Auditory brainstem implant: I. issues in surgical implantation

Derald E. Brackmann, William E. Hitselberger, Ralph A. Nelson, Jean Moore, Michael D. Waring, Franco Portillo, Robert V. Shannon, Fred F. Telischi

Research output: Contribution to journalArticle

163 Scopus citations

Abstract

Most patients with neurofibromatosis type 2 (NF2) are totally deaf after removal of their bilateral acoustic neuromas. Twenty-five patients with neurofibromatosis type 2 have been implanted with a brainstem electrode during surgery to remove an acoustic neuroma. The electrode is positioned in the lateral recess of the fourth ventricle, adjacent to the cochlear nuclei. The present electrode consists of three platinum plates mounted on a Dacron mesh backing, a design that has been demonstrated to be biocompatible and positionally stable in an animal model. Correct electrode placement depends on accurate identification of anatomic landmarks from the translabyrinthine surgical approach and also on intrasurgical electrophysiologic monitoring. Some tumors and their removal can result in significant distortion of the brainstem and surrounding structures. Even in the absence of identifiable anatomic landmarks, electrode location can be adjusted during surgical placement to find the location that maximizes the auditory evoked response and minimizes activation of other monitored cranial nerves. Stimulation of the electrodes produces auditory sensations in most patients, with results similar to those of single-channel cochlear implants. A coordinated multidisciplinary team is essential for successful application of an auditory brainstem implant.

Original languageEnglish (US)
Pages (from-to)624-633
Number of pages10
JournalOtolaryngology-Head and Neck Surgery
Volume108
Issue number6
DOIs
StatePublished - Jun 1993

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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    Brackmann, D. E., Hitselberger, W. E., Nelson, R. A., Moore, J., Waring, M. D., Portillo, F., Shannon, R. V., & Telischi, F. F. (1993). Auditory brainstem implant: I. issues in surgical implantation. Otolaryngology-Head and Neck Surgery, 108(6), 624-633. https://doi.org/10.1177/019459989310800602