5/1/2023 0 Comments Auditory brainstem implantFurthermore, electrical stimulation of the cochlear nucleus may produce nonauditory side effects, minor and major, due to its close proximity to other anatomical structures within the brainstem. Thus, ABI surgery is substantially more invasive and complex than CI surgery ( Aaron, Kari, Friedman, & Niparko, 2016 Wilkinson et al., 2017). Instead of insertion through the scala tympani of the cochlea similar to a CI electrode array, an ABI electrode paddle is placed directly on the cochlear nucleus of the brainstem. The external components of the ABI are essentially the same as those for the CI, but the internal components differ both in design and in surgical placement. The ABI is advocated for deaf individuals who are unable to benefit from a CI due to such conditions as neurofibromatosis type 2 (NF2), cochlear nerve deficiency or aplasia, temporal bone fracture, and severely malformed or ossified cochleae ( Birman et al., 2016 Buchman et al., 2011 Colletti, Shannon, & Colletti, 2014 Noij et al., 2015 Shannon, 2015). Specific to those children identified with abnormal anatomical structures, the auditory brainstem implant (ABI) has become a relatively recent prosthetic option. The most likely impediments to success with the CI are associated with developmental delays and/or additional disabilities ( Barnard et al., 2015 Cruz et al., 2012 Johnson, Wiley, & Meinzen-Derr, 2016), as well as anatomical malformation of the inner ear and neural structures ( Birman, Powell, Gibson, & Elliott, 2016 Buchman et al., 2011 Young, Kim, Ryan, Tournis, & Yaras, 2012). Not all children achieve such high levels of success for a variety of reasons, including later age at implantation, limited pre-CI residual hearing, and low socioeconomic status ( Niparko et al., 2010). Despite these findings, large variability in outcomes is characteristic of this population. Today, multichannel cochlear implants (CI) provide access to speech, enabling many recipients to become proficient in spoken communication ( Geers, Mitchell, Warner-Czyz, Wang, & Eisenberg, 2017 Niparko et al., 2010). Implantable auditory technology has become the standard of care for children born with severe to profound sensorineural hearing loss. To date, the results indicate that spoken communication skills are slow to develop and that visual communication remains essential for post-ABI intervention. In addition, we report the scores on speech perception, speech production, and language (spoken and signed) for five children with 1–3 years of assessment post-ABI activation. In this paper, we describe the study protocol and the children who have enrolled in the study thus far. In the United States, the Food and Drug Administration has authorized a Phase I clinical trial to determine safety and feasibility of the ABI in up to 10 eligible young children who are deaf and either derived no benefit from the CI or were anatomically unable to receive a CI. The auditory brainstem implant (ABI) is an auditory sensory device that is surgically placed on the cochlear nucleus of the brainstem for individuals who are deaf but unable to benefit from a cochlear implant (CI) due to anatomical abnormalities of the cochlea and/or eighth nerve, specific disease processes, or temporal bone fractures.
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