![]() ![]() Only a limited number of ABI patients achieve the ability to recognize speech without using lip-reading. For most patients, the benefit of the ABI is restricted to sound awareness, partial identification of ambient sounds, or as aid for lip-reading. While the ABI can provide hearing to patients in whom auditory nerve function is impaired, perceptual outcomes are often poorer than those for cochlear implant recipients, in whom the auditory nerve remains functional. Over time, its indications have been extended to adults with other non-tumor diseases and children with cochlear nerve aplasia or severe inner ear malformations however, indications remain controversial for pathologies such as neuropathy and trauma with temporal bone fracture. Initially, it was indicated for patients affected by neurofibromatosis type 2, who were totally deaf after acoustic neuroma removal. It is used to restore hearing sensation in patients for whom a cochlear implant (CI) is not effective and/or applicable. ![]() The multichannel auditory brainstem implant (ABI) is a surgically implanted neuro-prosthetic device developed to electrically stimulate auditory neurons of the cochlear nucleus complex (CNC) bypassing the auditory nerve. Perceptual outcomes were better for children than for adults, despite a lower number of active electrodes. Among patients with 10-year follow-up, at least 11/21 active electrodes were needed to support good word detection and closed-set recognition and 14/21 electrodes to support good open-set word and sentence recognition. The number of active electrodes was associated with long-term perceptual outcomes. Regardless of the stimulation approach, the intraoperative estimate of viable electrodes greatly overestimated the number of active electrodes in the clinical map. The interoperative electrophysiological recordings were used to estimate the number of viable electrodes and were compared to the number of activated electrodes at initial clinical fitting. In this retrospective study, we reviewed intraoperative electrophysiological data from 24 ABI patients (16 adults and 8 children) obtained with two stimulation approaches that differed in terms of neural recruitment. Furthermore, the relationship between initial ABI stimulation with and long-term perceptual outcomes is unknown. Currently, there is limited knowledge regarding the relationship between intraoperative data and post-operative outcomes. While there presently is no optimal procedure for intraoperative electrode positioning, intraoperative assessments may provide useful information regarding viable electrodes that may be included in patients’ clinical speech processors. One of the greatest challenges in ABI surgery is the intraoperative positioning of the electrode paddle, which must fit snugly within the cochlear nucleus complex. A major limitation to ABI outcomes is the number of implanted electrodes that can produce auditory responses to electric stimulation. However, patient outcomes with the ABI are typically much poorer than those for cochlear implant recipients. The auditory brainstem implant (ABI) can provide hearing sensation to individuals where the auditory nerve is damaged.
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