Initial Outcomes of Auditory Brainstem Implants in Children receiving Auditory-Verbal Therapy

Background: Over the last number of years Auditory Brainstem Implant (ABI) candidacy has expanded to include pediatric populations. Whilst many patients show some level of benefit, outcomes have been limited and few achieve open set speech recognition. In 2017, ABI surgery was performed for the first time in Israel at the Shaare Zedek Medical Centre. This study follows the outcomes of the first patients of the Shaare Zedek ABI program.

Objective: To review the latest outcomes of 3 patients implanted with an ABI who are receiving Auditory- Verbal Therapy.

Methods: Two children with cochlear nerve deficiency and one with cochlea aplasia underwent Auditory Brainstem Implantation with a Cochlear ABI 541 device. The children were aged 1:11, 4:1 and 4:11 at the time of implantation. No known additional disabilities were identified. All children are being followed up and mapped at Shaare Zedek and are enrolled in and committed to an Auditory Verbal Therapy program. A systematic review of current audiological and language data (including map parameters, aided audiograms and age appropriate speech perception outcomes) was conducted.

Results: All children have demonstrated significant improvement since initial activation. Map parameters varied in terms of number of active electrodes (influenced by the degree of non-auditory stimulation), pulse width and maxima. Aided audiograms were shown to be similar to those obtained with a cochlear implant. The child with the longest duration of implant use demonstrated significant open set speech perception and has shown improvement in the contralateral cochlear implant ear.

Conclusion: Whilst further follow up of these patients is warranted, initial data has shown good progression in the development of speech and language through the auditory channel with the ABI. The lack of co-morbid conditions and the commitment of the parents to an Auditory-Verbal Therapy program may be instrumental in determining the level of potential benefit.