Overview

An auditory brainstem implant, or ABI, maybe the solution for you if you are affected by NF2 or a missing or malfunctioning cochlear (inner ear) or auditory nerve. Individuals with severe hearing loss retrieve natural hearing power to experience sound through an ABI, which can also improve their ability to read lips.

What is an auditory brainstem implant?

An auditory brainstem implant, shortly known as ABI, is a medical instrument that provides the experience of listening to people with severe hearing impairment due to a nonworking or missing cochlea (inner ear) or nerve of hearing. People can try their best:-

• Awareness of sound.
• Lip-reading capacity.
• Recognition of sound, which sometimes even includes word and sentence recognition.

What is an auditory brainstem implant?

The implant is made up of two parts:-

Processor: You wear this device on your ear or the side of your head. The processor contains a microphone that picks up the sounds around you. It sends the sounds as an electrical signal to the implant. You remove the processor when you sleep.

Internal implant: A physician implants this device, which is made up of:-

• The receiver-stimulator is implanted under your skin on the side of your head, terminating in an electrode paddle.
• The electrode paddle, on the cochlear nucleus complex, is the surface area of the brainstem involved in hearing.

How does an ABI work?

The electrodes in the paddle stimulate your brainstem's neurons to produce sound sensations. The technology is analogous to cochlear implant technology. But in a cochlear implant, the electrodes stimulate your hearing nerve. An ABI bypasses your hearing nerve to stimulate your brainstem.

Who would be a good candidate for an ABI?

You could be a candidate for an ABI if you experience severe hearing loss with a nonfunctioning or missing cochlea (inner ear) or auditory (hearing) nerve.

Scientists originally developed ABI for neurofibromatosis 2 (NF2) patients, a highly uncommon genetic disease. In NF2, growths known as acoustic neuromas develop along the hearing nerve. Both the growths and their removal with treatment can harm the nerve irreversibly. Patients typically end up with deafness in both ears. Cochlear implants and hearing aids cannot restore hearing in such a situation.

Your nerve of hearing is a bridge from your brain to your inner ear. If the bridge is down, your brain cannot hear sound. An ABI bypasses the nerve and stimulates your brainstem directly, where sound is transmitted to your brain.

NF2 patients were first treated with an ABI. Other patients with profound hearing loss due to nonfunctioning or missing hearing nerves or inner ears have been aided with these implants. ABI can help infants, children and adults, including those who:-

• They are born without a working auditory nerve (aplasia) or with an abnormally formed auditory nerve (Hypoplasia).
• Are deaf because of an abnormally developed inner ear (cochlea), underdevelopment of the inner ear (cochlear Hypoplasia), missing inner ear structures (cochlea aplasia), overgrowth of bone (cochlear otosclerosis) or defective bone development (cochlear ossification) within the inner ear.
• Possess either a damaged or severed auditory nerve, perhaps as the result of breaks in their temporal bone (the top of their head over the ear) on either side of their head.

They have other causes of deafness that cannot fixed with a cochlear implant or hearing aid.

What happens before an auditory brainstem implant?

This is what you can expect beforehand for an auditory brainstem implant:-

• Behavioral testing: Audiologists will assess your hearing ability with and without hearing aids.
• Communication evaluation: A speech-language pathologist will assess your communication pattern and language development.
• Electrophysiologic testing: Audiologists will test you to determine the location and extent of hearing loss.
• Imaging tests: You will have a CT scan and MRI to examine your cochlea, auditory nerve and adjacent structures.
• Neuropsychological evaluation: Your physician will evaluate how much brain function and capacity you have.

Who performs auditory brainstem implant surgery?

The device must be implanted using an operation requiring a skilled team of surgeons to work together. The team typically will include:-

• Neurosurgeon (brain surgeon).
• Anesthesiologist, who administers pain relief and keeps you from moving when you are under anaesthesia
• Neurotologist, a board-eligible otolaryngologist with subspecialty training in surgical care for patients with auditory nerve disorders.
• The physician performs intraoperative testing to ensure the device works effectively and optimizes the electrode paddle's placement.

When is auditory brainstem implant surgery performed?

You may lose hearing after tumour removal surgery if you have NF2, which causes an acoustic Neuroma. Your operating team will generally implant the ABI intraoperatively during tumour removal surgery. You will require a second surgery to implant the ABI if you:-

• Have previously had surgery or radiation treatment for NF2 or any other reason.
• Are deformed in the inner ear, traumatized, or otherwise deaf and for whom a cochlear implant is not indicated.

How long may I be in the hospital after my operation?

You'll likely spend two to four days in the hospital following surgery. The stay may be longer depending on your particular condition and the type of surgery. Your team implants the device at the time of surgery and turns it on several weeks later.

What are the advantages of an auditory brainstem implant?

An ABI can't restore normal hearing but can enhance awareness and recognition of sound and lip-reading. Outcomes are highly variable.

Children with an ABI at an early age (following a brief period of deafness) will have better word comprehension than adults with NF2 (who've had a prolonged period of deafness).

Other things that may influence outcomes besides the duration of profound deafness may be involvement in hearing therapy following surgery, tumour size and location, and other medical considerations.

Discuss with your physician to thoroughly consider the risks versus benefits. Together, you can make an educated decision for your health.

What are the risks/dangers of this surgery?

An auditory brainstem implant is a complicated neurosurgery. Any surgery on the brain carries risks. It's also hard to know how well an ABI will perform for you.

Are there complications of auditory implant surgery?

The rate of complications for ABI surgery is low, mainly if an experienced team does your surgery. Your surgical team will explain potential complications of the operation and management or treatment options for these complications. Complications are:-

• Cerebrospinal fluid leaks.
• Implant failure (when the device fails to deliver beneficial auditory sensations or electrodes shift position).
• Non-auditory stimulation (when the device produces annoying stimulation of structures other than the hearing centres).
• Incomplete tumor removal.
• Meningitis.
• Palsy of your facial nerve (nerve damage that produces loss of facial movement).
• Wound infection.

Recovery & Outlook

You will probably be in the hospital for two to four days. If you have NF2 and had tumour removal simultaneously, you might require a more extended hospital stay. Your team will set up the ABI in the PACU (Post Anesthesia Care Unit).

The device is activated around four to six weeks after surgery. Your care team refines the device programming over a few days and monthly throughout the first year following surgery.

Does an ABI restore normal hearing?

No, ABI cannot restore normal hearing. However what it does include:-

• Sound awareness.
• Ability to hear and recognize sounds (a child's voice versus an adult voice).
• Capacity to recognize sounds in the surroundings (dog barking vs. phone ringing).
• Lip-reading capacity, leading to improved face-to-face communication.

What are the outcomes of ABI surgery?

Researchers have established that outcomes vary by patient group. Individuals without NF2 generally have improved hearing outcomes compared to individuals with NF2.Kids, with or without NF2, can sense noises around them and have more advanced language. Their ability to hear continues to improve years after the operation.

When should I contact my doctor or healthcare provider?

If you develop pain or fever after ABI surgery, call your doctor. Your care team will take close care of you after surgery to avoid any complications. After surgery, you must also follow up with your audiologist to program the device.

Why Choose Tender Palm Super Speciality Hospital for Auditory Brainstem Implant in Lucknow, India?

Tender Palm is best hospital for Auditory Brainstem Implant in Lucknow, India. We have an experienced team of neurosurgeons, ENT specialists, audiologists, and rehabilitation experts. We provide advanced diagnostics, safe surgical intervention, and personalised auditory rehabilitation for patients with non-functional or absent auditory nerves due to NF2, cochlear aplasia, or trauma.

To Seek an Expert Consultation for Auditory Brainstem Implant in Lucknow, India

Call us at +91-9076972161
Email at care@tenderpalm.com

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