title: Cochlear implantation and contralateral auditory brainstem implantation.
abstract: OBJECTIVE
  Report outcomes of 2 first known cases using a cochlear implant (CI) and a contralateral auditory brainstem implant (ABI).
  
  
  METHODS
  Two adult patients with postlingual sensorineural deafness.
  
  
  METHODS
  Both patients had unilateral CI insertion followed by contralateral ABI insertion. In 1 case, there was a large left vestibular schwannoma in the only hearing left ear. CI insertion was first performed in the right longstanding deaf ear. Shortly afterward during the left translabyrinthine surgery, a left ABI was simultaneously inserted. The second patient had Ménière's disease controlled initially by right translabyrinthine vestibular neurectomy but complicated by a right dead ear. When symptoms recurred she underwent left retrosigmoid vestibular neurectomy with auditory nerve preservation. This allowed left CI insertion and a subsequent right ABI insertion.
  
  
  METHODS
  Pure tone audiometry (PTA), speech discrimination in quiet (SDq), speech discrimination in noise (SDn), and sound localization. Testing was performed with the following: 1) ABI activated alone, 2) CI activated alone, 3) CI and ABI activation (CI-ABI), and 4) CI linked to a contralateral routing of sound (CROS) hearing aid system (CI-CROS). Quality of life assessments were made using a validated questionnaire.
  
  
  RESULTS
  PTA was worst with the ABI activated alone. SDq was best with the CI-CROS. Regarding SDn with noise coming from the CI side, the head shadow effect was only overcome by the CI-ABI; however, the CI-CROS worked best in the presence of noise opposite to the CI. The CI activated alone and CI-ABI produced useful sound localization. Quality-of-life assessments were best with the CI-CROS.
  
  
  CONCLUSIONS
  Bilateral sound detection seems more beneficial than unilateral in profoundly deaf cases with only 1 functioning auditory nerve. A CI-CROS may produce similar gains to a CI-ABI.
authors: Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Nord-Chemin des Bourrelly, Marseille, France. rajsinn@aol.com
authors: Arasa Raj
authors: AR
authors: Sinnathuray
authors: Renaud
authors: R
authors: Meller
authors: Marie
authors: M
authors: Cosso
authors: Jacques
authors: J
authors: Magnan
mesh_terms: D001301:Audiometry, Pure-Tone; D038263:Auditory Brain Stem Implantation / Q000379:methods*; D019929:Cochlear Implantation / Q000379:methods*; D003056:Cochlear Nerve / Q000503:physiopathology; D007758:Ear, Inner / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006053:Goldenhar Syndrome / Q000150:complications; D006319:Hearing Loss, Sensorineural / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000601:surgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications; D011788:Quality of Life; D013017:Sound Localization / Q000502:physiology; D013063:Speech Discrimination Tests; D013067:Speech Perception / Q000502:physiology; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000601:surgery; D055815:Young Adult