Implante auditivo de tronco cerebral: técnica cirúrgica e resultados auditivos precoces em pacientes com neurofibromatose tipo 2

Abstract

Audi tory Brainstem Implants were developed to partially restore the hearing capabilities of patients without cochlear nerves bilaterally. Aim: this paper aims to discuss the clinical and surgical findings of four ABI patients. Materials and method: four patients diagnosed with bilateral schwannomas received auditory brainstem implants (ABI) and had one of their tumors resected in the same surgical procedure. Clinical aspects, surgical technique, anatomic landmarks, and outcomes were analyzed. Results: the anatomic landmarks were identified in all four patients in relation to the foramina of Luschka. Two patients had CSF leaks. The electrodes were well positioned and hearing sensation was good enough to allow for sound recognition and assist patients perform lip reading. Conclusion: the outcomes observed in our patients were quite encouraging and offer great perspectives for those suffering from deep bilateral deafness and impaired central auditory pathways.Keywords: surgery, auditory brain stem implantation, neurofibromatosis type 2, results.original article Rev Bras Otorrinolaringol 2008;74(5):647-51.

Satisfação e qualidade de vida em usuários de implante auditivo de tronco cerebral

“…This is usually the case of individuals with Neurofibromatosis type 2 (NF-2), malformation or agenesis of cochlear nerves and/or cochlea, as well as in cases of cochlea ossification following meningitis (1)(2)(3)(4) . The ABI allows access to speech and environmental sounds.…”

“…Results of speech perception vary widely -some studies have only reported increased attention to sound (5,6) , while others (7,8) have shown that ABI users presented sentence recognition results in open context in silence of 10% to 100%. Some authors (3) reported that few ABI users can understand speech without the aid of lipreading, and that most of these users benefit from the detection of environmental and speech sounds, presenting lower hearing performance than that achieved by CI users. However, the authors emphasized that these results significantly improve communication and the quality of life of this population.…”

“…In the literature, some authors have observed that ABI users reported clinical improvement in quality of life after using the device (3,8) . Quality of life is a measure that reflects an individual's perception of their health condition and how they react and act with regard to various aspects, such as their emotional and psychological level, social relationships and the environment (9) .…”

Benefícios do implante auditivo de tronco cerebral em adultos e crianças

“…O Implante auditivo de tronco cerebral, mais comumente conhecido como ABI (Auditory Brainstem Implant) na literatura internacional, é um dispositivo eletrônico indicado quando as características anatômicas ou funcionais, não possibilitam o benefício do implante coclear (IC) ou de outras tecnologias auditivas, como as próteses auditivas totalmente implantáveis e os aparelhos auditivos de amplificação sonora individual (AASI). Isso, geralmente ocorre nos casos de indivíduos portadores de Neurofibromatose tipo 2 (NF2), malformação ou agenesia de nervos cocleares e/ou de cóclea e ainda nas situações de cócleas ossificadas após meningite (Colletti et al, 2004;Brito et al, 2005;Bento et al, 2008;Bento et al, 2012).…”

“…Outros autores (Bento et al, 2008) relataram que poucos usuários de ABI conseguem compreender a fala sem o apoio da leitura orofacial (LOF) e que a maioria destes usuários são capazes de detectar os sons ambientais e de fala, apresentando um desempenho auditivo inferior do que aquele alcançado pelos usuários de IC. Contudo, os autores ressaltaram que esses resultados melhoram de forma significativa a comunicação e a qualidade de vida desta população.…”