Auditory brainstem implantation in patient with bilateral acoustic neuromas

Abstract

To restore auditory sensation for patient suffering loss of hearing due to bilateral acoustic neuromas. One patient of bilateral acoustic neuromas received auditory brainstem implant (ABI) at the same surgery for resection of the second tumor. The retrosigmoid approach was used for resection of the tumor and to exposure the lateral recess of the fourth ventricle for placement of ABI electrode array. Intraoperative 7th and 9th nerves monitoring and electrically evoked auditory brainstem responses (EABR) were recorded to localize the placement of ABI electrode array. Initial ABI switch-on was performed eight weeks after the surgery under close monitoring of vital signs. Auditory sensation was perceived on stimulation of all channels. The multichannel ABI could effectively restore auditory sensation for patient deafened by bilateral acoustic neuromas. The accurate location of the cochlear complex during surgery was the critical factor for success of ABI.

目的:探討聽覺腦干置入(ABI)用于雙側聽神經瘤全聾患者的聽力康復。方法:對1例雙側聽神經瘤全聾患者,在經乙狀竇枕下徑路切除第2側聽神經瘤時,同期將12道聽覺腦干裝置的電極陣置入第4腦室的側隱窩內,術中行第Ⅶ、Ⅸ腦神經監測,并且記錄電刺激腦干誘發電位,以確定和校正電極位置。術后2個月開通電極并作調試。結果:術后頭顱X線側位片示電極位置正確,術后開通調試發現電刺激12個電極均能引起聽覺反應,無一電極引起非聽覺反應。結論:多道ABI能讓雙側聽神經瘤全聾患者產生有意義的聽覺。術中電極陣準確地置入到腦干耳蝸核是手術成功的關鍵。