Auditory brainstem implantation in a 16-month-old boy with cochlear hypoplasia

Objective: To determine the safety and feasibility of auditory brainstem implantation in children younger than 5 years. Patient(s): Patients younger than 5 years who were not candidates for cochlear implantation because of anatomic considerations were included in the analyses. Intervention(s): Auditory brainstem implantation via retrosigmoid craniotomy. Main Outcome Measure(s): Audiologic, speech, quality of life, and safety outcomes were assessed. Results: Auditory brainstem implantation was performed in a 16-month-old male infant with bilateral cochlear hypoplasia and cochlear nerve hypoplasia after a prior aborted attempt at cochlear implantation. Intraoperatively, multiphasic evoked auditory brainstem responses (EABRs) characteristic of synchronized responses of central auditory pathways were obtained on multiple electrodes. There were no complications in the immediate postoperative period, and the child was discharged home on Postoperative Day 4. Audiologic testing 2 and 4 months after activation indicated sound detection between 45 and 70 dB HL for warble tones, improvements in Infant Meaningful Auditory Integration Scale scores, and subjective gains in sound awareness, as well as quality of life measures. There were no major or minor complications of the procedure. Conclusion: Based on our experience in combination with the work of others internationally, auditory brainstem implantation is feasible and safe in children younger than 5 years.