Retrolabyrinthine approach for surgical placement of auditory brainstem implants in children

Abstract

ABI placement via the RLA was successfully performed in all children without any further complications except multidirectional nystagmus in one child. The RLA we employed differed from that used for vestibular schwannoma only in the removal of the posterior semicircular canal. The lateral and superior semicircular canals and the vestibule remained intact, and there was no need to expose the dura of the internal auditory meatus. The jugular bulb was completely exposed to allow adequate visualization of the ninth cranial nerve and cerebellar flocculus.

Satisfação e qualidade de vida em usuários de implante auditivo de tronco cerebral

“…This is usually the case of individuals with Neurofibromatosis type 2 (NF-2), malformation or agenesis of cochlear nerves and/or cochlea, as well as in cases of cochlea ossification following meningitis (1)(2)(3)(4) . The ABI allows access to speech and environmental sounds.…”

Auditory brainstem implant outcomes and MAP parameters: Report of experiences in adults and children

“…All NF2 patients received the ABI on their second side VIIIth tumor removal. All of them were implanted with a Nucleus 24 Multichannel ABI (Cochlear Ltd., Sydney, Australia), with either the retrolabyrinthine or translabyrinthine approach pending the presence of a tumor, for which the surgical technique has been reported elsewhere [7,8]. Adult and children in this sample had profound deafness in both ears, and the ear to be implanted was chosen according to the best anatomical and surgical conditions.…”

Auditory Brainstem Implants in Children: Results Based on a Review of the Literature

“…The translabyrinthine approach is the only one allowed by the FDA, [15,22] as it is considered by some authors as the most straightforward way to the foramen of Luschka, but experimental evidence suggests the necessity for more manipulation in order to observe the lateral recess, increasing the risks [22] . Bento et al [19] showed the feasibility of exposing of the jugular bulb without complications when using the retrolabyrinthine approach. The authors [19] also state that the distance to the bulbar nerves, in their series of patients, was short, allowing good manipulation of the cerebellar flocculus and choroid plexus, as well as excellent visualization of the foramen of Luschka.…”

“…Bento et al [19] showed the feasibility of exposing of the jugular bulb without complications when using the retrolabyrinthine approach. The authors [19] also state that the distance to the bulbar nerves, in their series of patients, was short, allowing good manipulation of the cerebellar flocculus and choroid plexus, as well as excellent visualization of the foramen of Luschka.…”

“…Twelve (10.0%) of the patients had associated anatomic deformities, and 15 (12.5%) had other associated deficiencies or disabilities, as presented in Tables 1 and 2 [7,[10][11][12][13] . Among the studies, 13 patients [10,14] were fitted with the Pulsar CI100 ABI ® (Med-El Co., Innsbruck, Austria), 5 patients were fitted with a Concerto ABI ® (Med-El Co., Innsbruck, Austria) [10] , 1 patient received a Nucleus 22 Auditory Brainstem Implant System ® (Cochlear Co., Lane Cove, Australia) [15] , and the other 48 [7,13,14,[16][17][18][19] were fitted with the Nucleus 24 Auditory Brainstem Implant System ® (Cochlear Co., Lane Cove, Australia). The Nucleus 24 and 21 ABI ® were activated using the spectral peak coding (SPEAK) strategy [7,13,14,[16][17][18][19] , and the Pulsar CI100 ABI ® was activated using the continuous interleaved sampling (CIS) technique [5] .…”