Paediatric auditory brainstem implantation: The South Asian experience.

Area of Science:

• Neurosurgery
• Audiology
• Pediatric Otolaryngology

Background:

• Auditory Brainstem Implantation (ABI) is crucial for children with congenital cochlear aplasia or absent/hypoplastic vestibulocochlear nerve, where cochlear implantation is not feasible.
• Understanding brainstem anatomy and its variations is essential for successful ABI surgery.

Purpose of the Study:

• To investigate anatomical variants in pediatric patients undergoing ABI.
• To evaluate the impact of anatomical variants on ABI electrode placement.
• To assess audiological and speech outcomes following ABI surgery.

Main Methods:

• A prospective study of 24 children who underwent ABI surgery at Madras ENT Research Foundation.
• Post-operative follow-up for 1 year, including assessment of anatomical variants.
• Evaluation of patient outcomes using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR) scores.

Main Results:

• Patients demonstrated progressive improvement in audiological and verbal outcomes post-ABI.
• Mean CAP and SIR scores improved from 2.07 and 1.37 at 6 months to 3.42 and 2.33 at 1 year, respectively.
• Despite insertion difficulties due to anatomical variants (e.g., flocculus grades), outcomes were comparable to those without variants.

Conclusions:

• Anatomical variations around the lateral recess frequently complicate ABI electrode placement.
• While anatomical variants present surgical challenges, Auditory Brainstem Implantation yields promising results for pediatric patients.