Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Abstract

Objective To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear. Design Retrospective case review. Setting Tertiary referral hospital. Participants Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects. Main outcome measures Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI. Results Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P = .002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions. Conclusion Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.

Audiological Performance in Children with Inner Ear Malformations Before and After Cochlear Implantation: A Cohort Study of 274 Patients

“…Cochlear nerve deficiency is common in children with CH, so, if auditory perception and language development with CI are limited, contralateral side ABI should be considered without delay. 4,19 In our study, all IP-I, 20 Tucci et al 21 Auditory perception and speech production vary across IEMs.…”

Evaluating Common Cavity Cochlear Deformities Using CT Images and 3D Reconstruction

“…Batuk et al report a case series of 12 children who received auditory brainstem implant after poor hearing outcomes with CI alone. They found a common CVN in cases of CC and report one case of CA with a hypoplastic CN 24 . Monsanto et al found a hypoplastic CN in 66% of their cases with CA 23 .…”

“…As a sidenote, the assumed CC was further analyzed concerning its size. In cases that present inconclusive anatomy or hypoplastic CN, the decision between ABI and CI is reported to be challenging, and as a first‐approach CI is still recommended 24 . In patients with CC, the neural elements have been described as present along the medial wall of the CC.…”

Neurosensory Prosthetics: An Integral Neuromodulation Part of Bioelectronic Device

“…However, ABI users could identify few words using the auditory sensations provided by the device alone (not more that 20% of words in simple sentences; Colletti et al, 2012). Batuk et al (2020) investigated the bimodal stimulation of children who have inner ear malformation and found that the coherent use of CIs and ABIs increased performance and speech perception. In another study on the efficacy of ABIs, for improvement of speech perception and audiometry tests in patients with post meningitis hearing loss, there was an increase in hearing performance post implantation of the device (Malerbi et al, 2018).…”