[AUDITORY BRAINSTEM IMPLANTS (ABI) IN CHILDREN: CASE SERIES IN SHAARE ZEDEK MEDICAL CENTER].

Harefuah Pub Date : 2023-08-01
Ronen Perez, Jean-Yves Sichel, Riki Salem, Dina Hildesheimer, John Thomas Roland, Nevo Margalit
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Abstract

Background: Cochlear implants (CI) are the treatment of choice for individuals with severe to profound sensorineural hearing loss. A small group of patients, with pathology central to the cochlea, cannot benefit from CI. Examples in children include absence of the cochlear-nerve or cochlear aplasia. In these cases, implantation of an auditory brainstem implant (ABI), directly stimulating the cochlear nucleus, bypassing the inner-ear and auditory-nerve, may be beneficial.

Objectives: Describe a series of children with ABI's treated in Shaare-Zedek, including the first ABI implantation in Israel (2017).

Methods: Of 9 patients with ABI's treated in Shaare Zedek Medical Center ,7 were children implanted between ages 2-8.6 years. Five boys and two girls. Surgeries were conducted in collaboration between neurosurgeons, neurotologists and audiologists (five implanted in Shaare-Zedek and two in New-York University). Follow-up was between 2-6 years. Hearing evaluation was conducted, mainly, with audiograms, categories of auditory performance (CAP), speech perception testing when possible and estimation of device use per day.

Results: Six of the seven children, who initially underwent unsuccessful CI, had deficient auditory-nerves. One child had cochlear-aplasia. In 3 children hearing loss was part of the CHARGE syndrome. CAP scores ranged from 0-7 (0,1,3,5,5,7). One child was able to achieve open-set speech perception.

Conclusions: Although functional auditory outcomes for children with ABI are inferior to CI recipients and are highly variable, some children were able to obtain significant benefit. In these children, who are not candidates for CI, the ABI presents the only chance for auditory awareness and may be recommended.

Discussion: John Thomas Roland is a consultant and recipient of research support from Cochlear Americas.

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[儿童听觉脑干植入(abi): shaare zedek医疗中心的病例系列]。
背景:人工耳蜗(CI)是重度到重度感音神经性听力损失患者的治疗选择。一小部分以耳蜗为中心病变的患者不能从CI中获益。儿童的例子包括耳蜗神经缺失或耳蜗发育不全。在这些情况下,植入听觉脑干植入物(ABI),直接刺激耳蜗核,绕过内耳和听神经,可能是有益的。目的:描述一系列在share - zedek治疗的ABI儿童,包括以色列的第一例ABI植入(2017年)。方法:在Shaare Zedek医疗中心治疗的9例ABI患者中,7例为2 ~ 8.6岁的儿童植入。五个男孩和两个女孩。手术由神经外科医生、神经学家和听力学家合作进行(5例植入share - zedek, 2例植入纽约大学)。随访时间为2-6年。听力评估主要包括听力图、听觉表现分类(CAP)、尽可能进行语音感知测试和估计每天的设备使用情况。结果:最初接受CI失败的7名儿童中有6名有听觉神经缺陷。一名儿童患有耳蜗发育不全。3例患儿听力丧失是CHARGE综合征的一部分。CAP得分范围为0-7(0,1,3,5,5,7)。其中一个孩子能够实现开放式语言感知。结论:尽管ABI患儿的功能性听觉结果不如CI患者,且差异很大,但一些患儿能够获得显著的益处。在这些不适合CI的儿童中,ABI提供了唯一的听觉意识机会,可以推荐使用。讨论:约翰·托马斯·罗兰是美国耳蜗协会的顾问和研究支持的接受者。
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