Paediatric auditory brainstem implant: How we do it

BACKGROUND: The auditory brainstem implant (ABI) is a surgically implanted neuroprosthetic that may be used in the management of profound hearing loss in paediatric patients that are ineligible for cochlear implantation, primarily due to anatomical constraints. METHOD: We describe our technique for the implantation of a paediatric ABI. Surgical steps include post auricular incision, the creation of a periosteal flap, subperiosteal pocket and bony recess for the device, retrosigmoid craniotomy, placement of the electrodes adjacent to the cochlear nucleus and multi-layer closure. We highlight novel technical modifications to reduce the risk of complications and optimise outcomes. CONCLUSION: Paediatric auditory brainstem implants offer the possibility of sound awareness to patients with profound hearing loss that would not benefit from cochlear implantation or other hearing aid solutions.