Auditory Brainstem Implants

Cochlear implants require a functioning auditory nerve to transmit impulses from the cochlea to the auditory processing centers of the brainstem. In contrast, auditory brainstem implants (ABI) bypass the need for a functioning auditory nerve by directly stimulating the auditory processing centers of the brainstem. This class of auditory prosthesis currently represents the best auditory prosthesis for individuals with absence, malformation, or destruction of the auditory nerve. This device is commonly used in people with neurofibromatosis type II. [Colletti: 2012]
ABI components are similar to those found in cochlear implants and consist of an external speech processor and receiver that transmit sound waves in the form of electrical impulses to a microelectrode array. This array is inserted through an opening in the mastoid bone and is advanced to the lateral recess of the fourth ventricle, adjacent to the ventral cochlear nucleus.
The first generation of auditory brainstem implants were designed to stimulate the surface of the ventral cochlear nucleus in the auditory brainstem. [Hitselberger: 1984] These surface-electrode ABIs rarely provided the range of frequency information and resolution required for speech understanding, although speech reception in combination with lip-reading was markedly improved.
A new generation of ABIs has been designed that incorporates penetrating microelectrodes. These implants provide significant benefit in terms of hearing, language, and cognitive development for children who are not candidates for cochlear implantation. [Colletti: 2008] [Colletti: 2007]
Currently the US Food and Drug Administration has limited approval for ABIs. Children must be 12 years of age or older to be candidates for these implants. Other countries have different regulatory requirements.


Information & Support

For Parents and Patients

Auditory Brainstem Implant (Mayo Clinic)
Information about the Mayo Clinic’s auditory brainstem implantation program.

Auditory Brainstem Implants (Barrow Quarterly)
Detailed information about the history and development of auditory brainstem implants that includes surgical approaches in the US and Europe; Vol 20, No 4, 2004.

Helpful Articles

Rauschecker JP, Shannon RV.
Sending sound to the brain.
Science. 2002;295(5557):1025-9. PubMed abstract

House WF, Hitselberger WE.
Twenty-year report of the first auditory brain stem nucleus implant.
Ann Otol Rhinol Laryngol. 2001;110(2):103-4. PubMed abstract

Lim HH, Lenarz M, Lenarz T.
Auditory midbrain implant: a review.
Trends Amplif. 2009;13(3):149-80. PubMed abstract


Authors: Richard Harward, AuD - 8/2010
Karl White, Ph D - 9/2008
Content Last Updated: 8/2010

Page Bibliography

Colletti L.
Beneficial auditory and cognitive effects of auditory brainstem implantation in children.
Acta Otolaryngol. 2007;127(9):943-6. PubMed abstract

Colletti L, Shannon R, Colletti V.
Auditory brainstem implants for neurofibromatosis type 2.
Curr Opin Otolaryngol Head Neck Surg. 2012;20(5):353-7. PubMed abstract

Colletti L, Zoccante L.
Nonverbal cognitive abilities and auditory performance in children fitted with auditory brainstem implants: preliminary report.
Laryngoscope. 2008;118(8):1443-8. PubMed abstract

Hitselberger WE, House WF, Edgerton BJ, Whitaker S.
Cochlear nucleus implants.
Otolaryngol Head Neck Surg. 1984;92(1):52-4. PubMed abstract