Implante auditivo de tronco encefálico em pacientes com perda auditiva neurossensorial profunda por meningite e ossificação coclear total bilateral 

Abstract

Introduction: The Auditory Brainstem Implant (ABI) is an option to auditory restoration in patients with severe to profound sensorineural hearing loss who cannot be fitted with a cochlear implant. This is the only option in patients with post meningitis hearing loss presenting with bilateral total cochlear ossification. Objectives: The main objective of the study is to evaluate the hearing contribution in audiometry and speech perception tests at least 12 months after ABI implantation in patients with post-meningitis profound hearing loss. The complications of the procedure were also described. Materials and Methods: Ten patients with post-meningitis hearing loss went an ABI through extended retrolabyrinthine approach in a tertiary center by the same surgeons. The same audiologist was responsible for audiological follow-up. Tonal audiometry and speech perception tests were made before and at least 12 months after the ABI activation. The procedure complications were described for all patients. Results: Eight of ten patients became ABI users. Two patients had no auditory response and abandoned the treatment. Eight users showed benefit in tonal audiometry, word and vowels perception tests after an average follow up of 3.3 years. Two patients were able to recognize 30 and 40% of closed sentences without lip reading. There were no complications due to the ABI procedure. Conclusion:The extended retrolabyrinthine approach for the ABI is a safe surgical option for patients with post-meningitis hearing loss and totally ossified cochleae. It contributes to hearing performance in audiometry and speech perception tests. Even though the ABI results are poorer than the cochlear implants, in this study the majority of patients use their ABI more than eight hours a day and report benefits in daily activities.

Percepção auditiva e desenvolvimento de linguagem oral após cirurgia de implante auditivo de tronco encefálico: uma revisão de escopo

“…Há, ainda, casos em que não há a indicação do IC e podese avaliar a necessidade de indicação do implante auditivo de tronco encefálico (auditory brainstem implant -ABI). O ABI foi desenvolvido para restaurar a audição (2) em indivíduos diagnosticados com neurofibromatose tipo 2 (NF-2), por manifestarem schwannomas vestibulares bilaterais, indivíduos com ossificação coclear, mas com integridade do VIII par craniano (nervo vestibulococlear), com ausência ou má formação do nervo auditivo (3)(4)(5) e com lesões por traumas ou com desordem do espectro da neuropatia auditiva (DENA) (4) .…”

“…O primeiro modelo do ABI foi desenvolvido com apenas um eletrodo monocanal, na Califórnia, e foi utilizado de 1979 a 1992 com resultados inconsistentes (1,6) . Apesar de a primeira cirurgia ter sido realizada em 1979, foi em 2000 que houve a aprovação para uso clínico pela Food and Drug Administration (FDA), nos Estados Unidos, e só em 2005 o dispositivo chegou ao Brasil (4,6) .…”

Auditory perception and oral language in brainstem auditory implant users: a scoping review

“…Furthermore, there are cases in which CI is not indicated, and the need for an auditory brainstem implant (ABI) can be evaluated. Auditory brainstem implants were developed to restore hearing (2) : in individuals diagnosed with neurofibromatosis type 2 (NF-2) for manifesting bilateral vestibular schwannomas; and individuals with cochlear ossification, but with the integrity of the VIII cranial pair (vestibulocochlear nerve), absence or malformation of the auditory nerve (3)(4)(5) , and trauma injuries or auditory neuropathy spectrum disorder (ANSD) (4) .…”

“…Even though the first surgery was performed in 1979, the approval for clinical use by the Food and Drug Administration (FDA) in the United States occurred in 2000. The devices arrived in Brazil only in 2005 (4,6) .…”