Restoration of Hearing with ABI in Prelingual Deaf Children

Objective: The objective of this study was to demonstrate the effectiveness of ABI in prelingual deaf children for restoration of hearing. Methods: The MedEl ABI system was used in 20 implantations in 19 children. One child had revision surgery. Mean age was 3.5 years, range 1.25 to 6.5. Surgery was performed in supine position with retrosigmoid approach, multimodal monitoring, and E-BERA. Results: Magnetic resonance imaging and computed tomography revealed in 13 children aplasia of N.8. Six had cochlear nerve dysplasia with hypoplasia of N.8. In most cases, surgery was difficult due to complete or partial occlusion of the foramen of Luschka. In 75% branches of the AICA were crossing the implant site. In each case, the electrode paddle was small enough to fit properly into the recess. E-BERA recordings could be derived in each case. There were four subcutaneous cerebrospinal fluid leaks but no neurologic complications. All children with activated device regained sound awareness using the implant all day. Four regained word recognition and Ling sound detection, three started to use speech, and one even bilingual. Conclusion: ABI is a safe and successful procedure for restoration of hearing and speech in prelingual deaf children. Precious time of plasticity of the auditory pathways should be used as early and intensively as possible. Therefore, in doubtful CI candidates, ABI should be the primary indication.