First Auditory Brain Stem Implant in New England

May 2009

Editor: I have to admit I was a little surprised by this story. I thought that auditory brainstem implant operations were common enough that some would have been performed in all regions of the country. In any case, the folks at the Massachusetts Eye and Ear Infirmary and Mass. General Hospital have done the first one in New England. Here's the story.

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Surgeons from Massachusetts Eye and Ear Infirmary and Mass. General Hospital will perform the first Auditory Brain Stem Implant (ABI) surgery in New England on May 20.

The ABI, which can restore the sense of hearing to certain patients, has been implanted in about 500 people worldwide. Since its initial development in 1979 at the House Ear Institute in California, and with its approval by the Food and Drug Administration in 2000, the ABI is used primarily to restore some degree of hearing loss due to Neurofibromatosis Type 2 (NF2).

NF2 is a hereditary disease that causes the growth of multiple brain tumors, including bilateral tumors on both balance nerves. Because the auditory nerve is located near the balance nerve, the auditory nerve is damaged from tumor growth or surgical removal. Once this happens, the auditory nerve is unable to transmit signals to the brain, causing deafness. Virtually all NF2 patients develop severe to profound hearing loss in both ears.

Unlike a cochlear implant, the ABI bypasses the inner ear and auditory nerve and is surgically implanted on the cochlear nucleus, a bundle of nerves located on the brainstem. The ABI electrically activates nerves in the brainstem and restores a sense of hearing to patients with NF2. The current device is the only hearing option for deaf NF2 patients and allows them to hear sounds in their environment, such as horns and doorbells, as well as enhancing communication when combined with lip-reading. The ABI provides an option for those with hearing loss for whom other surgical methods to restore hearing loss are not possible.

Encouraging new work from abroad has also shown the recent success of ABI to restore meaningful hearing in both pediatric and adult non-NF2 patients who are deaf and cannot receive cochlear implants, such as those born without auditory nerves or others who have severely scarred inner ears. Several FDA approved studies in the United States are now underway.

History and Development of the Helene and Grant Wilson ABI Program at Mass. Eye and Ear

The ABI program at Mass. Eye and Ear and Mass. General Hospital was founded with a generous gift from Helene and Grant Wilson. The program is comprised of a multidisciplinary team including audiologists, hearing scientists, neurotologists and neurosurgeons, and provides both clinical care to patients as well as performing research and development to discover ways to advance the technology and improve ABI performance.

Objectives of the Wilson ABI Program include working to develop a measurement system that would be used during surgical implantation to allow for more accurate location of the cochlear nucleus, as well as where to place the device on the cochlear nucleus to achieve the best results.

This ABI surgery will be performed at Massachusetts General Hospital by a team of specialists including Dr. Daniel Lee and Dr. Fred Barker. All follow-up care will be provided at Mass. Eye and Ear. This program is the first of its kind in the New England area.

ABI Program Faculty:

Surgeons, Mass. Eye and Ear: Daniel Lee, M.D., Michael McKenna, M.D., Ron deVenecia, M.D., Ph.D.

Surgeons, MGH: Frederick Barker, M.D., Robert Martuza, M.D.

Audiologists: Barbara Herrmann, Ph.D., Sharon Kujawa, Ph.D., Michael Skrip, Au.D.

Scientists: M. Christian Brown, Ph.D., Donald Eddington, Ph.D., Ken Hancock, Ph.D.

WEB LINKS of possible interest:

http://www.masseyeandear.org/specialties/otolaryngology/otology-neurotology/

http://www.masseyeandear.org/research/ent/eaton-peabody/epl-investigators/

http://harvardabi.org/