: 10.1080/02699206.2020.1869833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
Auditory brainstem implantation provides hearing sensations in children and adults with anomalies of the auditory nerves. In children, perceptual benefits have been established, and research already demonstrated (limited) effects on children's speech production. The current study extends the literature by scrutinizing the phonological development of three children with ABI. Spontaneous speech samples were used to establish their phonemic inventories of vowels, word-initial consonants and word-final consonants, both independently of the target phoneme and relative to the target phoneme. The three children produced all vowels with longer device use and larger vocabulary size. Word-initial and word-final consonants appeared in the three children's spontaneous productions. However, the segmental accuracy was only moderate in the children's productions.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
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15
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Faes J, Gillis S. Word characteristics and speech production accuracy in children with auditory brainstem implants: a longitudinal triple case report. CLINICAL LINGUISTICS & PHONETICS 2021; 35:874-890. [PMID: 33146054 DOI: 10.1080/02699206.2020.1838613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 06/11/2023]
Abstract
Auditory brainstem implants (ABI) in children in the first years of life is a recent innovation. Analyses of their speech and language development on the basis of spontaneous language samples are still largely lacking. The aim was to investigate the phonological complexity of the words children with ABI use in their spontaneous speech, and to compare their accuracy with that of children with cochlear implants (CI) and children with normal hearing (NH). Longitudinal recordings of spontaneous speech were collected of three children with ABI. Children with ABI target mainly words of low phonological complexity in their spontaneous speech, just as children with NH and children with CI do. The complexity of the words they attempt increases over time, but this development is less outspoken in comparison to children with CI and NH at the same hearing ages. The accuracy of the ABI children's word productions is situated in the lower ranges of the 95% confidence intervals of the NH and the CI groups, and - depending on the specific measure - even fall below the 95% border. The ABI intervention appears to be beneficial in the three cases studied, although their development is slow compared to children with CI and NH.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (Clips) Research Center, University of Antwerp, Antwerp, Belgium
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16
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Baş B, Yücel E. Evaluation of phoneme recognition skills in pediatric auditory brainstem implant users. Eur Arch Otorhinolaryngol 2021; 279:1741-1749. [PMID: 33977366 DOI: 10.1007/s00405-021-06840-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aims to evaluate the relationship between phoneme recognition skills and language development skills in pediatric auditory brainstem implant (ABI) users. It further intends to identify the delays and problems that may occur in the phoneme recognition skills of children with ABI and shed light on rehabilitation programs. METHODS Our study included 20 children using ABI and another 20 using cochlear implants (CI). They were aged between 6 and 8 years 11 months. The participants exhibited homogenous demographic and audiological characteristics. The Turkish version of the Test of Language Development-Primary: Fourth Edition (TOLDP:4) was used to evaluate the language development skills, and the Turkish version of the Phoneme Recognition Test (PRT) was applied to assess the phoneme recognition skills. RESULTS There was a statistically significant difference (p < 0.05) in the PRT values as well as in the language development skills between the children with ABI and those with CI. It was observed that the values of the children with CI were significantly higher than those of children with ABI. CONCLUSION Although children with ABI were not able to match the skills of their peers with CI, their language development and communication skills improved. It is believed that this study will contribute to the literature by demonstrating that the use of ABI improves phoneme recognition skills in children who are not eligible for CI or who do not adequately benefit from CI.
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Affiliation(s)
- Banu Baş
- Faculty of Health Sciences, Department of Audiology, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
| | - Esra Yücel
- Faculty of Health Sciences, Department of Audiology, Hacettepe University, Ankara, Turkey
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17
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Shetty KR, Ridge SE, Kanumuri V, Zhu A, Brown MC, Lee DJ. Clinical and scientific innovations in auditory brainstem implants. World J Otorhinolaryngol Head Neck Surg 2021; 7:109-115. [PMID: 33997720 PMCID: PMC8103538 DOI: 10.1016/j.wjorl.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/27/2020] [Accepted: 02/10/2021] [Indexed: 12/03/2022] Open
Abstract
The auditory brainstem implant (ABI) was originally developed to provide rehabilitation of retrocochlear deafness caused by neurofibromatosis type 2 (NF2). Recent studies of the ABI have investigated outcomes in non-NF2 cohorts, such as patients with cochlear nerve aplasia or cochlear ossification and more recently, intractable tinnitus. New technologies that improve the ABI-neural tissue interface are being explored as means to improve performance and decrease side effects. Innovative discoveries in optogenetics and bioengineering present opportunities to continually evolve this technology into the future, enhancing spatial selectivity of neuronal activation in the cochlear nucleus and preventing side effects through reduction in activation of non-target neuronal circuitry. These advances will improve surgical planning and ultimately improve patients’ audiological capabilities. ABI research has rapidly increased in the 21st century and applications of this technology are likely to continually evolve. Herein, we aim to characterize ongoing clinical, basic science, and bioengineering advances in ABIs and discuss future directions of this technology.
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Affiliation(s)
- Kunal R Shetty
- Department of Otorhinolaryngology Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA.,Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Sarah E Ridge
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Vivek Kanumuri
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Angela Zhu
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - M Christian Brown
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Daniel J Lee
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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18
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Abstract
The Auditory Brainstem Implant (ABI) is based on the classic cochlear implant (CI) but uses a different stimulation electrode. At MED-EL, the early development activities on ABI started in the year 1994, with the suggestion coming from J. Helms and J. Müller from Würzburg, Germany in collaboration with the Univ. of Innsbruck Austria. The first ABI surgery in a neuro-fibromatosis (NF2) patient with the MED-EL device took place in the year 1997. Later, the indication of ABI was expanded to non-NF2 patients with severe inner-ear malformation, for whom a regular CI will not be beneficial. Key translational research activities at MED-EL in collaboration with numerous clinics investigating the factors that affect the hearing performance amongst ABI patients, importance of early ABI implantation in children, tools in pre-operative assessment of ABI candidates and new concepts that were pursued with the MED-EL ABI device. The CE-mark for the MED-EL ABI to be used in adults and children down to the age of 12 months without NF-2 was granted in 2017 mainly based on two long-term clinical studies in the pediatric population. This article covers the milestones of translational research from the first concept to the widespread clinical use of ABI in association with MED-EL.
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Affiliation(s)
| | - Ingeborg Hochmair
- MED-EL Elektromedizinische Geraete Gesellschaft m.b.H., Innsbruck, Austria
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19
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Almomani F, Al-Momani MO, Garadat S, Alqudah S, Kassab M, Hamadneh S, Rauterkus G, Gans R. Cognitive functioning in Deaf children using Cochlear implants. BMC Pediatr 2021; 21:71. [PMID: 33568086 PMCID: PMC7874642 DOI: 10.1186/s12887-021-02534-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 02/02/2021] [Indexed: 11/26/2022] Open
Abstract
Background Cognitive abilities like language, memory, reasoning, visualization, and perceptual functioning shape human action and are considered critical to the successful interaction with the environment. Alternatively, hearing loss can disrupt a child’s ability to communicate, and negatively impact cognitive development. Cochlear implants (CI) restore auditory input thereby supporting communication and may enhance cognitive performance. This study compares general cognitive development after cochlear implantation (2017–2019) in two groups of Jordanian children implanted earlier (age:4–6 years, N = 22) and later (7–9 years, N = 16) to the development of randomly selected normal hearing peers (N = 48). Design Visualization, reasoning, memory, and attention were assessed using the Leiter-R scale at baseline (before implantation), 8 months and 16 months post implantation for children with hearing loss. Same times of testing (baseline, 8 months and 16 months) were used for normal hearing peers. Results Over the 16-month period, the cognitive improvement of 4–6-year-old deaf children was greater than that of their normal hearing peers on the scales of visualization (5.62 vs. 4.40), reasoning (2.53 vs. 2.38) and memory (17.19 vs. 11.67). while the improvement of 7–9-year-old was less major than that of their normal hearing peers on all scales. Conclusions These results suggest that CI not only enhances communication skills but may improve cognitive functioning in deaf children. However, the extent of this improvement was dependent on age at intervention; current results demonstrated that the children received CI at young ages had better cognitive improvements.
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Affiliation(s)
- Fidaa Almomani
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | | | - Soha Garadat
- Department of Hearing and Speech Sciences, The University of Jordan, Amman, Jordan
| | - Safa Alqudah
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Manal Kassab
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, 22110, Jordan.,Associate (Clinical Fellow) in Nursing at University of Technology, Sydney (UTS), Ultimo, Australia
| | - Shereen Hamadneh
- Department of Maternal and Child Health, Nursing School, Al Al Bayt University, Mafraq, Jordan
| | - Grant Rauterkus
- American Institute of Balance, Clear Water, Pinellas Park, FL, USA.,Tulane University, New Orleans, LA, USA
| | - Richard Gans
- American Institute of Balance, Clear Water, Pinellas Park, FL, USA
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20
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Fernandes NF, de Queiroz Teles Gomes M, Tsuji RK, Bento RF, Goffi-Gomez MVS. Auditory and language skills in children with auditory brainstem implants. Int J Pediatr Otorhinolaryngol 2020; 132:110010. [PMID: 32234651 DOI: 10.1016/j.ijporl.2020.110010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/15/2020] [Accepted: 03/15/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study is to characterize the development of auditory and language skills in children during the first 3 years of auditory brainstem implant (ABI) use. METHOD It is a retrospective longitudinal analysis of auditory and language skills in 12 children and pre-adolescents with pre-lingual deafness following ABI surgery (mean age at surgery: 4 years; age range: 2-11 years). Responses were analyzed aboutInfant Toddler Meaningful Auditory Integration Scale (IT-MAIS), MAIS, and Meaningful Use of Speech Scale (MUSS) at 1, 3, 6, 12, 18, 24, and 36 months after ABI activation. RESULTS Maximum IT-MAIS/MAIS and MUSS scores after 3 years of ABI use were 45.35% and 35.28%, respectively. CONCLUSION Pediatric patients exhibit slow progressive development of auditory and language skills following ABI activation.
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Affiliation(s)
- Nayara Freitas Fernandes
- Hospital of Clínicas, Faculty of Medicine, University of São Paulo - USP, São Paulo (SP), Brazil.
| | | | - Robinson Koji Tsuji
- Hospital of Clínicas, Faculty of Medicine, University of São Paulo - USP, São Paulo (SP), Brazil
| | - Ricardo Ferreira Bento
- Hospital of Clínicas, Faculty of Medicine, University of São Paulo - USP, São Paulo (SP), Brazil
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21
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22
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Rajeswaran R, Kameswaran M. Auditory brainstem implantation (ABI) in children without neurofibromatosis type II (NF2): communication performance and safety after 24 months of use. Cochlear Implants Int 2019; 21:127-135. [DOI: 10.1080/14670100.2019.1690264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Mohan Kameswaran
- Madras ENT Research Foundation (MERF), Chennai, Tamil Nadu, India
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23
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Sirirattawan J, Khuancharee K. Measures of Comparative Behavior in Hearing Loss Patients with Cochlear Implant: Caretaker Assessment. Indian J Otolaryngol Head Neck Surg 2019; 71:1147-1152. [DOI: 10.1007/s12070-018-01574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 12/24/2018] [Indexed: 11/24/2022] Open
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Hearing Restoration in Cochlear Nerve Deficiency: the Choice Between Cochlear Implant or Auditory Brainstem Implant, a Meta-analysis. Otol Neurotol 2019; 39:428-437. [PMID: 29494474 DOI: 10.1097/mao.0000000000001727] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To answer the dilemma clinician's face when deciding between cochlear implant (CI) and auditory brainstem implant (ABI) treatment options in patients with cochlear nerve deficiency (CND). STUDY DESIGN Case study supplemented with literature review and meta-analysis. SETTING Tertiary referral center. PATIENT(S) Child with CHARGE syndrome and congenital deafness. INTERVENTION(S) ABI as there was no benefit after bilateral cochlear implantation. MAIN OUTCOME MEASURES Speech and language development, quality of life. RESULTS In one ear the cochleovestibular nerve was present on magnetic resonance imaging (MRI) without preoperative ABR responses. In the contra lateral ear the nerve could not be identified, despite present ABR responses. Nevertheless, there was no positive outcome with CI. The patient had improved speech and language and quality of life with ABI. Of the 108 patients with CND and CI identified in the literature review, 25% attained open-set speech perception, 34% attained closed-set speech perception, and 41% detected sounds or less. The appearance of the cochlear nerve on MRI was a useful predictor of success, with cochlear nerve aplasia on MRI associated with a smaller chance of a positive outcome post cochlear implantation compared with patients with cochlear nerve hypoplasia. CONCLUSION Although patients with (apparent) cochlear nerve aplasia are less likely to benefit from CI, CI before ABI is supported as some patients attain closed or open-set levels of speech perception after cochlear implantation.
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25
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Wong K, Kiringoda R, Kanumuri VV, Barber SR, Franck K, Sahani N, Brown MC, Herrmann BS, Lee DJ. Effect of anesthesia on evoked auditory responses in pediatric auditory brainstem implant surgery. Laryngoscope 2019; 130:507-513. [PMID: 31095742 DOI: 10.1002/lary.28008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/04/2019] [Accepted: 03/28/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Electrically evoked auditory brainstem responses (EABR) guide placement of the multichannel auditory brainstem implant (ABI) array during surgery. EABRs are also recorded under anesthesia in nontumor pediatric ABI recipients prior to device activation to confirm placement and guide device programming. We examine the influence of anesthesia on evoked response morphology in pediatric ABI users by comparing intraoperative with postoperative EABR recordings. STUDY DESIGN Retrospective review. METHODS Seven children underwent ABI surgery by way of retrosigmoid craniotomy. General anesthesia included inhaled sevoflurane induction and propofol maintenance during which EABRs were recorded to confirm accurate positioning of the ABI. A mean of 7.7 ± 2.8 weeks following surgery, the ABI was activated under general anesthesia or sedation (dexmedetomidine) and EABR recordings were made. A qualitative analysis of intraoperative and postoperative waveform morphology was performed. RESULTS Seven subjects (mean age 20.6 months) underwent nine ABI surgeries (seven primary, two revisions) and nine activations. EABRs were observed in eight of nine postoperative recordings. In three cases, intraoperative EABRs during general anesthesia were similar to postoperative EABRs with sedation. In one case, sevoflurane and propofol were used for intra- and postoperative recordings, and waveforms were also similar. In four cases, amplitude and latency changes were observed for intraoperative versus postoperative EABRs. CONCLUSION Similarity of EABR morphology in the anesthetized versus sedated condition suggests that anesthesia does not have a large effect on far-field evoked potentials. Changes in EABR waveform morphology observed postoperatively may be influenced by other factors such as movements of the surface array. LEVEL OF EVIDENCE 4 Laryngoscope, 130:507-513, 2020.
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Affiliation(s)
- Kevin Wong
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Ruwan Kiringoda
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Vivek V Kanumuri
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Samuel R Barber
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Kevin Franck
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Audiology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Nita Sahani
- Department of Anesthesiology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - M Christian Brown
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Barbara S Herrmann
- Department of Audiology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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Faes J, Gillis S. Auditory brainstem implantation in children with hearing loss: Effect on speech production. Int J Pediatr Otorhinolaryngol 2019; 119:103-112. [PMID: 30690306 DOI: 10.1016/j.ijporl.2019.01.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 11/28/2022]
Abstract
Auditory brainstem implantation (ABI) is a recent technique in children's hearing restoration. Up till now the focus in the literature has mainly been the perceptual outcomes after implantation, whereas the effect of ABI on spoken language is still an almost unexplored area of research. This study presents a one-year follow-up of the volubility of two children with ABI. The volubility of signed and oral productions is investigated and oral productions are examined in more detail. Results show clear developmental trends in both children, indicating a beneficial effect of ABI on spoken language development.
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Affiliation(s)
- Jolien Faes
- Computational Linguistics & Psycholinguistics (CLiPS) Research Center, University of Antwerp, Lange Winkelstraat 40-42, B-2000, Antwerp, Belgium.
| | - Steven Gillis
- Computational Linguistics & Psycholinguistics (CLiPS) Research Center, University of Antwerp, Lange Winkelstraat 40-42, B-2000, Antwerp, Belgium
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27
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Deep NL, Choudhury B, Roland JT. Auditory Brainstem Implantation: An Overview. J Neurol Surg B Skull Base 2019; 80:203-208. [PMID: 30931229 DOI: 10.1055/s-0039-1679891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 12/31/2018] [Indexed: 01/27/2023] Open
Abstract
An auditory brainstem implant (ABI) is a surgically implanted central neural auditory prosthesis for the treatment of profound sensorineural hearing loss in children and adults who are not cochlear implant candidates due to a lack of anatomically intact cochlear nerves or implantable cochleae. The device consists of a multielectrode surface array which is placed within the lateral recess of the fourth ventricle along the brainstem and directly stimulates the cochlear nucleus, thereby bypassing the peripheral auditory system. In the United States, candidacy criteria for ABI include deaf patients with neurofibromatosis type 2 (NF2) who are 12 years or older undergoing first- or second-side vestibular schwannoma resection. In recent years, several non-NF2 indications for ABI have been explored, including bilateral cochlear nerve avulsion from trauma, complete ossification of the cochlea due to meningitis, or a severe cochlear malformation not amenable to cochlear implantation. In addition, growing experience with ABI in infants and children has been documented with encouraging outcomes. While cochlear implantation generally remains the first-line option for hearing rehabilitation in NF2 patients with stable tumors or post hearing preservation surgery where hearing is lost but a cochlear nerve remains accessible for stimulation, an ABI is the next alternative in cases where the cochlear nerve is absent and/or if the cochlea cannot be implanted. Herein, we review ABI device design, clinical evaluation, indications, operative technique, and outcomes as it relates to lateral skull base pathology.
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Affiliation(s)
- Nicholas L Deep
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, United States
| | - Baishakhi Choudhury
- Department of Otolaryngology, Loma Linda University, Loma Linda, California, United States
| | - J Thomas Roland
- Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, United States
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28
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Polak M, Colletti L, Colletti V. Novel method of fitting of children with auditory brainstem implants. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:403-409. [DOI: 10.1016/j.anorl.2017.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/28/2017] [Accepted: 10/02/2017] [Indexed: 10/28/2022]
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Sung JKK, Luk BPK, Wong TKC, Thong JF, Wong HT, Tong MCF. Pediatric Auditory Brainstem Implantation: Impact on Audiological Rehabilitation and Tonal Language Development. Audiol Neurootol 2018; 23:126-134. [PMID: 30227389 DOI: 10.1159/000491991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/06/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This is a retrospective review of the impact of an Auditory Brainstem Implant (ABI) on the audiological rehabilitation and tonal language development of pediatric patients with prelingual profound deafness in Hong Kong. RESULTS From January 2009 to February 2015, 11 pediatric patients with profound prelingual deafness received an ABI in Hong Kong (age range 1.67-3.75 years). Etiologies included Cochlear Nerve Deficiency in 7, Severe Cochlear Malformations in 2, and Retrocochlear Deafness in 2. All of them were rehabilitated in Cantonese, a dialect of Chinese. Standard pediatric cochlear implant outcome measurements were used in this study that comprised of the 7-Sound Detection, Syllable Identification, Vowel Identification, Consonant Identification, Tone Imitation, Tone Production and Speech Perception Category. Audiological rehabilitation and speech development outcomes were reviewed. Age-matched outcomes of pediatric cochlear implant users were used for comparisons. CONCLUSION Encouraging results of speech development were found, especially with continued use of the ABI. There was considerable variation in outcomes. Children with coexisting developmental and nonauditory cognitive disabilities did not perform as well. Auditory brainstem implantation is a safe and beneficial treatment for profound prelingual deafness in Cantonese-speaking pediatric patients.
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Ehrmann-Müller D, Kühn H, Matthies C, Hagen R, Shehata-Dieler W. Outcomes after cochlear implant provision in children with cochlear nerve hypoplasia or aplasia. Int J Pediatr Otorhinolaryngol 2018; 112:132-140. [PMID: 30055722 DOI: 10.1016/j.ijporl.2018.06.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/22/2018] [Accepted: 06/23/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Cochlear nerve aplasia or hypoplasia is found in up to a half of patients with unilateral or bilateral hearing loss. There is an ongoing discussion regarding the indication of cochlear implants for hearing rehabilitation in cases with radiologically-defined aplasia or hypoplasia of the cochlear nerve in those patients, especially in children. At present there is conflicting evidence whether the audiological outcomes of those children with a CI are comparable to those of children with a CI and a radiologically-normal cochlear nerve. The primary aim of this study was to assess the audiological abilities before and after CI provision in children with cochlear nerve hypoplasia or aplasia. Additionally, we aimed to determine if audiological outcomes differed in children with aplasia from those with hypoplasia. Such data should be helpful in determining if CI provision is appropriate for such children. METHODS This retrospective study presents 7 children who were diagnosed with cochlear nerve aplasia or hypoplasia and received a CI. The pre- and postoperative audiological performance and the hearing and speech development of the children were examined. RESULTS 4 children were unilateral CI users and 3 were bilateral CI users. Hearing reactions could be detected in all children. Already at first fitting, prompt responses and reactions to songs were observed. The aided thresholds in free field in children with hypoplasia were between 30 and 60 dB. Even in children with aplasia, the results in free field with CI averaged between 30 and 70 dB. Therefore the aided thresholds in children with hypoplasia and in children with aplasia of the CN are similar. It could be demonstrated that hearing reactions improve with the long term use of the implant. Improvement in general development could be observed in all children despite the very heterogeneous conditions and the accompanying handicaps. CONCLUSION The results of this study support the hypothesis that children with radiologically-defined CN hypoplasia or aplasia and detectable responses to electrical or acoustical stimuli can improve their sound detection thresholds and their awareness of sound when provided with a CI.
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Affiliation(s)
- Désirée Ehrmann-Müller
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany.
| | - Heike Kühn
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany
| | - Cordula Matthies
- Department of Neurosurgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Esthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Wuerzburg, Germany
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Eisenberg LS, Hammes Ganguly D, Martinez AS, Fisher LM, Winter ME, Glater JL, Schrader DK, Loggins J, Wilkinson EP. Early Communication Development of Children with Auditory Brainstem Implants. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2018; 23:249-260. [PMID: 29718280 PMCID: PMC5995196 DOI: 10.1093/deafed/eny010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 03/20/2018] [Accepted: 04/12/2018] [Indexed: 06/06/2023]
Abstract
The auditory brainstem implant (ABI) is an auditory sensory device that is surgically placed on the cochlear nucleus of the brainstem for individuals who are deaf but unable to benefit from a cochlear implant (CI) due to anatomical abnormalities of the cochlea and/or eighth nerve, specific disease processes, or temporal bone fractures. In the United States, the Food and Drug Administration has authorized a Phase I clinical trial to determine safety and feasibility of the ABI in up to 10 eligible young children who are deaf and either derived no benefit from the CI or were anatomically unable to receive a CI. In this paper, we describe the study protocol and the children who have enrolled in the study thus far. In addition, we report the scores on speech perception, speech production, and language (spoken and signed) for five children with 1-3 years of assessment post-ABI activation. To date, the results indicate that spoken communication skills are slow to develop and that visual communication remains essential for post-ABI intervention.
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Affiliation(s)
| | | | - Amy S Martinez
- Keck School of Medicine of the University of Southern California
| | - Laurel M Fisher
- Keck School of Medicine of the University of Southern California
| | | | - Jamie L Glater
- Keck School of Medicine of the University of Southern California
| | - Debra K Schrader
- Keck School of Medicine of the University of Southern California
| | - Janice Loggins
- Keck School of Medicine of the University of Southern California
| | - Eric P Wilkinson
- Keck School of Medicine of the University of Southern California
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Auditory Brainstem Implant Array Position Varies Widely Among Adult and Pediatric Patients and Is Associated With Perception. Ear Hear 2018; 38:e343-e351. [PMID: 28700445 DOI: 10.1097/aud.0000000000000448] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The auditory brainstem implant (ABI) provides sound awareness to patients who are ineligible for cochlear implantation. Auditory performance varies widely among similar ABI cohorts. We hypothesize that differences in electrode array position contribute to this variance. Herein, we classify ABI array position based on postoperative imaging and investigate the relationship between position and perception. DESIGN Retrospective review of pediatric and adult ABI users with postoperative computed tomography. To standardize views across subjects, true axial reformatted series of scans were created using the McRae line. Using multiplanar reconstructions, basion and electrode array tip coordinates and array angles from vertical were measured. From a lateral view, array angles (V) were classified into types I to IV, and from posterior view, array angles (T) were classified into types A to D. Array position was further categorized by measuring distance vertical from basion (D1) and lateral from midline (D2). Differences between array classifications were compared with audiometric thresholds, number of active electrodes, and pitch ranking. RESULTS Pediatric (n = 4, 2 with revisions) and adult (n = 7) ABI subjects were included in this study. Subjects had a wide variety of ABI array angles, but most were aimed superiorly and posteriorly (type II, n = 7) from lateral view and upright or medially tilted from posterior view (type A, n = 6). Mean pediatric distances were 8 to 42% smaller than adults for D1 and D2. In subjects with perceptual data, electrical thresholds and the number of active electrodes differed among classification types. CONCLUSIONS In this first study to classify ABI electrode array orientation, array position varied widely. This variability may explain differences in auditory performance.
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Anwar A, Singleton A, Fang Y, Wang B, Shapiro W, Roland JT, Waltzman SB. The value of intraoperative EABRs in auditory brainstem implantation. Int J Pediatr Otorhinolaryngol 2017; 101:158-163. [PMID: 28964288 DOI: 10.1016/j.ijporl.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 08/04/2017] [Accepted: 08/05/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the intraoperative electrically evoked auditory brainstem response (EABR) morphologies between neurofibromatosis II (NF2) adult auditory brainstem implant (ABI) recipients who had auditory percepts post-operatively and those who did not and between NF2 adult ABI recipients and non-NF2 pediatric ABI recipients. METHODS This was a retrospective case series at a single tertiary academic referral center examining all ABI recipients from 1994 to 2016, which included 34 NF2 adults and 11 non-NF2 children. The morphologies of intraoperative EABRs were evaluated for the number of waveforms showing a response, the number of positive peaks in those responses, and the latencies of each of these peaks. RESULTS 27/34 adult NF2 patients and 9/10 children had EABR waveforms. 20/27 (74.0%) of the adult patients and all of the children had ABI devices that stimulated post-operatively. When comparing the waveforms between adults who stimulated and those who did not stimulate, the proportion of total number of intraoperative EABR peaks to total possible peaks was significantly higher for the adults who stimulated than for those who did not (p < 0.05). Children had a significantly higher proportion of total number of peaks to total possible peaks when compared to adults who stimulated (p < 0.02). Additionally, there were more likely to be EABR responses at the initial stimulation than intraoperatively in the pediatric ABI population (p = 0.065). CONCLUSIONS The value of intraoperative EABR tracing may lie in its ability to predict post-operative auditory percepts based on the placement of the array providing the highest number of total peaks.
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Affiliation(s)
- Abbas Anwar
- New York University School of Medicine, NYU Langone Medical Center, United States.
| | - Alison Singleton
- New York University School of Medicine, NYU Langone Medical Center, United States
| | - Yixin Fang
- New York University School of Medicine, NYU Langone Medical Center, United States
| | - Binhuan Wang
- New York University School of Medicine, NYU Langone Medical Center, United States
| | - William Shapiro
- New York University School of Medicine, NYU Langone Medical Center, United States
| | - J Thomas Roland
- New York University School of Medicine, NYU Langone Medical Center, United States
| | - Susan B Waltzman
- New York University School of Medicine, NYU Langone Medical Center, United States
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Sennaroğlu L, Sennaroğlu G, Yücel E, Bilginer B, Atay G, Bajin MD, Mocan BÖ, Yaral M, Aslan F, Çnar BÇ, Özkan B, Batuk MÖ, Kirazl ÇE, Karakaya J, Ataş A, Saraç S, Ziyal İ. Long-term Results of ABI in Children With Severe Inner Ear Malformations. Otol Neurotol 2017; 37:865-72. [PMID: 27273392 DOI: 10.1097/mao.0000000000001050] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To report the long-term outcomes of children who received auditory brainstem implant (ABI) because of severe inner ear malformations. STUDY DESIGN Retrospective chart review. SETTING Tertiary referral otolaryngology clinic. SUBJECTS AND METHODS Between July 2006 and October 2014, 60 children received ABI at Hacettepe University. Preoperative work up included otolaryngologic examination, audiological assessment, radiological evaluation together with assessment of language development and psychological status. The surgeries were performed via retrosigmoid approach with a pediatric neurosurgeon. Intraoperatively, electrical auditory brainstem response was utilized. Initial stimulation was done 4 to 5 weeks postoperatively. Outcomes were evaluated with Categories of Auditory Performance (CAP), speech intelligibility rate (SIR), functional auditory performance of cochlear implant (FAPCI) and Manchester Spoken Language Development Scale scores; receptive and expressive language ages were determined. RESULTS Sixty children who received ABI were between ages of 12 and 64 months. Thirty-five patients with follow up period of at least 1 year, were reported in means of long-term audiological and language results. The most prevelant inner ear malformation was cochlear hypoplasia (n = 19). No major complication was encountered. Majority of the patients were in CAP 5 category, which implies that they can understand common phrases without lip reading. SIR was found out to be better with improving hearing thresholds. Children with ABI were performing worse than average cochlear implantation (CI) users when FAPCI scores were compared. Patients with the best hearing thresholds have expressive vocabulary of 50 to 200 words when evaluated with Manchester Spoken Language Development Scale. There was no relationship between the number of active electrodes and hearing thresholds. The type of inner ear anomaly with the best and the worst hearing thresholds were common cavity and cochlear aperture aplasia, respectively. Patients with additional handicaps had worse outcomes. Among 35 children, 29 had closed set discrimination and 12 developed open set discrimination above 50%. It was determined that, progress of the patients is faster in the initial 2 years when compared with further use of ABI. CONCLUSION ABI is an acceptable and effective treatment modality for pediatric population with severe inner ear malformations. Bilateral stimulation together with CI and contralateral ABI should be utilized in suitable cases.
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Affiliation(s)
- Levent Sennaroğlu
- *Department of Otolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey †Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey ‡Department of Language and Speech Pathology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey §Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey ¶Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey #Department of Audiology, Faculty of Health Sciences, İstanbul University, İstanbul, Turkey **Department of Otolaryngology, Liv Hospital, İstanbul, Turkey ††Department of Neurosurgery, Faculty of Medicine, Marmara University, İstanbul, Turkey
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Abstract
OBJECTIVE To assess cochlear implant (CI) outcomes, and factors affecting outcomes, for children with aplasia/ hypoplasia of the cochlea nerve. We also developed a new grading system for the nerves of the internal auditory meatus (IAM) and cochlea nerve classification. STUDY DESIGN Retrospective patient review. SETTING Tertiary referral hospital and cochlear implant program. PATIENTS Children 0 to 16 years inclusive with a CI who had absent/hypoplastic cochlea nerve on magnetic resonance imaging (MRI). INTERVENTION Cochlear implant. MAIN OUTCOME MEASURES MRI, trans-tympanic electrical auditory brainstem response, intraoperative electrical auditory brainstem response, Neural Response Telemetry, Categories of Auditory Perception score, Main mode of communication. RESULTS Fifty CI recipients (26 males and 24 females) were identified, 21 had bilateral CIs, 27 had developmental delay. MRI showed cochlea nerve aplasia in 64 ears, hypoplasia in 25 ears, and a normal nerve in 11 ears. Main mode of communication was analyzed for 41 children: 21 (51%) used verbal language (15 speech alone, 5 speech plus some sign, 1 bilingual in speech and sign), and 20 (49%) used sign language (10 sign alone, 9 sign plus some speech, 1 tactile sign). Seventy-three percent of children used some verbal language. Cochlea nerve aplasia/ hypoplasia and developmental delay were both significant factors affecting main mode of communication. Categories of Auditory Performance scores were available for 59 CI ears; 47% with CN Aplasia (IAM nerve grades 0-III) and 89% with CN hypoplasia (IAM nerve grade IV) achieved Categories of Auditory Performance scores of 5 to 7 (some verbal understanding) (p = 0.003). CONCLUSION Our results are encouraging and useful when counselling families regarding the likelihood of language outcomes and auditory understanding.
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Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children. Otol Neurotol 2017; 38:212-220. [PMID: 27898605 DOI: 10.1097/mao.0000000000001287] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the safety and feasibility of the auditory brainstem implant (ABI) in congenitally deaf children with cochlear aplasia and/or cochlear nerve deficiency. STUDY DESIGN Phase I feasibility clinical trial of surgery in 10 children, ages 2 to 5 years, over a 3-year period. SETTING Tertiary children's hospital and university-based pediatric speech/language/hearing center. INTERVENTION(S) ABI implantation and postsurgical programming. MAIN OUTCOME MEASURE(S) The primary outcome measure is the number and type of adverse events during ABI surgery and postsurgical follow-up, including behavioral mapping of the device. The secondary outcome measure is access to and early integration of sound. RESULTS To date, nine children are enrolled. Five children have successfully undergone ABI surgery and postoperative behavioral programming. Three children were screen failures, and one child is currently undergoing candidacy evaluation. Expected adverse events have been documented in three of the five children who received the ABI. One child experienced a cerebral spinal fluid leak, which resolved with lumbar drainage. One child demonstrated vestibular side effects during device programming, which resolved by deactivating one electrode. One child experienced postoperative vomiting resulting in an abdominal radiograph. Four children have completed their 1-year follow-up and have speech detection thresholds of 30 to 35 dB HL. Scores on the IT-MAIS/MAIS range from 8 to 31 (out of a total of 40), and the children are demonstrating some ability to discriminate between closed-sets words that differ by number of syllables (pattern perception). CONCLUSION ABI surgery and device activation seem to be safe and feasible in this preliminary cohort.
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Goyal S, Krishnan SS, Kameswaran M, Vasudevan MC, Ranjith, Natarajan K. Does cerebellar flocculus size affect subjective outcomes in pediatric auditory brainstem implantation. Int J Pediatr Otorhinolaryngol 2017; 97:30-34. [PMID: 28483247 DOI: 10.1016/j.ijporl.2017.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The objectives of study was to 1) Describe relevant surgical anatomy in defining and accessing the lateral recess for placement of electrode, 2) Propose a working classification for grades of Flocculus; 3) To determine if different grades of cerebellar flocculus effects placement of ABI electrode and subjective outcomes in implantees. METHODS Our study was a prospective study, and comprised of cohort of 12 patients who underwent ABI surgery via retrosigmoid approach between 1 Jan 2012 to 31 Dec 2014. All children with congenital profound sensorineural hearing loss with either absent cochlea or cochlear nerve were included in the study. Relevant anatomy was noted. We also noted down the difficulty encountered during the placement of ABI electrode. Auditory perception and speech intelligibility was scored post operatively for 1 year. RESULTS Cerebellar flocculus was divided into 4 grades depending on the morphology of cerebellar flocculus. It was noted that Grade 3 & 4 flocculus (Group B) had difficult ABI electrode placement in comparison to Grade 1 & 2 flocculus (Group A). The subjective outcomes of Group A was better than Group B. However the p value was not statistically significant. CONCLUSION Cerebellar flocculus can be graded depending on morphology and size. Flocculus of higher grades can make the placement of ABI electrodes difficult and adversely effects the postoperative subjective outcomes.
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Affiliation(s)
- Sunil Goyal
- Department of ENT, Command Hospital (Southern Command), Wanowrie, Pune 411040, Maharashtra, India.
| | - Shyam Sundar Krishnan
- Department of Neurosurgery, Dr Achanta Lakshmipathi Neurosurgical Centre, VHS Medical Centre, Adyar, Chennai 600113, Tamil Nadu, India
| | - Mohan Kameswaran
- Department of ENT, MERF-Madras ENT Research Foundation (Pvt) Ltd, 1, First Cross Street, Off Second Main Road, Raja Annamalai Puram, Chennai 600028, Tamil Nadu, India.
| | - M C Vasudevan
- Department of Neurosurgery, Dr Achanta Lakshmipathi Neurosurgical Centre, VHS Medical Centre, Adyar, Chennai 600113, Tamil Nadu, India
| | - Ranjith
- MERF Institute of Speech and Hearing (MERFISH), No. 1, South Canal Bank Road, Mandavellipakkam, Chennai 600028, Tamil Nadu, India
| | - Kiran Natarajan
- Department of ENT, MERF-Madras ENT Research Foundation (Pvt) Ltd, 1, First Cross Street, Off Second Main Road, Raja Annamalai Puram, Chennai 600028, Tamil Nadu, India
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Bony cochlear nerve canal and internal auditory canal measures predict cochlear nerve status. The Journal of Laryngology & Otology 2017; 131:676-683. [DOI: 10.1017/s0022215117001141] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectives:The bony cochlear nerve canal is the space between the fundus of the internal auditory canal and the base of the cochlear modiolus that carries cochlear nerve fibres. This study aimed to determine the distribution of bony labyrinth anomalies and cochlear nerve anomalies in patients with bony cochlear nerve canal and internal auditory canal atresia and stenosis, and then to compare the diameter of the bony cochlear nerve canal and internal auditory canal with cochlear nerve status.Methods:The study included 38 sensorineural hearing loss patients (59 ears) in whom the bony cochlear nerve canal diameter at the mid-modiolus was 1.5 mm or less. Atretic and stenotic bony cochlear nerve canals were examined separately, and internal auditory canals with a mid-point diameter of less than 2 mm were considered stenotic. Temporal bone computed tomography and magnetic resonance imaging scans were reviewed to determine cochlear nerve status.Results:Cochlear hypoplasia was noted in 44 out of 59 ears (75 per cent) with a bony cochlear nerve canal diameter at the mid-modiolus of 1.5 mm or less. Approximately 33 per cent of ears with bony cochlear nerve canal stenosis also had a stenotic internal auditory canal and 84 per cent had a hypoplastic or aplastic cochlear nerve. All patients with bony cochlear nerve canal atresia had cochlear nerve deficiency. The cochlear nerve was hypoplastic or aplastic when the diameter of the bony cochlear nerve canal was less than 1.5 mm and the diameter of the internal auditory canal was less than 2 mm.Conclusion:The cochlear nerve may be aplastic or hypoplastic even if temporal bone computed tomography findings indicate a normal cochlea. If possible, patients scheduled to receive a cochlear implant should undergo both computed tomography and magnetic resonance imaging of the temporal bone. The bony cochlear nerve canal and internal auditory canal are complementary structures, and both should be assessed to determine cochlear nerve status.
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Resorbable Mesh Cranioplasty Repair of Bilateral Cerebrospinal Fluid Leaks Following Pediatric Simultaneous Bilateral Auditory Brainstem Implant Surgery. Otol Neurotol 2017; 38:606-609. [DOI: 10.1097/mao.0000000000001338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thomas Roland J, Buchman C, Eisenberg L, Henderson L, He S, Firszt J, Francis H, Dunn C, Sladen D, Arndt S, May B, Zeitler D, Niparko JK, Emmett S, Tucci D, Chen J, McConkey Robbins A, Schwefler E, Geers A, Lederberg A, Hayes H, Hughes M, Bierer J, Schafer E, Sorkin D, Kozma-Spytek L, Childress T. Proceedings of the Annual Symposium of the American Cochlear Implant Alliance. Cochlear Implants Int 2016; 17:211-237. [PMID: 27635521 PMCID: PMC5062039 DOI: 10.1080/14670100.2016.1225348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
| | | | | | | | - Shuman He
- e Boys Town National Research Hospital (previously University of North Carolina)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle Hughes
- e Boys Town National Research Hospital (previously University of North Carolina)
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Chen MM, Oghalai JS. Diagnosis and Management of Congenital Sensorineural Hearing Loss. CURRENT TREATMENT OPTIONS IN PEDIATRICS 2016; 2:256-265. [PMID: 28083467 PMCID: PMC5222593 DOI: 10.1007/s40746-016-0056-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hearing loss is the most common sensory disorder in the USA. The diagnosis of congenital hearing loss starts with newborn hearing screening, which is best performed with auditory brainstem evoked responses in order to avoid the risk of missing auditory neuropathy spectrum disorder. A careful history and physical exam can occasionally help reveal the etiology for congenital hearing loss. Imaging studies, either CT temporal bones or MRI of the internal auditory canals without gadolinium, and genetic testing, in particular for connexin 26, connexin 30, and Pendred syndrome, are the most useful diagnostic tests. Management of congenital hearing loss involves early fitting of amplification. Early cochlear implantation, preferably before 2 years of age, should be strongly considered for children with bilateral severe hearing loss.
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Affiliation(s)
| | - John S. Oghalai
- Department of Otolaryngology–Head and Neck Surgery, Stanford University, 801 Welch Road, Palo Alto, CA, 94305-5739, USA,
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Abstract
Auditory brainstem implants (ABIs) provide auditory perception in patients with profound hearing loss who are not candidates for the cochlear implant (CI) because of anatomic constraints or failed CI surgery. Herein, the authors discuss (1) preoperative evaluation of pediatric ABI candidates, (2) surgical approaches, and (3) contemporary ABI devices and their use in the pediatric population. The authors also review the surgical and audiologic outcomes following pediatric ABI surgery. The authors' institutional experience and the nearly 200 cases performed in Europe and the United States indicate that ABI surgery in children can be safe and effective.
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Affiliation(s)
- Sidharth V Puram
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA; Department of Otology and Laryngology, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
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Puram SV, Barber SR, Kozin ED, Shah P, Remenschneider A, Herrmann BS, Duhaime AC, Barker FG, Lee DJ. Outcomes following Pediatric Auditory Brainstem Implant Surgery: Early Experiences in a North American Center. Otolaryngol Head Neck Surg 2016; 155:133-8. [PMID: 27095049 DOI: 10.1177/0194599816637599] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 02/16/2016] [Indexed: 11/16/2022]
Abstract
There are no approved Food and Drug Administration indications for pediatric auditory brainstem implant (ABI) surgery in the United States. Our prospective case series aims to determine the safety and feasibility of ABI surgery in pediatric patients <5 years old with congenital deafness at a tertiary North American center. The inclusion criterion was pre- or postlinguistic deafness in children not eligible for cochlear implantation. Seventeen candidates were evaluated (mean ± SD: age, 2.52 ± 0.39 years). Four patients underwent ABI surgery (age, 19.2 ± 3.43 months), including 4 primary procedures and 1 revision for device failure. Spontaneous device failure occurred in another subject postoperatively. No major/minor complications occurred, including cerebrospinal fluid leak, facial nerve injury, hematoma, and nonauditory stimulation. All subjects detected sound with environmental awareness, and several demonstrated babbling and mimicry. Poor durability of older implants underscores need for updated technology.
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Affiliation(s)
- Sidharth V Puram
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Samuel R Barber
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Elliott D Kozin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Parth Shah
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Aaron Remenschneider
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - Barbara S Herrmann
- Department of Audiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Ann-Christine Duhaime
- Department of Pediatric Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA Department of Surgery (Neurosurgery), Harvard Medical School, Boston, Massachusetts, USA
| | - Fred G Barker
- Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA Department of Surgery (Neurosurgery), Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
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Lundin K, Stillesjö F, Nyberg G, Rask-Andersen H. Experiences from Auditory Brainstem Implantation (ABIs) in four paediatric patients. Cochlear Implants Int 2016; 17:109-15. [PMID: 26841821 DOI: 10.1080/14670100.2016.1142693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Indications for auditory brainstem implants (ABIs) have been widened from patients with neurofibromatosis type 2 (NF2) to paediatric patients with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, or cochlear ossification after meningitis. We present four ABI surgeries performed in children at Uppsala University Hospital in Sweden since 2009. METHODS Three children were implanted with implants from Cochlear Ltd. (Lane Cove, Australia) and one child with an implant from MedEl GMBH (Innsbruck, Austria). A boy with Goldenhar syndrome was implanted with a Cochlear Nucleus ABI24M at age 2 years (patient 1). Another boy with CHARGE syndrome was implanted with a Cochlear Nucleus ABI541 at age 2.5 years (patient 2). Another boy with post-ossification meningitis was implanted with a Cochlear Nucleus ABI24M at age 4 years (patient 3). A girl with cochlear aplasia was implanted with a MedEl Synchrony ABI at age 3 years (patient 4). In patients 1, 2, and 3, the trans-labyrinthine approach was used, and in patient 4 the retro-sigmoid approach was used. RESULTS Three of the four children benefited from their ABIs and use it full time. Two of the full time users had categories of auditory performance (CAP) score of 4 at their last follow up visit (6 and 2.5 years postoperative) which means they can discriminate consistently any combination of two of Ling's sounds. One child has not been fully evaluated yet, but is a full time user and had CAP 2 (responds to speech sounds) after 3 months of ABI use. No severe side or unpleasant stimulation effects have been observed so far. There was one case of immediate electrode migration and one case of implant device failure after 6.5 years. CONCLUSION ABI should be considered as an option in the rehabilitation of children with similar diagnoses.
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Affiliation(s)
- Karin Lundin
- a Department of Surgical Sciences, Section of Otorhinolaryngology, and Head & Neck Surgery , Uppsala University , Uppsala , Sweden
| | - Fredrik Stillesjö
- a Department of Surgical Sciences, Section of Otorhinolaryngology, and Head & Neck Surgery , Uppsala University , Uppsala , Sweden
| | - Gunnar Nyberg
- a Department of Surgical Sciences, Section of Otorhinolaryngology, and Head & Neck Surgery , Uppsala University , Uppsala , Sweden
| | - Helge Rask-Andersen
- a Department of Surgical Sciences, Section of Otorhinolaryngology, and Head & Neck Surgery , Uppsala University , Uppsala , Sweden
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Colletti G, Mandalà M, Colletti L, Colletti V. Surgical Visual Reference for Auditory Brainstem Implantation in Children with Cochlear Nerve Deficiency. Otolaryngol Head Neck Surg 2015; 153:1071-3. [DOI: 10.1177/0194599815612075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 09/25/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Giacomo Colletti
- Department of Maxillo-facial Surgery, University of Milan, Milan, Italy
| | - Marco Mandalà
- Otological and Skull Base Surgery Department, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Vittorio Colletti
- International Center for Performing and Teaching Auditory Brainstem Surgery in Children, Milan, Italy
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Two Laskers and Counting: Learning From the Past Enables Future Innovations With Central Neural Prostheses. Brain Stimul 2015; 8:439-41. [DOI: 10.1016/j.brs.2014.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 10/23/2014] [Accepted: 10/23/2014] [Indexed: 12/20/2022] Open
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Shannon RV. Auditory implant research at the House Ear Institute 1989-2013. Hear Res 2015; 322:57-66. [PMID: 25449009 PMCID: PMC4380593 DOI: 10.1016/j.heares.2014.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 11/29/2022]
Abstract
The House Ear Institute (HEI) had a long and distinguished history of auditory implant innovation and development. Early clinical innovations include being one of the first cochlear implant (CI) centers, being the first center to implant a child with a cochlear implant in the US, developing the auditory brainstem implant, and developing multiple surgical approaches and tools for Otology. This paper reviews the second stage of auditory implant research at House - in-depth basic research on perceptual capabilities and signal processing for both cochlear implants and auditory brainstem implants. Psychophysical studies characterized the loudness and temporal perceptual properties of electrical stimulation as a function of electrical parameters. Speech studies with the noise-band vocoder showed that only four bands of tonotopically arrayed information were sufficient for speech recognition, and that most implant users were receiving the equivalent of 8-10 bands of information. The noise-band vocoder allowed us to evaluate the effects of the manipulation of the number of bands, the alignment of the bands with the original tonotopic map, and distortions in the tonotopic mapping, including holes in the neural representation. Stimulation pulse rate was shown to have only a small effect on speech recognition. Electric fields were manipulated in position and sharpness, showing the potential benefit of improved tonotopic selectivity. Auditory training shows great promise for improving speech recognition for all patients. And the Auditory Brainstem Implant was developed and improved and its application expanded to new populations. Overall, the last 25 years of research at HEI helped increase the basic scientific understanding of electrical stimulation of hearing and contributed to the improved outcomes for patients with the CI and ABI devices. This article is part of a Special Issue entitled .
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Affiliation(s)
- Robert V Shannon
- Department of Otolaryngology, University of Southern California, Keck School of Medicine of USC, 806 W. Adams Blvd, Los Angeles, CA 90007-2505, USA.
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Lim HH, Lenarz T. Auditory midbrain implant: research and development towards a second clinical trial. Hear Res 2015; 322:212-23. [PMID: 25613994 DOI: 10.1016/j.heares.2015.01.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 12/04/2014] [Accepted: 01/08/2015] [Indexed: 11/30/2022]
Abstract
The cochlear implant is considered one of the most successful neural prostheses to date, which was made possible by visionaries who continued to develop the cochlear implant through multiple technological and clinical challenges. However, patients without a functional auditory nerve or implantable cochlea cannot benefit from a cochlear implant. The focus of the paper is to review the development and translation of a new type of central auditory prosthesis for this group of patients that is known as the auditory midbrain implant (AMI) and is designed for electrical stimulation within the inferior colliculus. The rationale and results for the first AMI clinical study using a multi-site single-shank array will be presented initially. Although the AMI has achieved encouraging results in terms of safety and improvements in lip-reading capabilities and environmental awareness, it has not yet provided sufficient speech perception. Animal and human data will then be presented to show that a two-shank AMI array can potentially improve hearing performance by targeting specific neurons of the inferior colliculus. A new two-shank array, stimulation strategy, and surgical approach are planned for the AMI that are expected to improve hearing performance in the patients who will be implanted in an upcoming clinical trial funded by the National Institutes of Health. Positive outcomes from this clinical trial will motivate new efforts and developments toward improving central auditory prostheses for those who cannot sufficiently benefit from cochlear implants. This article is part of a Special Issue entitled <Lasker Award>.
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Affiliation(s)
- Hubert H Lim
- Department of Biomedical Engineering, Department of Otolaryngology, and Institute for Translational Neuroscience, University of Minnesota, 312 Church Street S.E., Minneapolis, MN, 55455, USA.
| | - Thomas Lenarz
- Department of Otolaryngology, Hannover Medical School, Carl-Neuberg-Str.1, Hannover, 30625, Germany.
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Eisenberg LS. The contributions of William F. House to the field of implantable auditory devices. Hear Res 2014; 322:52-6. [PMID: 25159272 DOI: 10.1016/j.heares.2014.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/01/2014] [Accepted: 08/04/2014] [Indexed: 11/25/2022]
Abstract
William F. House was a pioneer in the evolving field of cochlear implants and auditory brainstem implants. Because of his vision, innovation and perseverance, the way was paved for future clinicians and researchers to carry on the work and advance a field that has been dedicated to serving adults and children with severe to profound hearing loss. Several of William House's contributions are highlighted in this prestigious volume to honor the recipients of the 2013 Lasker-Debakey Clinical Medical Research Award. Discussed are the early inventive years, clinical trials with the single-channel cochlear implant, the team approach, pediatric cochlear implantation, and the auditory brainstem implant. Readers may be surprised to learn that those early contributions continue to have relevance today. This article is part of a Special Issue entitled <Lasker Award>.
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Affiliation(s)
- Laurie S Eisenberg
- Keck School of Medicine of USC, Center for Childhood Communication, 806 West Adams Blvd., Los Angeles, CA 90007, USA.
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