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Auditory brainstem implant in bilateral and completely ossified cochleae.

AbstractOBJECTIVE:
To report and evaluate the results of auditory brainstem implantation in a case of postmeningitis hearing loss with totally ossified cochleae on both sides.
STUDY DESIGN:
Case report.
SETTING:
Tertiary referral center.
PATIENT:
A 49-year-old man was referred to the authors' department for bilateral total hearing loss subsequent to bacterial meningitis 2 years earlier. Pure tone audiometry, auditory brainstem response tests, and promontory tests did not reveal any cochlear activity. Computed tomography showed bilateral and totally ossified cochleae. Magnetic resonance imaging confirmed the diagnosis by showing no cochlear signal on T2-weighed images and ruled out brainstem and cerebellopontine angle abnormalities.
INTERVENTION:
A left auditory brainstem implantation was performed through a translabyrinthine route, using a Nucleus 22-channel device.
MAIN OUTCOME MEASURES:
Word and sentence recognition tests in sound-only and sound plus vision modes.
RESULTS:
No postoperative complication was observed. Twelve electrodes could be activated, and their tonotopy was defined. Nine other electrodes were inactivated because of an absence of auditory response (4 electrodes) or paresthesia (5 electrodes). At the last follow-up visit, 26 months after the implantation, 50% of disyllabic word scores and 60% of sentence scores were achieved using auditory brainstem implant sound only. These scores reached 80% and 93%, respectively, with lip-reading.
CONCLUSION:
Auditory brainstem implantation is an efficient means of auditory rehabilitation in cases of bilateral total hearing loss with totally ossified cochleae. It should be considered in cases of predictable failure in cochlear implantation.
AuthorsAlexis Bozorg Grayeli, Didier Bouccara, Michel Kalamarides, Emmanuelle Ambert-Dahan, Christelle Coudert, Françoise Cyna-Gorse, Wolfgang-Peter Sollmann, Alain Rey, Olivier Sterkers
JournalOtology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 24 Issue 1 Pg. 79-82 (Jan 2003) ISSN: 1531-7129 [Print] United States
PMID12544033 (Publication Type: Case Reports, Journal Article)
Topics
  • Brain Stem (physiopathology, surgery)
  • Cochlear Diseases (physiopathology, rehabilitation)
  • Cochlear Implantation (methods)
  • Deafness (physiopathology, rehabilitation)
  • Evoked Potentials, Auditory, Brain Stem (physiology)
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningitis, Bacterial (complications)
  • Middle Aged
  • Ossification, Heterotopic (physiopathology, rehabilitation)
  • Postoperative Complications (physiopathology)
  • Prosthesis Design
  • Speech Perception (physiology)
  • Tomography, X-Ray Computed

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