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Auditory Brainstem Implants (ABIs): 20 Years of Clinical Experience in Uppsala, Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
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2014 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 10, 1052-1061 p.Article in journal (Refereed) Published
Abstract [en]

CONCLUSIONS:

Even though sound perception may be limited after treatment with an auditory brainstem implant (ABI), it provides benefits and should be selectively offered to patients. Importantly the patients must be motivated, given reasonable expectations of outcome and offered long-term rehabilitation with a considerable 'learn to listen' period with the implant device.

OBJECTIVES:

To describe the clinical experiences and results of 24 ABI surgeries performed in Uppsala University Hospital between 1993 and 2013.

METHODS:

Most patients (n = 20) suffered from neurofibromatosis type 2 (NF2); a few patients (n = 4) were paediatric non-NF2 patients. The files were searched for information on the presurgery size of the vestibular schwannoma, whether the patient had undergone gamma knife treatment, the surgical approach, the side effects of the surgery and of the use of the implant, the electrode activation pattern and implant use, and categories of auditory performance (CAP) score.

RESULTS:

Our results show that many patients greatly benefited from an ABI, and most of the patients used their implants even though the hearing improvements usually consisted of awareness of surrounding sounds and improved lip-reading. No severe side effects were observed from implant stimulation.

Place, publisher, year, edition, pages
2014. Vol. 134, no 10, 1052-1061 p.
National Category
Otorhinolaryngology
Identifiers
URN: urn:nbn:se:uu:diva-233250DOI: 10.3109/00016489.2014.909051ISI: 000342204900011PubMedID: 24881643OAI: oai:DiVA.org:uu-233250DiVA: diva2:751526
Note

De två första författarna delar förstaförfattarskapet.

Available from: 2014-10-01 Created: 2014-10-01 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Experiences from Cochlear Implantation and Auditory Brainstem Implantation in Adults and Children: Electrophysiological Measurements, Hearing Outcomes and Patient Satisfaction
Open this publication in new window or tab >>Experiences from Cochlear Implantation and Auditory Brainstem Implantation in Adults and Children: Electrophysiological Measurements, Hearing Outcomes and Patient Satisfaction
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cochlear implants (CIs) and auditory brainstem implants (ABIs) are prostheses for hearing used in patients with profound hearing impairment. A CI requires an operational cochlear nerve to function in contrast to an ABI. ABIs were initially designed for adult patients with neurofibromatosis type 2 (NF2), suffering from bilateral vestibular schwannomas. Now ABIs are also used for patients, both adults and children, with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, and cochlear ossification. The aims of this thesis are to evaluate hearing outcome in patients implanted with a CI after long-term deafness. An extended period of deafness has earlier been considered as a contraindication for CI surgery. Further, we analyzed if electrically evoked auditory brainstem responses (eABRs) can predict CI outcome and pinpoint the optimal selection of treatment such as CI or ABI. We also disclose our experiences from ABI surgery in Uppsala, such as implant use, hearing outcome, complications, and satisfaction among the patients. Finally, we evaluated the results and benefits of ABIs in non-NF2 pediatric patients.

Results show that patients with an extended deafness period and durations over 20 years can achieve speech understanding and benefit from CIs. Patients with long-term deafness and limited years of hearing before deafness did not perform as well as those with shorter deafness duration and longer hearing experience did. eABR seems to have a definite role in the diagnostic armamentarium, to better consider alternative surgical strategies such as ABI. No eABR waveform predicted a poor CI outcome. There was no correlation between speech perception and eABR waveform latencies or eABR waveform quality. A majority of the ABI patients used their ABIs and benefited from them for at least some period. ABI assisted voice control in a majority of the full-time users and they reported improved understanding of speech with the implant switched on. No severe complications from ABI surgery or ABI stimulation were noted. The patients were generally satisfied, even if their hearing remained very limited. All pediatric patients but one used the implant continuously and benefited from it.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. 104 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1183
Keyword
cochlear implant, auditory brainstem implant, electrically evoked auditory brainstem responses, long deafness duration, neurofibromatosis type 2
National Category
Medical and Health Sciences
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-275091 (URN)978-91-554-9483-4 (ISBN)
Public defence
2016-04-15, Skoogsalen, ingång 78/79, Akademiska sjukhuset, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-03-22 Created: 2016-01-29 Last updated: 2016-04-05

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Lundin, KarinStillesjö, FredrikRask-Andersen, HelgeNyberg, Gunnar

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