Procedure Type
SurgicalProcedure Duration
4 - 6 hoursHospital Stay (Days)
5 - 10 daysAn Auditory Brainstem Implant (ABI) is a specialized electronic device designed to restore a sense of hearing in individuals who are profoundly deaf and cannot benefit from cochlear implants due to damage or absence of the cochlear nerve. This condition is often found in people with neurofibromatosis type II (NF2), a rare genetic disorder that leads to tumors on the auditory nerves. Unlike cochlear implants that stimulate the cochlea directly, ABIs bypass the inner ear altogether and directly stimulate the brainstem's cochlear nucleus to provide auditory perception.
The ABI is typically recommended for individuals with bilateral cochlear nerve damage, most commonly due to tumors such as vestibular schwannomas associated with NF2. It is also considered in patients with malformed inner ears or those who have suffered trauma or infections that have destroyed the cochlear nerves. Candidates undergo thorough evaluation by a multidisciplinary team that includes audiologists, neurologists, ENT surgeons, and radiologists to confirm eligibility and potential benefit.
The ABI system consists of two main parts: an internal implant and an external audio processor. The internal component is surgically placed on the surface of the cochlear nucleus in the brainstem. The external part, worn behind the ear, includes a microphone that picks up sounds from the environment and converts them into electrical signals. These signals are then transmitted to the implant via a magnetic coil, which in turn stimulates the brainstem to create sound perception. Although the sound quality is not identical to natural hearing, the ABI allows users to detect sounds, environmental cues, and in some cases, understand speech with practice and training.
Auditory brainstem implant surgery is a delicate neurosurgical procedure performed under general anesthesia. The surgeon gains access to the brainstem through a small opening made in the skull, usually at the back of the head. Using precise imaging and microsurgical tools, the implant is carefully placed on the cochlear nucleus of the brainstem. After securing the electrode array, the external part of the device is fitted after the healing period. The surgery typically lasts several hours and is followed by a recovery period in the hospital for monitoring.
PRINCIPAL DIRECTOR ENT
MBBS, MS - ENT, DNB - Otorhinolaryngology ENT/ Otorhinolaryngologist
Following the surgery, patients may experience general discomfort, headache, or dizziness as they recover from the operation. A healing period of about four to six weeks is required before the external sound processor can be activated. Once the system is turned on, patients begin a process of auditory training and speech therapy to adapt to the new way of hearing. While the initial sound may feel unusual or artificial, most users gradually adapt and improve their ability to interpret sounds with consistent use and support from audiologists.
The primary benefit of an ABI is that it provides access to sound for individuals who otherwise have no means of hearing. It can improve safety, communication, and quality of life by enabling users to detect warning signals, environmental noises, and, with effort, human speech. In children born without auditory nerves, early implantation may support the development of basic speech and language skills, although outcomes vary widely depending on age, condition, and therapy.
As with any brain surgery, auditory brainstem implant procedures carry risks, including infection, bleeding, cerebrospinal fluid leakage, or injury to surrounding brain structures. Post-surgical complications may include facial nerve weakness, balance issues, or headaches. Device-specific risks include limited sound clarity and the need for future adjustments or replacements. However, these risks are generally well managed in experienced medical centers.
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