Indications, Results, and New Frontiers of Auditory Brainstem Implants in Children

Abstract

Objectives: Review the literature regarding auditory brainstem implant (ABI) indications, surgical techniques, activation methods, and postsurgery follow-up in children. Methods: A search was performed in LILACS, MEDLINE, SciELO, and PubMed databases from January to March 2013, and the key words used in the search were brainstem AND implant OR implantation AND children OR child. Studies that referred to results of the ABI fitting process in children were selected. Results: Seventy-two studies that met the criteria were read in full; 17 studies referred to the ABI fitting process in children and were selected for appraisal. The studies showed the cases of 49 children (younger than 18 years old) fitted with ABIs. Evaluation after surgery showed that 47 (95.9%) of the patients improved in their ability to recognize environmental sounds and speech perception. Patients with tumors or those with cochlear or cochlear nerve malformations had good outcomes as well. Two of the children achieved no sound perception upon ABI activation. Conclusions: The US Food and Drug Administration (FDA) only approves the auditory brainstem implant for children older than 12 years old, but good outcomes in children younger than that age were achieved, improving environmental sound awareness and oral language development. The FDA only recently approved clinical trials for patients younger than 12 years old. We propose that the FDA auditory brainstem implant indications should be extended to patients with nontumoral diseases of the cochlea and cochlear nerve and younger than 12 years old.