Surgery for auditory brainstem implantation

Patients with neurofibromatosis 2 present complex and challenging management dilemmas. Surgical removal of vestibular schwannomas often results in total hearing loss. Early diagnosis using gadolinium-enhanced magnetic resonance imaging and refinements in hearing preservation surgery have improved our ability to prevent total hearing loss while achieving complete removal in smaller tumors, but for patients with larger tumors or for those with no useful hearing in that ear, the auditory brainstem implant (ABI) allows restoration of some auditory function when the tumor is removed. Additionally, children with cochlear aplasia and cochlear nerve deficiency have begun to be implanted with ABIs, with varied results. This article discusses surgical placement of the ABI.