Auditory Brainstem Implantation in a 16-Month-Old Boy With Cochlear Hypoplasia

Puram, Sidharth V.; Tward, Aaron D.; Jung, David; Dilger, Amanda E.; Herrmann, Barbara S.; Duhaime, Ann‐Christine; Barker, Fred G.; Lee, Dong Hoon

doi:10.1097/mao.0000000000000676

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…Our outcomes are reasonable as compared with minor complications reported previously, with CSF leaks occurring in up to 8.5% of non-NF2 patients. 11,12,15-17…”

Section: Discussionmentioning

confidence: 99%

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Outcomes following Pediatric Auditory Brainstem Implant Surgery

Puram

Barber

Kozin

et al. 2016

Otolaryngol.--head neck surg.

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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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“…Our outcomes are reasonable as compared with minor complications reported previously, with CSF leaks occurring in up to 8.5% of non-NF2 patients. 11,12,15-17…”

Section: Discussionmentioning

confidence: 99%

“…Inclusion and exclusion criteria and detailed surgical approach have been described. 11-13 Postoperative evaluation included behavioral and audiometric testing with developmentally appropriate measures.…”

Section: Methodsmentioning

confidence: 99%

Outcomes following Pediatric Auditory Brainstem Implant Surgery

Puram

Barber

Kozin

et al. 2016

Otolaryngol.--head neck surg.

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“…30 Finally, a child implanted in the US demonstrated device bonding and good speech detection at 4 months postactivation. [73][74][75] These sparse efficacy data indicate that development of auditory skills is slow, but likely supportive of voice monitoring and lip-reading for those children who attempt communication via spoken language. However, even this level of benefit is likely reduced in children with additional disabilities.…”

Section: Results: Demonstration Of Auditory Prosthesis Benefitmentioning

confidence: 99%

Assessing the Benefit-Risk Profile for Pediatric Implantable Auditory Prostheses

Fisher

Martinez

Richmond

et al. 2018

Ther Innov Regul Sci

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Pediatric patients who have abnormal anatomy and are candidates for an implantable auditory prosthetic require an individualized, multisystems review. The qualitative benefit-risk assessment used here to characterize the condition, the medical need, potential benefits, risks, and risk management strategies has revealed the complex factors involved. After implantation, continued team support for the family during extensive postimplant therapy is needed to develop maximum auditory skill benefit.

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“…At our center, pediatric ABI recipients undergo initial device activation and EABR testing under sedation or general anesthesia followed by awake activation the next day. EABRs identify electrodes most likely to elicit auditory sensation versus those likely to elicit side effects from neighboring nonauditory axons of passage . A change or absence in postoperative EABRs (compared to intraoperative measurements at the time of device placement) may 1) indicate shifting of the ABI array position due to intracranial pulsations or brain growth and 2) predict modest or absent perceptual responses in the awake condition.…”

Section: Introductionmentioning

confidence: 99%

Effect of anesthesia on evoked auditory responses in pediatric auditory brainstem implant surgery

et al. 2019

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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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Auditory Brainstem Implantation in a 16-Month-Old Boy With Cochlear Hypoplasia

Abstract: Based on our experience in combination with the work of others internationally, auditory brainstem implantation is feasible and safe in children younger than 5 years.

Cited by 8 publications

References 11 publications

Outcomes following Pediatric Auditory Brainstem Implant Surgery

Outcomes following Pediatric Auditory Brainstem Implant Surgery

Assessing the Benefit-Risk Profile for Pediatric Implantable Auditory Prostheses

Effect of anesthesia on evoked auditory responses in pediatric auditory brainstem implant surgery

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