Abstract
To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear. Retrospective case review. Tertiary referral hospital. Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects. Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI. Mean age of the subjects was 84.00±33.94months. Age at CI surgery and ABI surgery was 25.00±10.98months and 41.50±16.14months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P=.002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions. Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.
Highlights
Cochlear implantation (CI) is the most frequent surgical method used with an electronic device for individuals with severe to profound sensorineural hearing loss (SNHL).[1]
Auditory perception tests used during the follow-up period contained the following test battery: Meaningful Auditory Integration Scale (MAIS), pattern perception test, word recognition test, Speech Intelligence Rating (SIR) and Category of Auditory Performance (CAP) scale
Cochlear hypoplasia with hypoplastic cochlear aperture, the presence of an unbranched cochleovestibular nerve (CVN) and hypoplastic cochlear nerve (CN) constitute a dilemma for decision-making for CI and auditory brainstem implant (ABI) selection.[4,5]
Summary
Cochlear implantation (CI) is the most frequent surgical method used with an electronic device for individuals with severe to profound sensorineural hearing loss (SNHL).[1]. | 232 reports showing the benefits of CI in IEM, CI became an accepted procedure in this patient population.[3] when the IEM are severe and occur with cochlear nerve (CN) or cochleovestibular nerve (CVN) deficiency or hypoplasia, the clinicians are faced with the dilemma of deciding between CI and an auditory brainstem implantation (ABI). The first group was definite congenital indications, including complete labyrinthine aplasia (Michel aplasia), cochlear aplasia, CN aplasia and cochlear aperture aplasia. The second group was possible congenital indications, including hypoplastic cochlea with cochlear aperture hypoplasia, common cavity and incomplete partition type I cases with or without CN, the presence of a common CVN and the presence of hypoplastic CN.[4]
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