Abstract：
OBJECTIVE: Pediatric data regarding treatment via an auditory brainstem implant (ABI) remains sparse. The authors aimed to describe their experience at their institution and to delineate associated demographic data, audiometric outcomes, and surgical parameters.
METHODS: An IRB-approved, retrospective chart review was conducted among the authors\' pediatric patients who had undergone auditory brainstem implantation between 2012 and 2021. Demographic information including sex, age, race, coexisting syndrome(s), history of cochlear implant placement, average duration of implant use, and follow-up outcomes were collected. Surgical parameters collected included approach, intraoperative findings, number of electrodes activated, and complications.
RESULTS: A total of 19 pediatric patients had an ABI placed at the authors\' institution, with a mean age at surgery of 4.7 years (range 1.5-17.8 years). A total of 17 patients (89.5%) had bilateral cochlear nerve aplasia/dysplasia, 1 (5.3%) had unilateral cochlear nerve aplasia/dysplasia, and 1 (5.3%) had a hypoplastic cochlea with ossification. A total of 11 patients (57.9%) had a history of cochlear implants that were ineffective and required removal. The mean length of implant use was 5.31 years (0.25-10 years). Two patients (10.5%) experienced CSF-related complications requiring further surgical intervention. The most recent audiometric outcomes demonstrated that 15 patients (78.9%) showed improvement in their hearing ability: 5 with sound/speech awareness, 5 able to discriminate among speech and environmental sounds, and 5 able to understand common phrases/conversation without lip reading. Nine patients (47.4%) are in a school for the deaf and 7 (36.8%) are in a mainstream school with support.
CONCLUSIONS: The authors\' surgical experience with a multidisciplinary team demonstrates that the retrosigmoid approach for ABI placement in children with inner ear pathologies and severe sensorineural hearing loss is a safe and effective treatment modality. Audiometric outcome data showed that nearly 79% of these patients had an improvement in their environmental and speech awareness. Further multicenter collaborations are necessary to improve these outcomes and potentially standardize/enhance electrode placement.
METHODS: An IRB-approved, retrospective chart review was conducted among the authors\' pediatric patients who had undergone auditory brainstem implantation between 2012 and 2021. Demographic information including sex, age, race, coexisting syndrome(s), history of cochlear implant placement, average duration of implant use, and follow-up outcomes were collected. Surgical parameters collected included approach, intraoperative findings, number of electrodes activated, and complications.
RESULTS: A total of 19 pediatric patients had an ABI placed at the authors\' institution, with a mean age at surgery of 4.7 years (range 1.5-17.8 years). A total of 17 patients (89.5%) had bilateral cochlear nerve aplasia/dysplasia, 1 (5.3%) had unilateral cochlear nerve aplasia/dysplasia, and 1 (5.3%) had a hypoplastic cochlea with ossification. A total of 11 patients (57.9%) had a history of cochlear implants that were ineffective and required removal. The mean length of implant use was 5.31 years (0.25-10 years). Two patients (10.5%) experienced CSF-related complications requiring further surgical intervention. The most recent audiometric outcomes demonstrated that 15 patients (78.9%) showed improvement in their hearing ability: 5 with sound/speech awareness, 5 able to discriminate among speech and environmental sounds, and 5 able to understand common phrases/conversation without lip reading. Nine patients (47.4%) are in a school for the deaf and 7 (36.8%) are in a mainstream school with support.
CONCLUSIONS: The authors\' surgical experience with a multidisciplinary team demonstrates that the retrosigmoid approach for ABI placement in children with inner ear pathologies and severe sensorineural hearing loss is a safe and effective treatment modality. Audiometric outcome data showed that nearly 79% of these patients had an improvement in their environmental and speech awareness. Further multicenter collaborations are necessary to improve these outcomes and potentially standardize/enhance electrode placement.
摘要：
目的：关于通过听觉脑干植入物（ABI）治疗的儿科数据仍然很少。作者旨在描述他们在机构的经验，并描绘相关的人口统计数据，听力测量结果，和手术参数。
方法：经IRB批准的，作者对2012年至2021年间接受听觉脑干植入术的儿科患者进行了回顾性图表回顾.人口统计信息，包括性别，年龄,种族,共存综合征，人工耳蜗植入的历史，植入物使用的平均持续时间，并收集随访结果.收集的手术参数包括入路，术中发现,激活的电极数量，和并发症。
结果：共有19名儿科患者在作者机构进行了ABI，手术时的平均年龄为4.7岁（范围为1.5-17.8岁）。共有17例(89.5%)患者出现双侧耳蜗神经发育不全/发育不良,1例（5.3%）单侧耳蜗神经发育不全/发育不良，1例(5.3%)耳蜗发育不良伴骨化。共有11例患者（57.9％）有无效的人工耳蜗植入史，需要切除。植入物使用的平均时间为5.31年（0.25-10年）。两名患者（10.5％）经历了与CSF相关的并发症，需要进一步的手术干预。最近的听力测量结果表明，15名患者（78.9％）表现出听力能力的改善：5名具有声音/言语意识，5能够区分语音和环境声音，和5能够理解常见的短语/对话没有唇读。9名患者(47.4%)在聋人学校，7名患者(36.8%)在主流学校接受支持。
结论：作者与多学科团队的手术经验表明，乙状窦后入路在患有内耳病变和严重感音神经性听力损失的儿童中放置ABI是一种安全有效的治疗方式。听力测量结果数据显示，这些患者中近79％的环境和言语意识有所改善。需要进一步的多中心合作来改善这些结果并可能标准化/增强电极放置。
方法：经IRB批准的，作者对2012年至2021年间接受听觉脑干植入术的儿科患者进行了回顾性图表回顾.人口统计信息，包括性别，年龄,种族,共存综合征，人工耳蜗植入的历史，植入物使用的平均持续时间，并收集随访结果.收集的手术参数包括入路，术中发现,激活的电极数量，和并发症。
结果：共有19名儿科患者在作者机构进行了ABI，手术时的平均年龄为4.7岁（范围为1.5-17.8岁）。共有17例(89.5%)患者出现双侧耳蜗神经发育不全/发育不良,1例（5.3%）单侧耳蜗神经发育不全/发育不良，1例(5.3%)耳蜗发育不良伴骨化。共有11例患者（57.9％）有无效的人工耳蜗植入史，需要切除。植入物使用的平均时间为5.31年（0.25-10年）。两名患者（10.5％）经历了与CSF相关的并发症，需要进一步的手术干预。最近的听力测量结果表明，15名患者（78.9％）表现出听力能力的改善：5名具有声音/言语意识，5能够区分语音和环境声音，和5能够理解常见的短语/对话没有唇读。9名患者(47.4%)在聋人学校，7名患者(36.8%)在主流学校接受支持。
结论：作者与多学科团队的手术经验表明，乙状窦后入路在患有内耳病变和严重感音神经性听力损失的儿童中放置ABI是一种安全有效的治疗方式。听力测量结果数据显示，这些患者中近79％的环境和言语意识有所改善。需要进一步的多中心合作来改善这些结果并可能标准化/增强电极放置。
