Auditory Brainstem Implant in the Czech Republic

Overview

Background.
Auditory brainstem implant (ABI) is an electroprosthetic device enabling sound sensations in deafpersons with a bilateral lesion of auditory nerves. Stimulation of auditory nuclei in the floor of the IVth ventricle isrealized by an electrode array introduced during surgery in the lateral recess of the IVth ventricle.Methods and Results. The main indication group for ABI is represented by patients with neurofibromatosis 2 (NF2)suffering from bilateral vestibular schwannomas. During surgery aimed at tumour removal, auditory nerve functionand integrity are almost always destroyed, therefore, an ABI can be introduced as an one stage procedure. Implanteesuse the device mainly as the aid in lipreading, only very rarely they can comprehend speech without visual cues.Auditory brainstem implant programme has been introduced in the Czech Republic in the year 1999. It was the veryfirst ABI surgery in the Central Europe. Since that time, 5 patients had received the auditory brainstem implant, fromwhich the first four use the device for a longer time.Conclusions. The last operated patient has not been activated yet. It may be said, that ABI represents a benefit toall our patients, in one implanted this benefit is significant, since he can understand speech without lipreading, theother implantees use the device as an aid in lipreading. In one female patient, the device benefit is severely limitedby a motoric handicap after partial cerebellar resection during surgery. Nevertheless, she uses the implant on a dailybasis, but contact with her is limited and difficult.

Key words:
neurofibromatosis 2, vestibular schwannoma, acoustic neurinoma, deafness, brainstem implant, surgeryof deafness.