title: [A report of three cases and review of auditory brainstem implants in children].
abstract: OBJECTIVE
  To present three pediatric cases of auditory brainstem implantation (ABI) and review literature data concerning this topic.
  
  
  METHODS
  The first two children had a neurofibromatosis type II with bilateral sensorineural deafness; in both cases, the implant was inserted during the surgical removal of a vestibular schwannoma; the third patient had profound deafness due to bilateral cochlear nerve insufficiency associated with inner ear malformation.
  
  
  RESULTS
  Two postoperative complications were observed: patient 1 had a persistent fever which required the replacement of the fat graft used to seal the translabyrinthine approach; patient 3 had a CSF leakage requiring additional surgery and lumbar external drainage. In our three patients, the numbers of active electrodes were 6/22 (Cochlear ABI 24M ABI), 11/12 (Medel Opus II ABI) and 11/12 (implant Medel), respectively. Due to additional major surgical procedures and to disappointing functional results of the ABI, patient 1 stopped wearing her implant 18 months after implantation. Nine months after surgery, patient 2 achieved open-set speech recognition and was very satisfied with the implant. Six months after implantation, patient 3 (cochlear nerve deficiency), who was 3.5 years-old at the time, clearly reacted to some environmental sounds but was not yet able to achieve speech recognition.
  
  
  CONCLUSIONS
  ABI has now entered the list of treatments that can be proposed in pediatric profound sensorineural deafness. Its major risks of complications are CSF leakage and non-auditory side effects. Its outcomes are worse and less predictable than cochlear implants. Thus, its indications must remain restricted to cases meeting the following conditions: absence of alternative option to restore hearing, patients and parents high level of motivation and realistic expectations.
authors.affiliation: Service d'ORL pédiatrique, université Paris Descartes, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France. Electronic address: vincent.couloigner@nck.aphp.fr.
authors.forename: V
authors.initials: V
authors.lastname: Couloigner
authors.affiliation: Service d'ORL pédiatrique, université Paris Descartes, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Gratacap
authors.affiliation: Service d'ORL, université Pierre-et-Marie-Curie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Ambert-Dahan
authors.affiliation: Service d'ORL, université Pierre-et-Marie-Curie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Borel
authors.affiliation: Service d'ORL pédiatrique, université Paris Descartes, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Ettienne
authors.affiliation: Service d'ORL pédiatrique, université Paris Descartes, hôpital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Kerouedan
authors.affiliation: Service d'ORL, université Pierre-et-Marie-Curie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Bouccara
authors.affiliation: Service de neurochirurgie, université Paris Descartes, hôpital Necker-Enfants-Malades, AP-HP, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Zerah
authors.affiliation: Service de neurochirurgie, université Pierre-et-Marie-Curie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Kalamarides
authors.affiliation: Service d'ORL, université Pierre-et-Marie-Curie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Sterkers
mesh_terms: D038262:Auditory Brain Stem Implants; D001933:Brain Stem / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D016518:Neurofibromatosis 2 / Q000175:diagnosis / Q000601:surgery*; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cochlear nerve deficiency; Deafness; Dysplasie du nerf cochléaire; Hearing loss; NF2; Neurofibromatose de type 2; Neurofibromatosis type II; Surdité