Summary
The development of cochlear implantation has allowed the majority of patients deafened after the development of language to regain significant auditory benefit. In a subset of patients, however, loss of hearing results from destruction of the cochlear nerves, rendering cochlear implantation ineffective. The most common cause of bilateral destruction of the cochlear nerves is neurofibromatosis type 2 (NF2). The hallmark of this genetic disorder is the development of bilateral acoustic neuromas, the growth or removal of which causes deafness in most patients. Patients with NF2 may benefit from direct stimulation of the cochlear nucleus. We describe the development, use, and results of the auditory brainstem implant (ABI), which is typically implanted via craniotomy at the time of tumor removal. Most patients with the implant have good appreciation of environmental sounds, but obtain more modest benefit with regard to speech perception. The majority of patients make use of the implant to facilitate lip reading; some can, to varying degrees, comprehend speech directly. We discuss future directions in central implants for hearing, including the penetrating ABI, the use of ABI in nontumor patients, and the auditory midbrain implant.
Key Words: Auditory brainstem implant, deafness, neurofibromatosis type 2, acoustic neuroma, vestibular schwannoma
References
- 1.Edgerton BJ, House WF, Hitselberger W. Hearing by cochlear nucleus stimulation in humans. Ann Otol Rhinol Otolaryngol Suppl. 1982;91:117–124. [PubMed] [Google Scholar]
- 2.Otto SR, Shannon RV, Brackmann DE, Hitselberger WE, Staller S, Menapace C. The multichannel auditory brain stem implant: performance in twenty patients. Otolaryngol Head Neck Surg. 1998;118:291–303. doi: 10.1016/S0194-5998(98)70304-3. [DOI] [PubMed] [Google Scholar]
- 3.Otto SR, Brackmann DE, Hitselberger WE, Shannon RV, Kuchta J. Multichannel auditory brainstem implant: update on performance in 61 patients. J Neurosurg. 2002;96:1063–1071. doi: 10.3171/jns.2002.96.6.1063. [DOI] [PubMed] [Google Scholar]
- 4.Otto S, Staller S. Multichannel auditory brain stem implant: case studies comparing fitting strategies and results. Ann Otol Rhinol Laryngol Suppl. 1995;166:36–39. [PubMed] [Google Scholar]
- 5.Eisenberg LS, Maltan AA, Portillo F, Mobley JP, House WF. Electrical stimulation of the auditory brain stem structure in deafened adults. J Rehabil Res Dev. 1987;24:9–22. doi: 10.1682/JRRD.1987.07.0009. [DOI] [PubMed] [Google Scholar]
- 6.Brackmann DE, Hitselberger WE, Nelson RA, et al. Auditory brainstem implant: I. Issues in surgical implantation. Otolaryngol Head Neck Surg. 1993;108:624–633. doi: 10.1177/019459989310800602. [DOI] [PubMed] [Google Scholar]
- 7.Heller JW, Brackmann DE, Tucci DL, Nyenhuis JA, Chou CK. Evaluation of MRI compatibility of the modified nucleus multichannel auditory brainstem and cochlear implants. Am J Otol. 1996;17:724–729. [PubMed] [Google Scholar]
- 8.Slattery WH, Brackmann DE, Hitselberger W. Hearing preservation in neurofibromatosis type 2. Am J Otol. 1998;19:638–642. [PubMed] [Google Scholar]
- 9.Monsell EM, McElveen JT, Hitselberger WE, House WF. Surgical approaches to the human cochlear nuclear complex. Am J Otol. 1987;8:450–455. [PubMed] [Google Scholar]
- 10.Colletti V, Fiorino FG, Carner M, Giarbini N, Sacchetto L, Cumer G. The retrosigmoid approach for auditory brainstem implantation. Am J Otol. 2000;21:826–836. [PubMed] [Google Scholar]
- 11.Waring MD. Intraoperative electrophysiologic monitoring to assist placement of auditory brainstem implant. Ann Otol Rhinol Laryngol Suppl. 1995;166:33–36. [PubMed] [Google Scholar]
- 12.Shannon RV, Fayad J, Moore J, et al. Auditory brainstem implant: II. Postsurgical issues and performance. Otolaryngol Head Neck Surg. 1993;108:634–642. doi: 10.1177/019459989310800603. [DOI] [PubMed] [Google Scholar]
- 13.Shannon RV, Moore JK, McCreery DB, Portillo F. Threshold-distance measures from electrical stimulation of human brainstem. IEEE Trans Rehabil Eng. 1997;5:70–74. doi: 10.1109/86.559351. [DOI] [PubMed] [Google Scholar]
- 14.Finitzo-Hieber T, Gerling IJ, Matkin ND, Cherow-Skalka E. A sound effects recognition test for the pediatric audiological evaluation. Ear Hear. 1980;1:271–276. doi: 10.1097/00003446-198009000-00007. [DOI] [PubMed] [Google Scholar]
- 15.Erber NP, Alencewicz CM. Audiologic evaluation of deaf children. J Speech Hear Disord. 1976;41:256–267. doi: 10.1044/jshd.4102.256. [DOI] [PubMed] [Google Scholar]
- 16.Elliott LL, Katz DR. Development of a new children’s test of speech discrimination. St. Louis, MO: Auditec of St. Louis; 1980. [Google Scholar]
- 17.Giolas TG, Duff JR. Equivalency of CID and revised CID sentence lists. J Speech Hear Res. 1973;16:549–555. doi: 10.1044/jshr.1604.549. [DOI] [PubMed] [Google Scholar]
- 18.Tyler RS, Preece JP, Tye-Murray N. Iowa Audiovisual Speech Perception Laser Videodisc. Iowa City: University of Iowa; 1987. [Google Scholar]
- 19.Boothroyd A. CUNY Topic Related Sentence Test Laservideo Disk. New York: City University of New York; 1988. [Google Scholar]
- 20.Niparko JK, Altschuler RA, Xue XL, Wiler JA, Anderson DJ. Surgical implantation and biocompatibility of central nervous system auditory implants. Ann Otol Rhinol Laryngol. 1989;98:965–970. doi: 10.1177/000348948909801209. [DOI] [PubMed] [Google Scholar]
- 21.El-Kashlan HK, Niparko JK, Altschuler RA, Miller JM. Direct electrical stimulation of the cochlear nucleus: surface versus penetrating stimulation. Otolaryngol Head Neck Surg. 1991;105:533–543. doi: 10.1177/019459989110500405. [DOI] [PubMed] [Google Scholar]
- 22.McCreery DB, Shannon RV, Moore JK, Chatterjee M. Accessing the tonotopic organization of the ventral cochlear nucleus by intranuclear microstimulation. IEEE Trans Rehabil Eng. 1998;6:391–399. doi: 10.1109/86.736153. [DOI] [PubMed] [Google Scholar]
- 23.McCreery DG, Yuen TGH, Bullara LA. Chronic microstimulation in the feline ventral cochlear nucleus: physiologic and histologic effects. Hearing Res. 2000;149:223–238. doi: 10.1016/S0378-5955(00)00190-8. [DOI] [PubMed] [Google Scholar]
- 24.Colletti V, Shannon RV. Open set speech perception with auditory brainstem implant? Laryngoscope. 2005;115:1974–1978. doi: 10.1097/01.mlg.0000178327.42926.ec. [DOI] [PubMed] [Google Scholar]
- 25.Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F. Auditory brainstem implant (ABI); new frontiers in adults and children. Otolaryngol Head Neck Surg. 2005;133:126–138. doi: 10.1016/j.otohns.2005.03.022. [DOI] [PubMed] [Google Scholar]
- 26.Lenarz T, Lim HH, Reuter G, Patrick JF, Lenarz M. The auditory midbrain implant: a new auditory prosthesis for neural deafness—concept and device description. Otol Neurotol. 2006;27:838–843. doi: 10.1097/01.mao.0000232010.01116.e9. [DOI] [PubMed] [Google Scholar]