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Indications and contraindications of auditory brainstem implants: systematic review and illustrative cases

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Abstract

The number of non-neurofibromatosis type 2 (NF2) indications for auditory brainstem implant (ABI) in the literature is increasing. The objective of this study was to analyze and discuss the indications for ABI. Retrospective chart review and systematic review were conducted at Quaternary referral skull base center and referring centers. Analysis of ABI cases with non-NF2 indications and systematic review presenting non-NF2 ABI cases were performed. Fourteen referred cases with ABI were identified. All cases had unsatisfactory results of ABI and all could have been rehabilitated with a cochlear implant (CI). Of these 14 cases, 9 improved with a cochlear implant, and 2 with a hearing aid, two are still planned for CI, one received bilateral CI, no ABI. In literature, we found 31 articles presenting 144 non-NF2 ABI cases with at least 7 different indications other than NF2. ABI should be restricted to those patients who have no other rehabilitation options. Patency of the cochlea and evidence of an intact cochlear nerve should be examined with imaging and electrophysiologic testing. Sometimes a CI trial should be planned prior to proceeding with ABI. We have shown that in many cases a CI is still possible and CI provided better results than ABI. In vestibular schwannoma in the only hearing ear, cochlear otosclerosis, temporal bone fractures, (presumed) bilateral traumatic cochlear nerve disruption, auto-immune inner ear disease and auditory neuropathy primarily CI are indicated. Traumatic bilateral cochlear nerve disruption is exceptionally unlikely. In cochlear nerve aplasia, testing should be performed prior to meeting indications for ABI. In malformations, ABI is indicated only in severe cochlear hypoplasia or cochlear aplasia.

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Acknowledgments

We like to thank Spencer Voth, ENT surgeon, USA, for his excellent help.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, VU University Medical Center & EMGO+ Institute for Health and Care Research, KNO 1d-114, PO Box 7057, 1007 MB, Amsterdam, The Netherlands

    Paul Merkus

  2. Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy

    Fillipo Di Lella, Giuseppe Di Trapani & Mario Sanna

  3. Section of Middle Ear Microsurgery and Otoneurosurgery, Department of Otolaryngology-Head and Neck Surgery, University of Parma, Parma, Italy

    Enrico Pasanisi

  4. Department of Otolaryngology, S. Maria del Carmine Hospital, Rovereto, Italy

    Milo A. Beltrame

  5. Department of Otolaryngology, University of Brescia and S. Gerardo Hospital, Monza, Italy

    Diego Zanetti

  6. Department of Otolaryngology, Ramazzini Hospital, Carpi, Italy

    Maurizio Negri

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  1. Paul Merkus
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  2. Fillipo Di Lella
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  3. Giuseppe Di Trapani
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  8. Mario Sanna
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Correspondence to Paul Merkus.

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Merkus, P., Lella, F.D., Trapani, G.D. et al. Indications and contraindications of auditory brainstem implants: systematic review and illustrative cases. Eur Arch Otorhinolaryngol 271, 3–13 (2014). https://doi.org/10.1007/s00405-013-2378-3

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  • DOI: https://doi.org/10.1007/s00405-013-2378-3

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