Fayad Jose N, Otto Steven R, Brackmann Derald E
House Clinic, Los Angeles, Calif., USA.
Adv Otorhinolaryngol. 2006;64:144-153. doi: 10.1159/000094649.
Patients with neurofibromatosis type 2 often develop bilateral life-threatening vestibular schwannoma necessitating tumor removal, which results in deafness. We developed the auditory brainstem implant (ABI) in order to be able to electrically stimulate the cochlear nucleus complex in patients with bilateral cochlear nerve injury from bilateral schwannoma. After tumor removal, the electrode array of the ABI is inserted into the lateral recess of the fourth ventricle and placed over the surface of the ventral and dorsal cochlear nuclei. The ABI is designed to stimulate auditory neural structures within the cochlear nucleus in order to convey salient cues about the frequency, amplitude, and temporal characteristics of sounds. To date, more than 200 patients have received an ABI device at our institution. Recently, penetrating ABIs were introduced, and preliminary results of penetrating ABIs are discussed in this paper. The surgical anatomy of the nucleus and surgical placement of the ABI in patients with neurofibromatosis type 2 are described, and surgical considerations in this group of challenging patients are detailed.
2型神经纤维瘤病患者常发生双侧危及生命的前庭神经鞘瘤，需要切除肿瘤，这会导致耳聋。我们研发了听觉脑干植入物（ABI），以便能够对双侧神经鞘瘤导致双侧耳蜗神经损伤的患者的耳蜗核复合体进行电刺激。肿瘤切除后，将ABI的电极阵列插入第四脑室的外侧隐窝，并放置在腹侧和背侧耳蜗核表面。ABI旨在刺激耳蜗核内的听觉神经结构，以传递有关声音频率、幅度和时间特征的显著线索。到目前为止，我们机构已有200多名患者接受了ABI装置。最近，引入了穿透性ABI，本文讨论了穿透性ABI的初步结果。描述了2型神经纤维瘤病患者中核的手术解剖结构和ABI的手术放置，并详细说明了这组具有挑战性的患者的手术注意事项。
