(Press-News.org) May 21, 2015 -- A technique called auditory brainstem implantation can restore hearing for patients who can't benefit from cochlear implants. A team of US and Japanese experts has mapped out the surgical anatomy and approaches for auditory brainstem implantation in the June issue of Operative Neurosurgery, published on behalf of the Congress of Neurological Surgeons by Wolters Kluwer.
Dr. Albert L. Rhoton, Jr., and colleagues of University of Florida, Gainesville, and Fukuoka University, Japan, performed a series of meticulous dissections to demonstrate and illustrate surgical approaches to auditory brainstem implant placement. Their article shares exquisitely detailed anatomic color photographs, along with step-by-step descriptions of two alternative routes for neurosurgeons performing these demanding implant procedures.
Anatomy and Approaches for Auditory Brainstem Implantation
Auditory brainstem implants can restore varying degrees of hearing to patients with "retrocochlear" hearing loss. These patients have deafness caused by damage to the cochlear nerves -- sometimes called the acoustic or auditory nerves -- which transmit sound information from the inner ear to the brain. The cochlear nerve damage most commonly results from brain tumors associated with a genetic condition called neurofibromatosis type 2 (NF2).
Auditory brainstem implants are similar in principle to the more commonly placed cochlear implant, used in patients with damage to the cochlea -- part of the inner ear. Because of the need to place the implant and electrodes in the brainstem, rather than the inner ear, the surgery required for auditory brainstem implantation is much more complex.
In a series of ten cadaver brainstem dissections, the researchers explored the anatomy of the region that the neurosurgeon must navigate to perform auditory brainstem implantation. They also mapped out the best neurosurgical approaches, both for surgery to remove the tumors and for auditory brainstem implant placement.
Based on their findings, Dr. Rhoton and colleagues detail two surgical approaches: a "translabyrinthine" and a "retrosigmoid" approach. They outline a step-by-step route for both approaches, designed to provide safe access to the area while minimizing trauma to the brainstem and surrounding structures. The authors highlight the value of using endoscopes to help in visualizing and accessing the target area for implant placement.
More than 1,000 auditory brainstem implant procedures have been performed worldwide so far. The procedure was previously approved only for patients with NF2 aged 12 years or older. Recently, clinical trials were approved for children with congenital malformations or other causes of retrocochlear deafness.
Minimizing damage to the brainstem and associated blood vessels appears to be a critical factor in achieving good speech recognition after auditory brainstem implantation. The hearing results are also better in patients with a shorter duration of deafness.
Dr. Rhoton and colleagues hope that their descriptions and illustrations will help to increase understanding of the anatomy and surgical approaches to auditory brainstem implantation, contributing useful hearing to adults and children with NF2 and other causes of retrocochlear deafness.
INFORMATION:
Click here to read "Auditory Brainstem Implantation: Anatomy and Approaches."
Article: "Auditory Brainstem Implantation: Anatomy and Approaches" (doi: 10.1227/NEU.0000000000000736)
About Operative Neurosurgery
Operative Neurosurgery (ONS) is a companion publication to Neurosurgery from the Congress of Neurological Surgeons. It complements the clinical and research studies published in Neurosurgery by featuring technical material that highlights operative procedures, anatomy, instrumentation, devices, technology. ONS is the practical resource for cutting-edge material that connects the surgeon directly to the operating room.
About Wolters Kluwer
Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.
Wolters Kluwer reported 2014 annual revenues of €3.7 billion. The group serves customers in over 170 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on NYSE Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).
For more information about our products and organization, visit http://www.wolterskluwer.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.
Water behaves in mysterious ways. Especially below zero, where it is dubbed supercooled water, before it turns into ice. Physicists have recently observed the spontaneous first steps of the ice formation process, as tiny crystal clusters as small as 15 molecules start to exhibit the recognisable structural pattern of crystalline ice. This is part of a new study, which shows that liquid water does not become completely unstable as it becomes supercooled, prior to turning into ice crystals. The team reached this conclusion by proving that an energy barrier for crystal formation ...
New research shows that infections can impair your cognitive ability measured on an IQ scale. The study is the largest of its kind to date, and it shows a clear correlation between infection levels and impaired cognition.
Anyone can suffer from an infection, for example in their stomach, urinary tract or skin. However, a new Danish study shows that a patient's distress does not necessarily end once the infection has been treated. In fact, ensuing infections can affect your cognitive ability measured by an IQ test:
"Our research shows a correlation between hospitalisation ...
This news release is available in German. FRANKFURT. In laboratory tests, two out of ten teethers, plastic toys used to sooth babies' teething ache, release endocrine disrupting chemicals. One product contains parabens, which are normally used as preservatives in cosmetics, while the second contains six so-far unidentified endocrine disruptors. The findings were reported by researchers at the Goethe University in the current issue of the Journal of Applied Toxicology.
"The good news is that most of the teethers we analyzed did not contain any endocrine disrupting ...
Computer simulations have predicted a new phase of matter: atomically thin two-dimensional liquid.
This prediction pushes the boundaries of possible phases of materials further than ever before. Two-dimensional materials themselves were considered impossible until the discovery of graphene around ten years ago. However, they have been observed only in the solid phase, because the thermal atomic motion required for molten materials easily breaks the thin and fragile membrane. Therefore, the possible existence of an atomically thin flat liquid was considered impossible.
Now ...
Scientists and clinicians on the Norwich Research Park have carried out the first detailed study of how our intestinal tract changes as we age, and how this determines our overall health.
As well as digesting food, the gut plays a central role in programming our immune system, and provides an effective barrier to bacteria that could make us ill. In particular, immune cells that line the gut work to maintain the integrity of the barrier, as well as maintaining a balance that provides a healthy environment for beneficial bacteria, but reacts to combat invasion by pathogenic ...
Face perception plays an important role in social communication. There have been many studies of face perception in human using non-invasive neuroimaging and electrophysiological methods, but studies of face perception in children were quite limited. Here, a Japanese research team led by Dr. Miki Kensuke and Prof Ryusuke Kakigi, in the National Institute for Physiological Sciences, National Institutes of Natural Sciences, investigated the development of face perception in Japanese children, by using an electroencephalogram (EEG). The team also compared their results for ...
Qatar's capital city, Doha, is set to emerge as a major knowledge hub, with its educated, high-tech workforce and its international connectivity. However, the lack of a cohesive plan for development and the mobility of that workforce in and out of Qatar could stymie its success on the global stage.
The rulers of the Arab state of Qatar have shaped their capital city, Doha, into one of the fastest-growing cities in the world and also, through economic diversification and other measures, establishing it as a significant hub city in the global knowledge economy. Research ...
Patients with insulin-dependent diabetes can better control their HbA1c value with a combination of blood glucose self-monitoring (BGSM) and continuous interstitial glucose monitoring (CGM) using a real-time measurement device (real-time CGM) than with BGSM alone without severe or serious hypoglycaemia occurring more frequently.
Data were lacking for most other outcomes and research questions, or the study results were not statistically significant, or they did not provide a clear picture. This was the result of a final report published on 21 May 2015, which the German ...
Alternative splicing of obesity and type 2 diabetes related genes may contribute to the pathophysiology of obesity, according to research from the University of Eastern Finland. Obesity leads to changes in the splicing pattern of metabolically relevant genes such as TCF7L2 and INSR, resulting in impaired insulin action. However, weight loss, induced by either obesity surgery or a very low-calorie diet, reverses these changes. The findings, presented by Dorota Kaminska, MSc, in her doctoral dissertation, increase our understanding of splicing dysregulations in obesity and ...
A new study from North Carolina State University and Clemson University finds the toxin in a widely used genetically modified (GM) crop is having little impact on the crop pest corn earworm (Helicoverpa zea) - which is consistent with predictions made almost 20 years ago that were largely ignored. The study may be a signal to pay closer attention to warning signs about the development of resistance in agricultural pests to GM crops.
At issue is genetically engineered corn that produces a Bacillus thuringiensis (Bt) protein which, in turn produces a toxin called Cry1Ab. ...
