Systematic Review of Nontumor Pediatric Auditory Brainstem Implant Outcomes

Noij, Kimberley S.; Kozin, Elliott D.; Sethi, Rosh K.V.; Shah, Parth; Kaplan, Alyson B.; Herrmann, Barbara S.; Remenschneider, Aaron K.; Lee, Dong Hoon

doi:10.1177/0194599815596929

Cited by 48 publications

(36 citation statements)

References 43 publications

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“…CSF leak has been the most frequently reported significant complication in pediatric ABI surgery(8,19,20), occurring in up to 8.5% of cases. Nearly all centers in the world performing this procedure have experienced CSF leaks.…”

Section: Discussionmentioning

confidence: 99%

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Wilkinson

Eisenberg²,

Krieger³

et al. 2017

Otology &Amp; Neurotology

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Objective To determine the safety and feasibility of the auditory brainstem implant (ABI) in congenitally deaf children with cochlear aplasia and/or cochlear nerve deficiency. Study Design Phase I feasibility clinical trial of surgery in 10 children, ages 2 to 5 years, over a 3 year period. Setting Tertiary children’s hospital and university-based pediatric speech/language/hearing center. Intervention(s) ABI implantation and post-surgical programming. Main outcome measure(s) The primary outcome measure is the number and type of adverse events during ABI surgery and post-surgical follow-up, including behavioral mapping of the device. The secondary outcome measure is access to and early integration of sound. Results To date, nine children are enrolled. Five children have successfully undergone ABI surgery and postoperative behavioral programming. Three children were screen failures, and one child is currently undergoing candidacy evaluation. Expected adverse events have been documented in three of the five children who received the ABI. One child experienced a cerebral spinal fluid (CSF) leak, which resolved with lumbar drainage. One child demonstrated vestibular side effects during device programming, which resolved by deactivating one electrode. One child experienced postoperative vomiting resulting in an abdominal radiograph. Four children have completed their 1-year followup and have speech detection thresholds of 30 to 35 dB HL. Scores on the IT-MAIS/MAIS range from 8 to 31 (out of a total of 40), and the children are demonstrating some ability to discriminate between closed-sets words that differ by number of syllables (pattern perception). Conclusions ABI surgery and device activation appears to be safe and feasible in this preliminary cohort.

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Section: Discussionmentioning

confidence: 99%

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Wilkinson

Eisenberg²,

Krieger³

et al. 2017

Otology &Amp; Neurotology

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“…Some ABI patients achieve open-set speech perception (Behr et al 2014; V. Colletti 2006; Noij et al 2015; Yücel 2015), but the majority experience is limited to sound detection and speech pattern perception, both of which enhance lip-reading. In addition, there is subject-to-subject variability in 1) number and distribution of electrodes that elicit auditory sensations and 2) the number of electrodes that produce non-auditory side effects and are turned off during a subject’s ABI programming (Behr et al 2014; McSorley et al 2015; Noij et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Colletti 2006; Noij et al 2015; Yücel 2015), but the majority experience is limited to sound detection and speech pattern perception, both of which enhance lip-reading. In addition, there is subject-to-subject variability in 1) number and distribution of electrodes that elicit auditory sensations and 2) the number of electrodes that produce non-auditory side effects and are turned off during a subject’s ABI programming (Behr et al 2014; McSorley et al 2015; Noij et al 2015). Variable success with the ABI has been attributed to various causes, including damage to specific populations of cells in the cochlear nucleus (Colletti and Shannon 2005).…”

Section: Introductionmentioning

confidence: 99%

Auditory Brainstem Implant Array Position Varies Widely Among Adult and Pediatric Patients and Is Associated With Perception

et al. 2017

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Objectives The auditory brainstem implant (ABI) provides sound awareness to patients who are ineligible for cochlear implantation. Auditory performance varies widely among similar ABI cohorts. We hypothesize that differences in electrode array position contribute to this variance. Herein, we classify ABI array position based on postoperative imaging and investigate the relationship between position and perception. Design Retrospective review of pediatric and adult ABI users with postoperative computed tomography (CT). To standardize views across subjects, true-axial reformatted series of scans were created using the McRae line. Using multiplanar reconstructions, basion and electrode array tip coordinates and array angles from vertical were measured. From a lateral view, array angles (V) were classified into Types I-IV, and from posterior view, array angles (T) were classified into Types A-D. Array position was further categorized by measuring distance vertical from basion (D1) and lateral from midline (D2). Differences between array classifications were compared with audiometric thresholds, number of active electrodes, and pitch ranking. Results Pediatric (n=4, 2 with revisions) and adult (n=7) ABI subjects were included in this study. Subjects had a wide variety of ABI array angles, but most were aimed superiorly and posteriorly (Type II, n=7) from lateral view and upright or medially tilted from posterior view (Type A, n=6). Mean pediatric distances were 8 – 42% smaller than adults for D1 and D2. In subjects with perceptual data, electrical thresholds and the number of active electrodes differed among classification types. Conclusions In this first study to classify ABI electrode array orientation, array position varied widely. This variability may explain differences in auditory performance.

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“…A recent systematic review analyzed a total of 43 pediatric patients implanted with an ABI in 4 different studies. 5 At follow-up 5 years after ABI surgery, 47.9% of pediatric ABI users without NF2 achieved a degree of speech perception. (Table 1).…”

mentioning

confidence: 99%

“…One of the most common complications associated with ABI surgery is cerebrospinal fluid leakage. 5 Other potential complications of auditory brainstem implantation include meningitis, cerebellar contusion and hemorrhage, facial nerve dysfunction and device failure. …”

mentioning

confidence: 99%

Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

Shah

Kozin

Kaplan

et al. 2016

The Journal of the American Board of Family Medicine

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Introduction:The auditory brainstem implant (ABI) is a neuroprosthetic device that provides sound sensations to individuals with profound hearing loss who are not candidates for a cochlear implant (CI) because of anatomic constraints. Herein we describe the ABI for family physicians.Methods: PubMed was searched to identify articles relevant to the ABI, as well as articles that contain outcomes data for pediatric patients (age <18 years) who have undergone ABI surgery.Results: The ABI was originally developed for patients with neurofibromatosis type 2 (NF2) who become deaf from bilateral vestibular schwannomas. Over the past decade, indications for an ABI have expanded to adult patients without tumors (without NF2) who cannot receive a CI and children with no cochlea or cochlear nerve. Outcomes among NF2 ABI users are modest compared to cochlear implant patients, but recent studies from Europe suggest that some non-tumor adult and pediatric ABI users achieve speech perception.Conclusion: The ABI is a reasonable surgical option for children with profound hearing loss due to severe cochlear or cochlear nerve deformities. Continued prospective data collection from several clinical trials in the U.S. will provide greater understanding on long term outcomes that focus on speech intelligibility. ( J Am Board Fam Med 2016;29:286 -288.)

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Systematic Review of Nontumor Pediatric Auditory Brainstem Implant Outcomes

Abstract: 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.

Cited by 48 publications

References 43 publications

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Initial Results of a Safety and Feasibility Study of Auditory Brainstem Implantation in Congenitally Deaf Children

Auditory Brainstem Implant Array Position Varies Widely Among Adult and Pediatric Patients and Is Associated With Perception

Pediatric Auditory Brainstem Implant Surgery: A New Option for Auditory Habilitation in Congenital Deafness?

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