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Daoudi H, Torres R, Mosnier I, Ambert-Dahan E, Liagre-Cailles A, Smail M, Nguyen Y, Ferrary E, Sterkers O, Lahlou G, Kalamarides M. Long-term analysis of ABI auditory performance in patients with neurofibromatosis type 2-related schwannomatosis. Acta Neurochir (Wien) 2024; 166:390. [PMID: 39356313 DOI: 10.1007/s00701-024-06243-3] [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: 07/12/2024] [Accepted: 08/17/2024] [Indexed: 10/03/2024]
Abstract
PURPOSE This retrospective monocentric study aimed to evaluate long-term auditory brainstem implant (ABI) function in patients with neurofibromatosis type 2, and to investigate the prognostic factors for ABI use. METHODS Between 1997 and 2022, 27 patients with at least five years of follow-up underwent implantation with 32 ABIs. At 1- and 5-years post-implantation and at last follow-up, ABIs were classified as used or non-used and the size of the ipsilateral tumor was recorded. For patients who used their ABIs, we assessed speech perception (disyllabic words, MBAA sentences) in quiet conditions with the ABI only, by lip-reading (LR), and with a combination of the two (ABI + LR). Hearing improvement was calculated as Δ ABI = (ABI + LR)-LR scores. Predictive factors for ABI use were analyzed. RESULTS One year post-implantation, 74% patients were ABI-users and 66% of the ABIs were used. Two of these patients were non-users at five years, and another two at last follow-up (14 ± 5.2 years); 54% of the patients were ABI-users at last follow-up. Δ ABI revealed a hearing improvement of 32-41% (disyllabic words) and 28-37% (MBAA sentences). Among 16 ABIs with at least LR improvement at 1-year post-implantation, 4 decreased their performance, coinciding with a large growing ipsilateral tumor in 3/4 ABIs. We identified no significant prognostic factors for ABI use. CONCLUSIONS ABIs are indicated in case of bilateral deafness with a non-functional cochlear nerve. Half the patients with ABIs used their implants and auditory performance remained stable over time, except in cases of ipsilateral tumor growth.
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Affiliation(s)
- Hannah Daoudi
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France.
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France.
- ENT Department, Rothschild, APHP, Sorbonne University, Paris, France.
| | - Renato Torres
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France
| | - Isabelle Mosnier
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France
| | | | | | - Mustapha Smail
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
| | - Yann Nguyen
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France
| | - Evelyne Ferrary
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France
| | - Olivier Sterkers
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
| | - Ghizlène Lahlou
- ENT Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Université Paris Cité, Institut Pasteur, AP-HP, InsermFondation Pour L'AuditionInstitut de L'Audition, Technologies and Gene Therapy for Deafness, IHU reConnect, 75012, Paris, France
| | - Michel Kalamarides
- Neurosurgery Department, Pitié-Salpêtrière, APHP, Sorbonne University, Paris, France
- Genetics and Development of Brain Tumors, CRICM Inserm CNRS, Paris Brain Institute, Paris, France
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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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Wang B, Yan M, Liu C, Yang Z, Wang X, Zhao F, Wang Z, Li P, Wang Y, Li S, Liu G, Liu P. Auditory brainstem implants for hearing rehabilitation in NF2-schwannomatosis: A systematic review and single-arm meta-analysis. NeuroRehabilitation 2024; 54:213-225. [PMID: 38427506 DOI: 10.3233/nre-230198] [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] [Indexed: 03/03/2024]
Abstract
BACKGROUND NF2-schwannomatosis (NF2) is an autosomal dominant disorder prone to hearing loss. Auditory brainstem implants (ABIs) offer a promising solution for hearing rehabilitation in NF2. OBJECTIVE To synthesize existing literature on ABI implantation in NF2, focusing on audiological outcomes and ABI-related complications. METHODS The systematic review followed PRISMA guidelines and was registered in the PROSPERO database (CRD42022362155). Relevant studies were identified by searching PubMed, EMBASE, CENTRAL, CMB, and CNKI from inception to August 2023. Data on environmental sound discrimination, open-set discrimination, closed-set discrimination, and ABI-related complications were extracted and subjected to meta-analysis. Publication bias was evaluated using funnel plots and Egger's test. RESULTS Thirty-three studies were included. The pooled estimate was 58% (95% CI 49-66%) for environmental sound discrimination and 55% (95% CI 40-69%) for closed-set discrimination. Regarding open-set discrimination, the pooled estimates were 30% (95% CI 19-42%) for sound only, 46% (95% CI 37-54%) for lip-reading only, and 63% (95% CI 55-70%) for sound plus lip-reading. The pooled occurrence of ABI-related complications was 33% (95% CI 15-52%). CONCLUSION This meta-analysis underscores the effectiveness and safety of ABIs in NF2, providing valuable insights for evidence-based decision-making and hearing rehabilitation strategies.
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Affiliation(s)
- Bo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Minjun Yan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Congyu Liu
- School of Life Science, Tsinghua University, Beijing, China
| | - Zhijun Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingchao Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fu Zhao
- Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhenmin Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shiwei Li
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Gemingtian Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Pinan Liu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
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Hallin K, Rask-Andersen H. Auditory brainstem implant pitch discrimination and auditory outcome. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2022. [DOI: 10.1080/23772484.2022.2115915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Karin Hallin
- Department of Surgical Sciences, Otorhinolaryngology, Uppsala University, Uppsala, Sweden
| | - Helge Rask-Andersen
- Department of Surgical Sciences, Otorhinolaryngology, Uppsala University, Uppsala, Sweden
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Bozsoy Mİ, Batuk MÖ, Çınar BÇ, Yaralı M, Sennaroğlu G, Sennaroğlu L. Evaluation of the non-auditory responses in individuals with auditory brainstem implant. Am J Otolaryngol 2022; 44:103679. [DOI: 10.1016/j.amjoto.2022.103679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/14/2022] [Accepted: 10/16/2022] [Indexed: 11/01/2022]
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Krishnan SS, Nigam P, Mohanty P, Vasudevan MC, Kameswaran M. Surgical anatomy of lateral recess in paediatric auditory brainstem implant patients and its clinical correlates including grades of flocculus. Childs Nerv Syst 2018; 34:1745-1752. [PMID: 29948132 DOI: 10.1007/s00381-018-3829-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/13/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Auditory brainstem implant (ABI), a standard technique in treatment of profound sensorineural hearing loss in patients with neurofibromatosis 2, is now being increasingly employed in children with congenital bilateral sensorineural hearing loss, as in Michele's deformity. A detailed knowledge of the relevant surgical anatomy of the lateral recess and its anatomical landmarks including the flocculus, the choroid plexus and the root entry zones of facial-vestibulocochlear and glossopharyngeal-vagus nerve complexes and their anatomical variants is mandatory, as it is the conduit for electrode array placement. The placement of electrode may be eased or impeded by these variations. MATERIALS AND METHODS Thirty-two children with congenital bilateral hearing loss underwent surgery through retromastoid suboccipital approach for placement of auditory brainstem implant. The preoperative anatomy was reviewed in detail during procedure and again later in the operative videos. RESULTS The flocculus was classified into four grades based on its anatomy and relations. Among these, grade II (11 children) was the commonest while grade IV (five children) was least common. Choroid plexus was variable in size across grades of flocculus. Difficulty in defining the anatomy was significantly more (p value = 0.003) in the group with higher grade flocculus (grade III and IV) than in lower grade flocculus (grade I and II). CONCLUSION The flocculus in these patients is classifiable into one of the four grades and the surgical nuances such as difficulty in defining the anatomy for placement of ABI are dependent on the characteristics exhibited by the floccular anatomy and relations.
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Affiliation(s)
- Shyam Sundar Krishnan
- Dr. Achantha Lakshmipathi Neurosurgical Centre, Post Graduate Institute of Neurological Surgery, Voluntary Health Services Multi-Speciality Hospital & Research Centre, TTTI Post, Taramani, Adyar, Chennai, Tamil Nadu, 600113, India.
| | - Pulak Nigam
- Dr. Achantha Lakshmipathi Neurosurgical Centre, Post Graduate Institute of Neurological Surgery, Voluntary Health Services Multi-Speciality Hospital & Research Centre, TTTI Post, Taramani, Adyar, Chennai, Tamil Nadu, 600113, India
| | - Poonam Mohanty
- Dr. Achantha Lakshmipathi Neurosurgical Centre, Post Graduate Institute of Neurological Surgery, Voluntary Health Services Multi-Speciality Hospital & Research Centre, TTTI Post, Taramani, Adyar, Chennai, Tamil Nadu, 600113, India
| | - Madabhushi Chakravarthy Vasudevan
- Dr. Achantha Lakshmipathi Neurosurgical Centre, Post Graduate Institute of Neurological Surgery, Voluntary Health Services Multi-Speciality Hospital & Research Centre, TTTI Post, Taramani, Adyar, Chennai, Tamil Nadu, 600113, India
| | - Mohan Kameswaran
- Madras ENT Research Foundation, No. 1, 2nd Cross Street, RA Puram, Chennai, Tamil Nadu, 600028, India
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Malerbi AFDS, Goffi-Gomez MVS, Tsuji RK, Gomes MDQT, Brito Neto RD, Bento RF. Auditory brainstem implant in postmeningitis totally ossified cochleae. Acta Otolaryngol 2018; 138:722-726. [PMID: 29607748 DOI: 10.1080/00016489.2018.1449964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION An auditory brainstem implant (ABI) is an option for auditory rehabilitation in patients with totally ossified cochleae who cannot receive a conventional cochlear implant. OBJECTIVE To evaluate the outcomes in audiometry and speech perception tests after the implantation of an ABI via the extended retrolabyrinthine approach in patients with postmeningitis hearing loss. MATERIALS AND METHODS Ten patients, including children and adults, with postmeningitis hearing loss and bilateral totally ossified cochleae received an ABI in a tertiary center from 2009 to 2015. The extended retrolabyrinthine approach was performed in all the patients by the same surgeons. A statistical analysis compared pure tonal averages and speech perception tests before and at least 12 months after the ABI activation. RESULTS Eight patients (80%) showed improvements in tonal audiometry and the word and vowel perception tests after an average follow-up of 3.3 years. Two patients recognized up to 40% of the closed-set sentences without lip-reading. Two patients had no auditory response. CONCLUSIONS The ABI improved hearing performance in audiometry and speech perception tests in cases of postmeningitis hearing loss. The extended retrolabyrinthine approach is a safe surgical option for patients with postmeningitis hearing loss and bilateral totally ossified cochleae.
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Affiliation(s)
| | | | - Robinson Koji Tsuji
- Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marcos de Queiroz Teles Gomes
- Department of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rubens de Brito Neto
- Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Ferreira Bento
- Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Jung NY, Kim M, Chang WS, Jung HH, Choi JY, Chang JW. Favorable Long-Term Functional Outcomes and Safety of Auditory Brainstem Implants in Nontumor Patients. Oper Neurosurg (Hagerstown) 2017; 13:653-660. [PMID: 29186598 DOI: 10.1093/ons/opx046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 02/16/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Auditory brainstem implants (ABIs) were designed to restore hearing in deaf patients with auditory tumors or those unable to receive cochlear implants. Although ABIs may help some patients, their long-term outcomes have been rarely studied. OBJECTIVE To assess the long-term benefits and safety of ABIs in nontumor patients with sensorineural hearing loss (SNHL). METHODS We retrospectively reviewed the histories of 15 deaf patients (8 females, 7 males; mean age, 15.5 yr; range, 1-56 yr) who received ABIs for treatment of SNHL at our hospital from July 2008 to November 2015. These included 11 children with narrow internal auditory canals and 4 deaf adults with severe cochlear ossification. In each patient, a 12-channel ABI electrode was placed in the cochlear nucleus complex via a retrosigmoid approach. Auditory performance was evaluated using the Categories of Auditory Performance (CAP) index and sound detection and word identification tests. RESULTS One year after ABI placement, 13 of 15 patients showed adequate or significantly improved auditory function based on the CAP scores at the last follow-up. Generally, adult patients tended to show better CAP scores (3.50) than pediatric patients (2.15), but the difference was not significant (P = .058). Postoperative complications included electrode migration, cerebrospinal fluid leakage, nonauditory stimulation, and minor seizures without severe sequelae or mortality. CONCLUSION ABIs show favorable functional outcomes and long-term safety in nontumor deaf patients with limited treatment options. Collectively, our data indicate that ABIs represent an important treatment option for SNHL.
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Affiliation(s)
- Na Young Jung
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minsoo Kim
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Won Seok Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun Ho Jung
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Woo Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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Karin H, Behr R, Rask-Andersen H. Re-implantation of an auditory brainstem implant (ABI) in a child: A case report. ACTA OTO-LARYNGOLOGICA CASE REPORTS 2017. [DOI: 10.1080/23772484.2017.1350108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Hallin Karin
- Department of Surgical Sciences, Section of Otorhinolaryngology, Uppsala University, Uppsala, Sweden
| | - Robert Behr
- Klinikum Fulda gAG, Academic Hospital, University of Marburg, Fulda, Germany
| | - Helge Rask-Andersen
- Department of Surgical Sciences, Section of Otorhinolaryngology, Uppsala University, Uppsala, Sweden
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Schwartz MS, Wilkinson EP. Auditory brainstem implant program development. Laryngoscope 2016; 127:1909-1915. [PMID: 27716925 DOI: 10.1002/lary.26312] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Auditory brainstem implants (ABIs), which have previously been used to restore auditory perception to deaf patients with neurofibromatosis type 2 (NF2), are now being utilized in other situations, including treatment of congenitally deaf children with cochlear malformations or cochlear nerve deficiencies. Concurrent with this expansion of indications, the number of centers placing and expressing interest in placing ABIs has proliferated. Because ABI placement involves posterior fossa craniotomy in order to access the site of implantation on the cochlear nucleus complex of the brainstem and is not without significant risk, we aim to highlight issues important in developing and maintaining successful ABI programs that would be in the best interests of patients. DATA SOURCES Especially with pediatric patients, the ultimate benefits of implantation will be known only after years of growth and development. These benefits have yet to be fully elucidated and continue to be an area of controversy. The limited number of publications in this area were reviewed. REVIEW METHODS Review of the current literature was performed. RESULTS Disease processes, risk/benefit analyses, degrees of evidence, and U.S. Food and Drug Administration approvals differ among various categories of patients in whom auditory brainstem implantation could be considered for use. CONCLUSION We suggest sets of criteria necessary for the development of successful and sustaining ABI programs, including programs for NF2 patients, postlingually deafened adult nonneurofibromatosis type 2 patients, and congenitally deaf pediatric patients. Laryngoscope, 127:1909-1915, 2017.
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Affiliation(s)
- Marc S Schwartz
- House Clinic, Neurosurgery and Huntington Medical Research Institutes, Los Angeles, California, U.S.A
| | - Eric P Wilkinson
- House Clinic and Huntington Medical Research Institutes, Los Angeles, California, U.S.A
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Komune N, Yagmurlu K, Matsuo S, Miki K, Abe H, Rhoton AL. Auditory brainstem implantation: anatomy and approaches. Neurosurgery 2015; 11 Suppl 2:306-20; discussion 320-1. [PMID: 25793729 DOI: 10.1227/neu.0000000000000736] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Auditory brainstem implantation at the cochlear nuclei used mainly for neurofibromatosis type 2 patients with bilateral loss of the cochlear nerves has more recently been extended to the inferior colliculus. OBJECTIVE To examine the microsurgical and endoscopic anatomy of the cochlear nuclei and inferior colliculus as seen through the translabyrinthine and retrosigmoid approaches used for cochlear nuclei and inferior collicular implantation. METHODS Ten cerebellopontine angles of formalin-fixed adult cadaveric heads were examined with the aid of the surgical microscope and endoscope. The ascending auditory pathways between the cochlear nuclei and inferior colliculi and above were examined by the fiber dissection technique. RESULTS Both the translabyrinthine and retrosigmoid routes provide sufficient exposure for concurrent tumor removal and implantation at either the cochlear nuclei or inferior colliculus. The position of the inferior colliculus in the auditory pathways and its accessibility in the infratentorial supracerebellar exposure directed through either the translabyrinthine or retrosigmoid approach makes it an alternative site for electrode placement if the cochlear nuclei are not functionally or structurally suitable for implantation. Endoscopic assistance may aid the exposure and electrode placement at either site. CONCLUSION The translabyrinthine or retrosigmoid approaches provide access to the cochlear nuclei for implantation and also to the inferior colliculus through the translabyrinthine or retrosigmoid infratentorial supracerebellar route. The endoscope may aid in exposing either site.
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Affiliation(s)
- Noritaka Komune
- *Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; ‡Department of Neurosurgery, Fukuoka University, Fukuoka, Japan
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Lundin K, Stillesjö F, Nyberg G, Rask-Andersen H. Self-reported benefit, sound perception, and quality-of-life in patients with auditory brainstem implants (ABIs). Acta Otolaryngol 2015; 136:62-7. [PMID: 26426855 DOI: 10.3109/00016489.2015.1079925] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The majority of the patients used their auditory brainstem implants (ABIs) all the time, reporting that he/she would make the decision to receive an implant again if the decision were reconsidered. The findings support that the ABI is a valuable treatment in patients with type 2 neurofibromatosis (NF2) and in children with congenital inner ear and nerve anomalies or cochlear ossification. OBJECTIVE To evaluate the patients who underwent ABI implantation in Uppsala during 1993-2013. This study analyzed patients' implant use, perception of environmental sounds, perceived benefit from the implant, and quality-of-life (QoL). METHOD The NF2-patients (n = 20) comprised the majority of the patients, and there were a few non-NF2 pediatric patients (n = 4). The exclusion criteria included deceased patients (n = 4) and patients with no hearing sensations from the implant, or those with an inactivated ABI (n = 2). The data were collected from a questionnaire survey. RESULTS Eleven adult patients and two pediatric patients answered the questionnaires. Eight of the adult patients used their implants 'always'. The two children always used their implants. Hearing problems had the largest negative effect on the QoL. The non-users and the users scored equally on the NFTI-QoL.
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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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Noij KS, Kozin ED, Sethi R, Shah PV, Kaplan AB, Herrmann B, Remenschneider A, Lee DJ. Systematic Review of Nontumor Pediatric Auditory Brainstem Implant Outcomes. Otolaryngol Head Neck Surg 2015; 153:739-50. [PMID: 26227469 DOI: 10.1177/0194599815596929] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/01/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The auditory brainstem implant (ABI) was initially developed for patients with deafness as a result of neurofibromatosis type 2. ABI indications have recently extended to children with congenital deafness who are not cochlear implant candidates. Few multi-institutional outcome data exist. Herein, we aim to provide a systematic review of outcomes following implantation of the ABI in pediatric patients with nontumor diagnosis, with a focus on audiometric outcomes. DATA SOURCES PubMed, Embase, and Cochrane. REVIEW METHODS A systematic review of literature was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Variables assessed included age at implantation, diagnosis, medical history, cochlear implant history, radiographic findings, ABI device implanted, surgical approach, complications, side effects, and auditory outcomes. RESULTS The initial search identified 304 articles; 21 met inclusion criteria for a total of 162 children. The majority of these patients had cochlear nerve aplasia (63.6%, 103 of 162). Cerebrospinal fluid leak occurred in up to 8.5% of cases. Audiometric outcomes improved over time. After 5 years, almost 50% of patients reached Categories of Auditory Performance scores >4; however, patients with nonauditory disabilities did not demonstrate a similar increase in scores. CONCLUSION ABI surgery is a reasonable option for the habilitation of deaf children who are not cochlear implant candidates. Although improvement in Categories of Auditory Performance scores was seen across studies, pediatric ABI users with nonauditory disabilities have inferior audiometric outcomes.
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Affiliation(s)
- Kimberley S Noij
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Elliott D Kozin
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Rosh Sethi
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Parth V Shah
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Alyson B Kaplan
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Barbara Herrmann
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Audiology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Aaron Remenschneider
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Daniel J Lee
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Lassaletta L, Aristegui M, Medina M, Aranguez G, Pérez-Mora RM, Falcioni M, Gavilán J, Piazza P, Sanna M. Ipsilateral cochlear implantation in patients with sporadic vestibular schwannoma in the only or best hearing ear and in patients with NF2. Eur Arch Otorhinolaryngol 2014; 273:27-35. [PMID: 25537817 DOI: 10.1007/s00405-014-3450-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/13/2014] [Indexed: 10/24/2022]
Abstract
The aim of this study was to evaluate the cochlear implant (CI) performances in neurofibromatosis type 2 (NF2) patients with bilateral vestibular schwannoma (VS) and in patients with sporadic VS in the only or better hearing ear. All patients with bilateral VS or sporadic VS in the only or better hearing ear who underwent cochlear implantation, either simultaneous to VS surgery or staged after treatment for VS, in the tumor side were chosen for the study. Postimplantation audiometric scores (sound detection, closed-set and open-set discrimination scores) and device use patterns were the main outcome measures. 15 patients were implanted. Eight patients (53 %) were NF2 and seven patients had VS in the only or better hearing ear. One patient was explanted for cerebrospinal fluid leak. In the CI-only condition, the other 14 patients obtained sound detection, 64 % of them achieving open-set discrimination (mean 70 ± 38 %) and 85 % achieving closed-set discrimination (mean 41 ± 33 %). At the last follow-up 10 patients (67 %) were using the CI. Cochlear implantation provides hearing in particular cases of patients with bilateral VS or VS in the only or better hearing ear. As long as anatomic preservation of the cochlear nerve is achieved, cochlear implantation may offer improvement in communication skills for most patients.
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Affiliation(s)
- Luis Lassaletta
- Department of Otolaryngology, IdiPaz Research Institute, "La Paz" University Hospital, Paseo de La Castellana 261, 28046, Madrid, Spain.
| | - Miguel Aristegui
- Department of Otolaryngology, "Gregorio Marañon" University Hospital, C/Doctor Esquerdo 46, 28007, Madrid, Spain
| | - Marimar Medina
- Department of Otolaryngology, "Rey Juan Carlos" Hospital, C/ Gladiolo, s/n, 28933, Móstoles, Madrid, Spain
| | - Gracia Aranguez
- Department of Otolaryngology, "Gregorio Marañon" University Hospital, C/Doctor Esquerdo 46, 28007, Madrid, Spain
| | - Rosa M Pérez-Mora
- Department of Otolaryngology, IdiPaz Research Institute, "La Paz" University Hospital, Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Maurizio Falcioni
- Department of Otology and Skull Base Surgery, Gruppo Otologico Piacenza-Rome, University of Chieti, Chieti. Via Emmanueli 42, 29121, Piacenza, Italy
| | - Javier Gavilán
- Department of Otolaryngology, IdiPaz Research Institute, "La Paz" University Hospital, Paseo de La Castellana 261, 28046, Madrid, Spain
| | - Paolo Piazza
- Department of Neuroradiology, University of Parma, Parma, Italy
| | - Mario Sanna
- Department of Otology and Skull Base Surgery, Gruppo Otologico Piacenza-Rome, University of Chieti, Chieti. Via Emmanueli 42, 29121, Piacenza, Italy
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