ABI-auditory brainstem implant.

The Auditory Brainstem Implant (ABI) is based on the classic cochlear implant (CI) but uses a different stimulation electrode. At MED-EL, the early development activities on ABI started in the year 1994, with the suggestion coming from J. Helms and J. Müller from Würzburg, Germany in collaboration with the Univ. of Innsbruck Austria. The first ABI surgery in a neuro-fibromatosis (NF2) patient with the MED-EL device took place in the year 1997. Later, the indication of ABI was expanded to non-NF2 patients with severe inner-ear malformation, for whom a regular CI will not be beneficial. Key translational research activities at MED-EL in collaboration with numerous clinics investigating the factors that affect the hearing performance amongst ABI patients, importance of early ABI implantation in children, tools in pre-operative assessment of ABI candidates and new concepts that were pursued with the MED-EL ABI device. The CE-mark for the MED-EL ABI to be used in adults and children down to the age of 12 months without NF-2 was granted in 2017 mainly based on two long-term clinical studies in the pediatric population. This article covers the milestones of translational research from the first concept to the widespread clinical use of ABI in association with MED-EL.

Auditory brainstem implantation.

The use of cochlear implants for selected individuals with bilateral severe to profound sensorineural hearing loss who derive limited benefit from conventional hearing aids is well established. There are situations where cochlear implantation is contraindicated. Auditory brainstem implantation (ABI) is the only solution to restore hearing when the cochlear nerve is disrupted together with pathologies where the cochlea does not provide a suitable location for cochlear implant. Labyrinthine and cochlear aplasia and cochlear nerve aplasia constitute the congenital indications for ABI. In the present review article history and development of ABI, indications, side selection criteria, surgery and audiological outcome are presented.

Cochlear and brainstem implantation. 2002.

Cochlear and auditory brainstem implants offer safe and effective hearing habilitation and rehabilitation for profoundly deafened adults and children. Brainstem implant technology is currently approved for use in patients with type 2 Neurofibromatosis, who have lost integrity of auditory nerves following vestibular schwannoma removal. An update on implant devices, speech processing strategies, candidacy criteria, and perceptual performance are provided in this article.

Twenty-five years of auditory brainstem implants: perspectives.

The auditory brainstem implant (ABI) provides auditory sensations, recognition of environmental sounds and aid in spoken communication in more than 300 patients worldwide. It is no more a device under investigation but it is widely accepted for the treatment of patients who have lost hearing due to bilateral tumors of the vestibulocochlear nerve. Most of these patients are completely deaf when the implant is switched off. In contrast to the cochlear implants (CI), only few of the implanted patients achieve open-set speech recognition without the help of visual cues. In the last few years, patients with lesions other than tumors have also been implanted. Auditory perceptual performance in patients who are deaf due to trauma, cochlea aplasia or other non-tumor lesions of the cochlea or the vestibulocochlear nerve turned out to be much better than in NF2 tumor patients. Until recently, the target region for ABI implantation has been the ventral cochlear nucleus (CN). The electrodes are implanted via the translabyrinthine or retrosigmoid approach. Currently, new targets along the central auditory pathways and new, minimally invasive techniques for implantation are under investigation. These techniques may further improve auditory perceptual performance in ABI patients and provide hearing to a variety of types of central deafness.