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Experiences from Auditory Brainstem Implantation (ABI) in four Paediatric Patients
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.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
2016 (English)In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
2016.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:uu:diva-275226OAI: oai:DiVA.org:uu-275226DiVA: diva2:899343
Available from: 2016-02-01 Created: 2016-02-01 Last updated: 2017-11-30Bibliographically 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, FredrikNyberg, GunnarRask-Andersen, Helge

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