Long-term outcomes of pediatric bilateral sequential auditory brainstem implant user: A case report

Auditory brainstem implants (ABIs) are neuroprosthetic devices that stimulate the cochlear nuclei directly. Unilateral ABI applications are more common than bilateral. This paper reports our experience with a 7-year-old bilateral ABI user. Subjective and objective tests were applied, and bilateral profound sensorineural hearing loss was confirmed. The computerized tomography and magnetic resonance imaging of the temporal bone revealed bilateral cochlear aplasia with dilated vestibule. Intraoperative eABR was measured during both surgeries. Meaningful Auditory Integration Scale (MAIS), Categories of Auditory Performance (CAP) II, and Speech Intelligibility Rating (SIR) were used for evaluations of auditory perception. To evaluate auditory performance and hearing related quality of life, Functioning After Pediatric Cochlear Implantation instrument (FAPCI) and Pediatrics Quality of Life (PedsQL) scales were used. Free-field results improved rapidly following the second implant and soon reached 50-65 dB 0.5, 1, 2. and 4 kHz. With both implants, the CAP II and SIR scores were improved. ABI procedure is mostly performed unilaterally, but the outcomes tend to fall short of those attained by children with normal anatomy. Although our patient benefited significantly from her bilateral ABI, the surgery remains complex and is not routinely undertaken.