title: Auditory brainstem implantation in a 16-month-old boy with cochlear hypoplasia.
abstract: OBJECTIVE
  To determine the safety and feasibility of auditory brainstem implantation in children younger than 5 years.
  
  
  METHODS
  Patients younger than 5 years who were not candidates for cochlear implantation because of anatomic considerations were included in the analyses.
  
  
  METHODS
  Auditory brainstem implantation via retrosigmoid craniotomy.
  
  
  METHODS
  Audiologic, speech, quality of life, and safety outcomes were assessed.
  
  
  RESULTS
  Auditory brainstem implantation was performed in a 16-month-old male infant with bilateral cochlear hypoplasia and cochlear nerve hypoplasia after a prior aborted attempt at cochlear implantation. Intraoperatively, multiphasic evoked auditory brainstem responses (EABRs) characteristic of synchronized responses of central auditory pathways were obtained on multiple electrodes. There were no complications in the immediate postoperative period, and the child was discharged home on Postoperative Day 4. Audiologic testing 2 and 4 months after activation indicated sound detection between 45 and 70 dB HL for warble tones, improvements in Infant Meaningful Auditory Integration Scale scores, and subjective gains in sound awareness, as well as quality of life measures. There were no major or minor complications of the procedure.
  
  
  CONCLUSIONS
  Based on our experience in combination with the work of others internationally, auditory brainstem implantation is feasible and safe in children younger than 5 years.
authors.affiliation: *Department of Otolaryngology, Massachusetts Eye and Ear Infirmary; †Department of Otology and Laryngology, Harvard Medical School; ‡Department of Audiology, Massachusetts Eye and Ear Infirmary; §Departments of Pediatric Neurosurgery and ∥Neurosurgery, Massachusetts General Hospital; and ¶Department of Surgery (Neurosurgery), Harvard Medical School, Boston, Massachusetts, U.S.A.
authors.forename: Sidharth V
authors.initials: SV
authors.lastname: Puram
authors.forename: Aaron D
authors.initials: AD
authors.lastname: Tward
authors.forename: David H
authors.initials: DH
authors.lastname: Jung
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Dilger
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Herrmann
authors.forename: Ann-Christine
authors.initials: AC
authors.lastname: Duhaime
authors.forename: Fred G
authors.initials: FG
authors.lastname: Barker
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D038263:Auditory Brain Stem Implantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000002:abnormalities*; D003056:Cochlear Nerve / Q000002:abnormalities*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006309:Hearing / Q000502:physiology; D006312:Hearing Loss, Bilateral / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male