Systematic Review of Nontumor Pediatric Auditory Brainstem Implant Outcomes. (November 2015)

• Record Type: Journal Article
• Authors: Noij, Kimberley S.; Kozin, Elliott D.; Sethi, Rosh; Shah, Parth V.; Kaplan, Alyson B.; Herrmann, Barbara; Remenschneider, Aaron; Lee, Daniel J.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 153:Number 5(2015:Nov.)
• Page Start: 739
• Page End: 750
• Publication Date: 2015-11
• Subjects: auditory brainstem implant -- nontumor -- pediatric -- children -- deafness -- hearing loss -- systematic review -- review; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599815596929
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: The auditory brainstem implant (ABI) was initially developed for patients with deafness as a result of neurofibromatosis type 2. ABI indications have recently extended to children with congenital deafness who are not cochlear implant candidates. Few multi-institutional outcome data exist. Herein, we aim to provide a systematic review of outcomes following implantation of the ABI in pediatric patients with nontumor diagnosis, with a focus on audiometric outcomes. Data Sources: PubMed, Embase, and Cochrane. Review Methods: A systematic review of literature was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations. Variables assessed included age at implantation, diagnosis, medical history, cochlear implant history, radiographic findings, ABI device implanted, surgical approach, complications, side effects, and auditory outcomes. Results: The initial search identified 304 articles; 21 met inclusion criteria for a total of 162 children. The majority of these patients had cochlear nerve aplasia (63.6%, 103 of 162). Cerebrospinal fluid leak occurred in up to 8.5% of cases. Audiometric outcomes improved over time. After 5 years, almost 50% of patients reached Categories of Auditory Performance scores >4; however, patients with nonauditory disabilities did not demonstrate a similar increase in scores. Conclusion: ABI surgery is a reasonable option for the habilitation of deaf children who are not cochlear implant candidates. Although improvement in Categories of Auditory Performance scores was seen across studies, pediatric ABI users with nonauditory disabilities have inferior audiometric outcomes.