Pediatric auditory brainstem implantation: current status

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Mohan Kameswaran

Madras ENT Research Foundation, India

: J Otol Rhinol

Abstract

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Introduction: Auditory brainstem implant (ABI) is increasingly being used for non-tumoral indications, especially in pre-lingually deaf children with bilateral cochlear nerve aplasia. Apart from cochlear nerve aplasia, complete labyrinthine aplasia, cochlear aplasia and cochlear aperture aplasia are well-defined congenital indications for an ABI. The ABI bypasses the cochlear nerves and directly stimulates the cochlear nucleus. Materials and Methods: 30 pediatric patients with bilateral cochlear aplasia and cochlear nerve aplasia underwent ABI surgery over a 9 year period. The retrosigmoid approach was used in all patients. Results: Intensive post-operative habilitation was given to the implantees and the outcomes were found to improve with the duration of habilitation. Overall, the results of pediatric ABI were found to be satisfactory. Conclusion: The indications for pediatric ABI have evolved over the years. Appropriate selection of patients, thorough knowledge of anatomy, meticulous surgical technique and intensive postoperative habilitation are vital to achieve optimal outcomes. Recent Publications 1. Colletti V, Carner M, Fiorino F, Sacchetto L, Miorelli V, Orsi A, Cilurzo F and Pacini L (2002) Hearing restoration with auditory brainstem implant in three children with cochlear nerve aplasia. Otology & Neurotology 23(5):682-93. 2. Sidharth V Puram and Daniel J Lee (2015) Pediatric auditory brainstem implant surgery. Otolaryngologic Clinics of North America 48(6):1117-1148. 3. A K Klose and W P Sollmann (2000) Anatomical variations of landmarks for implantation at the cochlear nucleus. The Journal of Laryngology & Otology 114(27):8-10. 4. Rafael da Costa Monsanto, Aline Gomes Bittencourt, Natal José Bobato Neto, et al. (2014) Auditory brainstem implants in children: results based on a review of the literature. Journal of International Advanced Otology 10(3): 284-90. 5. Colletti V (2006) Auditory outcomes in tumor vs. nontumor patients fitted with auditory brainstem implants. Advances in Oto-Rhino-Laryngology 64:167-185.

Biography

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Mohan Kameswaran, Managing Director & Senior Consultant of Madras ENT Research Foundation, is the Visiting Professor of Rajah Muthiah Medical College Hospital, Annamalai University, Chidambaram and at Sri Ramachandra Medical University, Chennai. He graduated from Madras Medical College. He got his MS from Madras Medical College, Chennai and his Fellowship at the Royal College of Surgeons, Edinburgh. He has received several gold medals in his undergraduate and postgraduate days. He has been a recipient of the ‘PADMA SHRI’ National Award by the Government of India in recognition of his distinguished and exceptional service in the field of Medicine in 2006. Prof. Mohan Kameswaran was elected as an Executive Board Member of the International Federation of Otorhinolaryngological Societies (IFOS), in the recently concluded XIX WORLD CONGRESS OF OTO-RHINO-LARYNGOLOGY held from June 1 to 5, 2009 at São Paulo, Brazil. He is the FIRST Surgeon in South and South East Asia to have performed the AUDITORY BRAIN STEM IMPLANT and the FIRST PAEDIATRIC BRAINSTEM IMPLANT in Asia, January 2009. He is also the FIRST surgeon in Asia Pacific region to have performed the TOTALLY IMPLANTABLE HEARING DEVICE surgery.Along with general ENT Surgical work, he has focused on Cochlear Implants, Laser Surgery, Endoscopic Sinus Surgery and Skull Base Surgery. He is a pioneer in cochlear implant surgery and has the distinction of doing the first Contour Cochlear Implant & Freedom implant in the country. He is the first surgeon in India & South East Asia to have performed the Auditory Brain Stem Implant merfmk30@yahoo.com