J Neurol Surg B 2019; 80(02): 203-208
DOI: 10.1055/s-0039-1679891
Invited Review
Georg Thieme Verlag KG Stuttgart · New York

Auditory Brainstem Implantation: An Overview

Nicholas L. Deep
1  Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, United States
,
Baishakhi Choudhury
2  Department of Otolaryngology, Loma Linda University, Loma Linda, California, United States
,
J. Thomas Roland Jr.
1  Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, United States
› Author Affiliations
Further Information

Publication History

19 December 2018

31 December 2018

Publication Date:
14 February 2019 (eFirst)

Abstract

An auditory brainstem implant (ABI) is a surgically implanted central neural auditory prosthesis for the treatment of profound sensorineural hearing loss in children and adults who are not cochlear implant candidates due to a lack of anatomically intact cochlear nerves or implantable cochleae. The device consists of a multielectrode surface array which is placed within the lateral recess of the fourth ventricle along the brainstem and directly stimulates the cochlear nucleus, thereby bypassing the peripheral auditory system. In the United States, candidacy criteria for ABI include deaf patients with neurofibromatosis type 2 (NF2) who are 12 years or older undergoing first- or second-side vestibular schwannoma resection. In recent years, several non-NF2 indications for ABI have been explored, including bilateral cochlear nerve avulsion from trauma, complete ossification of the cochlea due to meningitis, or a severe cochlear malformation not amenable to cochlear implantation. In addition, growing experience with ABI in infants and children has been documented with encouraging outcomes. While cochlear implantation generally remains the first-line option for hearing rehabilitation in NF2 patients with stable tumors or post hearing preservation surgery where hearing is lost but a cochlear nerve remains accessible for stimulation, an ABI is the next alternative in cases where the cochlear nerve is absent and/or if the cochlea cannot be implanted. Herein, we review ABI device design, clinical evaluation, indications, operative technique, and outcomes as it relates to lateral skull base pathology.

Financial Material and Support

Internal departmental funding was utilized without commercial sponsorship or support.