Cochlear implantation versus auditory brainstem implantation in the management of complex inner ear malformations

Hearing rehabilitation in complex inner ear malformations offers unique challenges and requires a multidisciplinary approach for treatment. Cochlear implantation is safe and reliable in these cases and many patients are able to achieve open-set speech perception. More severe malformations require careful preoperative planning and counseling as they can be associated with aberrant facial nerve anatomy, CSF gusher, electrode misplacement, or increased performance variability. For cases associated with limited benefit from CI or severe malformations, ABI placement is an important alternative. Most ABI users are able to attain sound detection with a benefit from sound awareness, while some develop closed-set speech perception and a limited number achieve open-set speech perception.