Protocol for Auditory Brainstem Implants in Children

Abstract

Objectives: Auditory brainstem implants (ABIs) have been implanted in 64 children with no permanent major complications. We detail the protocol for ABI patient selection, ABI surgery and intra-operative monitoring, and device fitting and rehabilitation with children. Methods: Sixty-four children received the ABI between 2000 and 2013. The follow-up ranged from 6 months to 8 years. A protocol is presented for acoustic and electrophysiological assessment of ABI candidacy. A retrosigmoid-transmeatal approach was used in the Neurofibromatosis type 2 (NF2) and a retrosigmoid approach in the nontumor children. Tests for assessing auditory and cognitive development and rehabilitation are recommended. Results: All children, except NF2 subjects, scored 0 before ABI implantation on all tests, even the 31 children previously fitted with a cochlear implant. Perceptual outcomes showed statistically significant improvements over time. At the last follow-up no significant postoperative complications were observed. Conclusions: ABIs have been shown to be beneficial for children who cannot use a cochlear implant. However, implanting an ABI in a child requires special care and expertise and should only be undertaken by an experienced pediatric implant team. This paper presents a comprehensive protocol for application of ABIs in children.