New technologies in otorhinolaryngology: brainstem implantation
Janov Yu.K.¹, Kuzovkov V.E.¹, Koroleva I.V.^1,2, Levin S.V.^1,4, Behr R.³, Levina E.A.¹, Sugarova S.B.¹, Lilenko A.S.<sup>1

1</sup> St.Petersburg Research Institute of Ear, Nose, Throat and Speech
² Russian State Pedagogical University named after A.I. Herzen, St.Petersburg
³ Fulda Clinic, Germany
⁴ North-Western State Medical University named after I.I. Mechnikov, St.Petersburg 

Patients with deafness who have no surgical indications to the operation of cochlear implantation used to remain deaf for life.These are patients with retrochlear pathology and impaired cochlea development. To help this group of patients, a system of brainstem implantation was created. It is a modified cochlear implant that is installed by surgical operation in the brain stem on the surface of the cochlear nucleus.
Aim: to evaluate the effectiveness of the auditory brainstem implantation method in deaf patients.
Patients and Methods. 3 patients were selected. Two adult patients with type 2 neurofibromatosis and one child aged 2 years with bilateral cochlear aplasia. 
Results: In patients with the brainstem implantation, after connection of the speech processor, the hearing thresholds ranged from 50 to 60 dB in the frequency range from 500 Hz to 4,000 Hz. At the end of the first rehabilitation, the hearing thresholds were 45-50 dB. Adults perceived different sounds, distinguished words based on duration and syllabic structure. Six months after the connection, the patients showed a positive development of these skills. The child responded well to sounds of different frequencies. Pre-speech and speech vocalizations appeared. In 2 years after the operation, adult patients distinguished the words from the closed selection. The child had a passive vocabulary of about 200 words.
Conclusions: auditory brainstem implantation is a method of choice for the rehabilitation of deaf patients in which it is impossible or impractical to conduct a cochlear implantation. Adult patients note an improvement in the quality of their life. Speech intelligibility in this group of patients varies from 30% to 70%.

Key words: auditory brainstem implantation, cerebellopontine angle, implant, ventricle, brainstem implantation, auditory rehabilitation of deaf patients, deafness, cochlear implantation.
For citation: Janov Yu.K., Kuzovkov V.E., Koroleva I.V. et al. New technologies in otorhinolaryngology: brainstem implantation // RMJ. 2017. № 23. P. 1695–1698.