Auditory brainstem implant: I. Issues in surgical implantation

D. E. Brackmann, W. E. Hitselberger, R. A. Nelson, J. Moore, M. D. Waring, F. Portillo, R. V. Shannon, Fred F Telischi

Research output: Contribution to journalArticle

163 Citations (Scopus)

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
Pages (from-to)624-633
Number of pages10
JournalOtolaryngology - Head and Neck Surgery
Volume108
Issue number6
StatePublished - Jan 1 1993

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Auditory Brain Stem Implants
Electrodes
Neurofibromatosis 2
Anatomic Landmarks
Brain Stem
Cochlear Nucleus
Fourth Ventricle
Auditory Evoked Potentials
Polyethylene Terephthalates
Acoustic Neuroma
Cochlear Implants
Cranial Nerves
Platinum
Animal Models

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Brackmann, D. E., Hitselberger, W. E., Nelson, R. A., Moore, J., Waring, M. D., Portillo, F., ... Telischi, F. F. (1993). Auditory brainstem implant: I. Issues in surgical implantation. Otolaryngology - Head and Neck Surgery, 108(6), 624-633.

Auditory brainstem implant : I. Issues in surgical implantation. / Brackmann, D. E.; Hitselberger, W. E.; Nelson, R. A.; Moore, J.; Waring, M. D.; Portillo, F.; Shannon, R. V.; Telischi, Fred F.

In: Otolaryngology - Head and Neck Surgery, Vol. 108, No. 6, 01.01.1993, p. 624-633.

Research output: Contribution to journalArticle

Brackmann, DE, Hitselberger, WE, Nelson, RA, Moore, J, Waring, MD, Portillo, F, Shannon, RV & Telischi, FF 1993, 'Auditory brainstem implant: I. Issues in surgical implantation', Otolaryngology - Head and Neck Surgery, vol. 108, no. 6, pp. 624-633.
Brackmann DE, Hitselberger WE, Nelson RA, Moore J, Waring MD, Portillo F et al. Auditory brainstem implant: I. Issues in surgical implantation. Otolaryngology - Head and Neck Surgery. 1993 Jan 1;108(6):624-633.
Brackmann, D. E. ; Hitselberger, W. E. ; Nelson, R. A. ; Moore, J. ; Waring, M. D. ; Portillo, F. ; Shannon, R. V. ; Telischi, Fred F. / Auditory brainstem implant : I. Issues in surgical implantation. In: Otolaryngology - Head and Neck Surgery. 1993 ; Vol. 108, No. 6. pp. 624-633.
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