Bilateral implantation in children with cochleovestibular nerve hypoplasia

Oker, N.; Loundon, Natalie; Marlin, Sandrine; Rouillon, Isabelle; Leboulanger, Nicolas; Garabédian, E. N.

doi:10.1016/j.ijporl.2009.06.017

Cited by 20 publications

(13 citation statements)

References 35 publications

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“…Another remedy for these patients may be the bilateral application of CI. In fact, it was reported that bilateral CI provides more benefit for users with CN hypoplasia compared to unilateral CI in CVN deficiency . Considering the limited benefit of CI alone for these patients, ABI could provide better outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, it was reported that bilateral CI provides more benefit for users with CN hypoplasia compared to unilateral CI in CVN deficiency. 18 Considering the limited benefit of CI alone for these patients, ABI could provide better outcomes. An option in this case may be the removal of the CI electrode and ABI application to malformations.…”

Section: F I G U R E 1 Category Of Auditory Performance and Speech Inmentioning

confidence: 99%

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Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Batuk

Çınar

Yaralı

et al. 2020

Clinical Otolaryngology

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Objective 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. Design Retrospective case review. Setting Tertiary referral hospital. Participants 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. Main outcome measures Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI. Results Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, 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. Conclusion 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.

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Section: Discussionmentioning

confidence: 99%

Section: F I G U R E 1 Category Of Auditory Performance and Speech Inmentioning

confidence: 99%

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Batuk

Çınar

Yaralı

et al. 2020

Clinical Otolaryngology

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“…Clearly, some nerve fibers were available to transmit auditory signals to the brainstem [Casselman et al, 1997;Ozdoğmuş et al, 2004;Warren et al, 2010]. These encouraging results have led to inclusion of ABR testing to augment the imaging data [Kim et al, 2006;Oker et al, 2009;Buchman et al, 2011;Kutz et al, 2011;Pagarkar et al, 2011;Roland et al, 2012;Zhang et al, 2012;Vincenti et al, 2014;Wu et al, 2014]. At times, ABR testing may indicate the presence of a viable nerve in response to electrical stimulation; however, the absence of a response inconsistently predicts the aided auditory benefit [Nikolopoulos et al, 2000;Kim et al, 2008;Roland et al, 2012].…”

Section: Current Imaging Data Does Not Predict Auditorymentioning

confidence: 99%

Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

Kari

Loggins

et al. 2018

Audiol Neurotol

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Objective: Imaging characteristics and hearing outcomes in children with cochleovestibular or cochleovestibular nerve (CVN) abnormalities. Study Design: Retrospective, critical review. Setting: Tertiary referral academic center. Patients: Twenty-seven children with CVN abnormalities with magnetic resonance (MRI) and/or computed tomography (CT). Study Intervention(s): None. Main Outcome Measure(s): Determine the likely presence or absence of a CNV and auditory stimulation responses. Results: Two of 27 cases had unilateral hearing loss, and all others had bilateral loss. Eleven (46%) were identified with a disability or additional condition. Twenty-two (42%) ears received a cochlear implant (CI) and 9 ears (17%) experienced no apparent benefit from the device. MRI acquisition protocols were suboptimal for identification of the nerve in 22 (42%) ears. A likely CVN absence was associated with a narrow cochlear aperture and internal auditory canal and cochlear malformation. Thirteen (48%) children with an abnormal nerve exhibited normal cochleae on the same side. Hearing data were available for 30 ears, and 25 ears (83%) exhibited hearing with or without an assistive device. One child achieved closed set speech recognition with a hearing aid, another with a CI. One child achieved open set speech recognition with a CI. Conclusions: Current imaging cannot accurately characterize the functional status of the CVN or predict an assistive device benefit. Children who would have otherwise been denied a CI exhibited auditory responses after implantation. A CI should be considered in children with abnormal CVN. Furthermore, imaging acquisition protocols need standardization for clear temporal bone imaging.

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“…The remaining 18 studies, describing 97 subjects with individual postimplant auditory data, were included (see flowchart; Figure 1). [3][4][5][6][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Subject characteristics and speech perception outcome data were extracted from studies and entered into an Excel file by subject. Table 1 shows the studies that were included and the number of cases from each.…”

Section: Studies Includedmentioning

confidence: 99%

“…The presence of a cochlear malformation in the implanted ear was noted in many ears, representing up to 100% of cases in some studies, while vestibular malformations were also reported in some of the studies. The majority of subjects in most studies reporting radiologic findings had aplastic cochlear nerves, with the remainder having 3 1 Descriptive only Gray (1998) 4 1 Descriptive only Maxwell (1999) 5 1 Descriptive only Young (2012) 6 10 Level of performance Acker (2001) 10 1 LiP Bradley (2008) 11 6 CAP, MAIS, descriptive a Govaerts (2003) 12 4 GASP, descriptive a Ito (1999) 13 1 Descriptive only Kang (2010) 14 6 CAP, MAIS Kim (2004) 15 1 ESPT, PBK Kutz (2011) 16 9 SPC Oker (2009) 17 2 Descriptive only Valero (2012) 18 21 PROSPER Vincenti (2014) 19 5 SPC Warren (2010) 20 3 MAIS, descriptive a Wu (2015) 21 15 CAP Zanetti (2006) 22 1 MAIS, descriptive Zhang (2012) 23 9 MAIS, CAP hypoplasia. Full insertion of the electrode array, when reported, was achieved in most patients.…”

Section: Subjectsmentioning

confidence: 99%

Cochlear Nerve Aplasia and Hypoplasia: Predictors of Cochlear Implant Success

Peng

Kuan

Hagan

et al. 2017

Otolaryngol.--head neck surg.

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Objective To identify factors predicting performance outcomes following cochlear implantation in patients with cochlear nerve aplasia or hypoplasia. Data Sources Individual patient data extracted from published case series and reports. Review Methods The MEDLINE database, Cochrane Library, Embase, Web of Science, and Google Scholar were queried for "cochlear implant" in conjunction with "aplasia" or "hypoplasia" between 1985 and 2015. Eighteen studies were included describing 97 subjects with individual postimplant auditory data. Postimplant performance was categorized as follows: level 1, nonstimulation/minimal detection; level 2, improved detection; level 3, closed-set speech perception; or level 4, open-set speech perception. The subjects achieving speech perception (levels 3 and 4) were descriptively compared with those who did not. Results Subjects with a hypoplastic cochlear nerve on magnetic resonance imaging had higher reported rates of achieving speech perception than those with an aplastic nerve. Subjects with syndromic medical comorbidities had higher reported rates of nonstimulation than nonsyndromic subjects. The data showed that some children with an aplastic cochlear nerve or those with partial electrode insertion could obtain levels of speech discrimination. Reporting of patient characteristics and auditory outcomes was extremely variable across studies. Conclusion As previously shown, cochlear implant in patients with cochlear nerve aplasia or hypoplasia can provide meaningful hearing for select patients. The current study suggests that presence of a cochlear nerve on magnetic resonance imaging and lack of comorbid medical syndrome are associated with better auditory outcomes in such patients. Future efforts to report individual data in a consistent manner may allow better determination of predictive factors.

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Bilateral implantation in children with cochleovestibular nerve hypoplasia

Cited by 20 publications

References 35 publications

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Abnormal Cochleovestibular Anatomy and Hearing Outcomes: Pediatric Patients with a Questionable Cochleovestibular Nerve Status May Benefit from Cochlear Implantation and/or Hearing Aids

Cochlear Nerve Aplasia and Hypoplasia: Predictors of Cochlear Implant Success

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