6-year-old treated for profound deafness through an extremely high risk auditory brain stem implant surgery

About the Patient and condition

Baby Angela, a 6-year-old was brought to Indraprastha Apollo Hospitals, Delhi, with a history of zero hearing and negligible speech. Baby Angela from Mozambique, South Africa was born with significant abnormality of the hearing nerve and malformed cochlea which resulted in profound deafness. For six years Angela was not able to communicate – hear or speak, owing to profound deafness. The Standard Cochlear Implant was not an option as the hearing nerve was not present in the kid. Thus, the only line of treatment was opting for an auditory brain stem implant.

Case Scenario

Post-examination, it was found that her hearing nerve was absent/damaged, so cochlear implant was not a solution , as it required normal inner ear & normal hearing nerve which was absent in this case. Angela’s mother did not want her admitted to a special school, hence the only option left was going for auditory brain stem implant which was conducted by a team of multi-disciplinary doctors at Indraprastha Apollo Hospitals, led by Dr. (Prof) Ameet Kishore, Senior Consultant Surgeon, ENT and Cochlear Implant Surgeon, Indraprastha Apollo Hospitals, Ms. Neevita Narayan, Audiologist Speech therapist and Cochlear Implant Audiologist and Dr. Pranav Kumar, Senior Consultant, Neurosurgery at Indraprastha Apollo Hospitals. Dr. (Prof) Ameet Kishore said “Auditory brain stem implant is a high risk surgery where an auditory device is surgically implanted in the brainstem which provides a sensation of sound to a person who suffers from severe to profound hearing loss associated with severe abnormality of the inner ear/hearing nerves. The implant is a soft electronic implant which is highly elastic and curves perfectly to the surface of the auditory brainstem. The risk involved is high as the placement of the hearing electrode in the brain stem is a complicated procedure and can cause irreplaceable loss to the patient if the surgery goes wrong.”

Ms. Neevita Narayan said “Placement of the implant and connecting it to the auditory centres in brain stem is the first part of the surgery, but what is equally significant is the rehabilitation which is an ongoing process. Initial activation of the ABI feels like Angela at the age of six entering the world of sound for the first time, as she has never heard any sound and so does not understand sound perceived through the brain. Therefore, she will have to learn the meaning of each & every sound from the beginning, which means that the patient will need time to learn to interpret what they are sensing through the device as ‘sound’. In such cases the patient is adapting to both his hearing and speaking ability simultaneously. “Hearing loss can be devastating to a child’s social development, and for some children, the ABI is their last viable chance to hear, if the surgery is a success”

Worldwide Scenario

Auditory Brain Stem implant is a saviour for such patients who suffer from profound hearing loss with severe abnormality of the inner ear/hearing nerves and helps them restore hearing and speech through a prolonged rehabilitation process.

Expertise at Apollo Hospitals

Dr. Pranav Kumar said “This was a high-risk procedure owing to the young age of the patient. The team of doctors had to proceed with utmost care and tremendous precaution as the implant is placed in the brain stem which is an amalgamation of all the nerves controlling the important bodily functions in the body such as heartbeat, blood pressure amongst others. Risk factors include cerebrospinal fluid leaks, facial nerve palsies (loss of facial movement due to nerve damage), wound infection, meningitis, and failure of the implant to provide useful auditory sensations due to movement/displacement of the electrodes”

Apollo Hospitals – Touching Lives

Apollo Hospitals has always been successful in bringing back smile on the face of its patients and their family members. Every year we perform over 1000 major neurosurgeries. Our ENT surgeons have successfully operated many babies safely and efficiently, both national and international.

Patient’s testimonial

It was a new lease of life for six-year-old Angela, who for the first time could dance to the tunes of “Shakira Shakira”.