Artikel
Clinical experience and results with auditory brainstem implants
Klinische Erfahrungen und Ergebnisse mit auditorischen Hirnstamm-Implantaten
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: On the basis of the excellent results in CI patients, the 12 channel Med-El device Combi 40 / 40+ was used and a special electrode for insertion into the lateral recess of the 4th ventricle for stimulation of the cochlear nucleus was developped. Hearing sensation and speech understanding should be restored by electrical stimulation of the cochlear nucleus.
Methods: 34 NF-2 patients were included up to now. In 29 patients 32 ABI probes were implanted, 3 patients were operated twice, 2 due to probe dislocation, one due to implant failure. For several reasons 5 patients were not implanted.
One of the implanted patients is a non user from the beginning; another patient experienced a deterioration of the disease and could not benefit from the implant any longer, before she used the device on a basic level.
Until now, 7 patients were implanted with the new Pulsar 100 device and will be reported separately. In 3 patients contralateral hearing was present and 3 patients were implanted in Asia, they were not tested, or from the latter no detailed data exist.
Results: The others use the implant on a daily basis. They have tonotopy, sound discrimination and are able to perceive daily life and warning sounds. In the first 6 months period, the average increase of sentence lip reading ranges from 19.4% without implant to 59.6% with ABI (n=9). The average rate of Freiburg numbers in open set ABI only users was 40.1% (n=8), and 46% sentences (n=4). In those and ABI plus rip reading patients the rate was 58.5% sentences (n=12) and 53.3% numbers (n=9). In the 2 years period in lip reading plus ABI mode, sentence recognition was 67.5 (n=9) and numbers 81.3 (n=5). ABI only results were 42.7% sentences (n=8) and 51.7 numbers (n=9). Both groups together scored 71.1% correct sentences (n=12) and 78.5% numbers (n=11). More than 50% of the evaluated patients have open speech understanding at different performance levels. Three patients are able to use the telephone on a basic level. Complications attributed to ABI implantation are mainly CSF leakage, no neurological or other major complications occurred.
Conclusions: ABI implantation, and the device used, is a reliable and safe method for hearing rehabilitation and restoration in NF-2 patients.