Electrical stimulation of the cochlear nucleus. First results of the European auditory brainstem implant clinical trial

Sollmann, Wolf-Peter; Laszig, R.; Marangos, N.; Charachon, R; Ramsden, R. T.; Fraysse, Bernard; Lazorthes, Y.; Sterkers, Olivier; Rey, Alain; Lenarz, Thomas; Matthies, Cordula; Samii, Madjid

doi:10.1016/s0303-8467(97)81755-6

Cited by 5 publications

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“…Multi-electrode stimulation of the second auditory neuron by using transcutaneous signal transmission is possible. [1][2][3]5,6 The best results are obtained in patients with stable NF2 disease and primary surgery of small acoustic neuromas. ABI may be successful in tumour recurrences and with an interval of hearing loss up to 16 years or even more.…”

Section: Discussionmentioning

confidence: 99%

“…The rst results with diseases other than NF2 are promising. 5,6,12 The surgery should be carried out in selected centres in different countries by an established surgical technique, respecting the need for successful ABI implantation after complete tumour removal. The implantation will be most accurate if the surgeon removing the tumour preserves the anatomy perfectly and the ABI specialist is included at a stage where there still is a chance of identifying the landmarks and nding the direction of the cochlear nucleus.…”

Section: Discussionmentioning

confidence: 99%

“…4 The rst multichannel ABI was implanted by Laszig and Sollmann in 1992. 5,6 For successful ABI surgery, there are some important issues to respect: patient selection, choice of device, choice of approach and technique of tumour removal, knowledge of the micro-anatomical variations, intra-operative identi cation of the cochlear nucleus, and prevention of complications.…”

Section: Introductionmentioning

confidence: 99%

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Surgical experiences in 58 cases using the Nucleus 22 multichannel auditory brainstem implant

2000

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical experiences in 58 cases using the Nucleus 22 multichannel auditory brainstem implant

2000

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“…In all these eight patients the Nucleus 22 device was used, and in seven of these patients within the European Study Group. 18 Indication for auditory brainstem implant surgery All the patients had been known to the NF2 outpatient clinic for a minimum of six months to 10 years, on average 3.5 years. All the eight patients received a low or moderate scaling factor in the NF2 manifestation classi cation and a good rating regarding life prognosis and presented with a stable life phase of their NF2 disease.…”

Section: Incidence Of Neuro Bromatosis Typementioning

confidence: 99%

Auditory brainstem implants: current neurosurgical experiences and perspective

et al. 2000

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The objective of this study was to present aspects of the current treatment protocol, such as patient evaluation and selection for therapy, multimodality monitoring for optimal auditory brainstem implant (ABI) positioning and radiological evaluation, that might have an impact on the functional results of ABI.Out of a series of 145 patients with bilateral vestibular schwannomas 10 patients received an ABI, eight of which are reported here. Patient selection was based on disease course, clinical and radiological criteria (according to the Hannover evaluation and prognosis scaling of neuro bromatosis type 2 (NF2)), extensive otological test battery and psycho-social factors. ABI placement was controlled by multimodality electrophysiological monitoring in order to activate the auditory pathway and to prevent false stimulation of the cranial nerve nuclei or long sensory or motor tracts. Results of hearing function were correlated with patients' ages, duration of deafness, tumour extension, tumour-induced compression or deformation of the brainstem, and numbers of activated electrodes without any side-effects.Out of 59 patients with pre-operative deafness eight patients received an ABI of the Nucleus 22 type. All these patients became continuous users without any side effects and experienced improved quality of life. Speech reception in combination with lip-reading was markedly improved, with further improvement over a long period. A short duration of deafness may be favourable for achieving good results, while age was not a relevant factor. Lateral recess obstruction may necessitate a more meticulous dissection, but did not prevent good placement of the ABI in the lateral recess. Pre-existing brainstem compression did not prevent good results, but brainstem deformation and ipsi-and contralateral distortion were followed by a less favourable outcome.Among the factors that can be in uenced by the therapy management are the selection of patients with a slow progressing NF2 disease, a short duration of deafness, a careful analysis of brainstem deformation and consideration of either side for implantation. Long-standing brainstem deformation might not lead to recovery, but instead lead to a low number of active electrodes and possibly only moderate results.ABI treatment is a safe procedure that can increase a patient's quality of life considerably. ABI placement along with neurophysiological control helps to prevent side effects and to improve acoustic activation. Further studies on structural and functional changes of the brainstem after previous tumour compression and distortion should increase our understanding and facilitate a decision on the best side for ABI implantation.

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“…Functional results show great variability; from noise perception only to useful speech discrimination in audiovisual mode in a few patients so far. Since the early trials by Hitselberger and House in 1979, as reported by Edgerton et al 13 and Hit sel berger et al, 21 profound improvements in implant array, technology, and speech processing strategies 65 have brought about useful improvement in functional outcome, 4,8,9,17,23,29,31,32,37,42,43,45,46,48,58,59 but still results remain less favorable than in cochlear implants or auditory brainstem implants (ABIs) in patients without NF2. 8 Visionindependent speech perception is not generally achieved.…”

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Auditory brainstem implants in neurofibromatosis Type 2: is open speech perception feasible?

Matthies¹,

Brill²,

Várallyay

et al. 2014

JNS

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Object Patients with bilateral auditory nerve destruction may perceive some auditory input with auditory brainstem implants (ABIs). Despite technological developments and trials in new stimulation sites, hearing is very variable and of limited quality. The goal of this study was to identify advantageous and critical factors that influence the quality of auditory function, especially speech perception. Methods The authors conducted a prospective study on ABI operations performed with the aid of multimodality neuromonitoring between 2005 and 2009 in 18 patients with neurofibromatosis Type 2. Outcome was evaluated by testing word recognition (monotrochee-polysyllabic word test at auditory-only mode [MTPa]) and open speech perception (Hochmair-Schulz-Moser [HSM] sentence test), both in pure auditory mode. The primary outcome was the HSM score at 24 months. The predictive meaning of general clinical data, tumor volume, number of active electrodes, duration of deafness, and early hearing data was examined. Results In 16 successful ABI activations the average score for MTPa was 89% (SD 13%), and for HSM it was 41% (SD 32%) at 24 months. There were 2 nonresponders, 1 after radiosurgery and the other in an anatomical variant. Direct facial nerve reconstruction during the same surgery was followed by successful nerve recovery in 2 patients, with a simultaneous very good HSM result. Patients' age, tumor extension, and tumor volume were not negative predictors. There was an inverse relationship between HSM scores and deafness duration; 50% or higher HSM scores were found only in patients with ipsilateral deafness duration up to 24 months. The higher the deafness sum of both sides, the less likely that any HSM score will be achieved (p = 0.034). In patients with total deafness duration of less than 240 months, higher numbers of active electrodes were significantly associated with better outcomes. The strongest cross-correlation was identified between early MTPa score at 3 months and 24-month HSM outcome. Conclusions This study documents that open-set speech recognition in pure auditory mode is feasible in patients with ABIs. Large tumor volumes do not prevent good outcome. Positive preconditions are short ipsilateral and short bilateral deafness periods and high number of auditory electrodes. Early ability in pure auditory word recognition tests indicates long-term capability of open speech perception.

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Electrical stimulation of the cochlear nucleus. First results of the European auditory brainstem implant clinical trial

Cited by 5 publications

References 0 publications

Surgical experiences in 58 cases using the Nucleus 22 multichannel auditory brainstem implant

Surgical experiences in 58 cases using the Nucleus 22 multichannel auditory brainstem implant

Auditory brainstem implants: current neurosurgical experiences and perspective

Auditory brainstem implants in neurofibromatosis Type 2: is open speech perception feasible?

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