Jerusalem – For the first time in Israel, Jerusalem’s Shaare Zedek Medical Center performed an advanced brainstem implant. The patient was a five-year-old boy born deaf because he lacked an auditory nerve, the hospital announced on Friday.
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Prof. Thomas Roland, head of the department of otolaryngology and head and neck surgery, and colleagues at New York University Langone Medical Center came specially from Manhattan to help perform the unusual operation with Shaare Zedek ear-nose-and-throat surgeons, neurosurgeons and speech therapists.
Since the development of cochlear implants, the number of deaf people in the world has declined significantly, and in most cases, the implant connects well with the auditory nerve and allows the deaf to hear. The implant is particularly successful in babies that were born deaf and are transplanted at an early age. It is also performed in adults who had normal hearing in the past but became deaf for various reasons.
In a small number of cases in which the hearing nerve is absent or nonfunctional, cochlear implants are not the solution to the problem. In such cases, an innovative implant called ABI is inserted surgically into a specific location on the brain stem instead of the auditory nucleus, bypassing the missing auditory nerve.
Transplanting the device requires cooperation among three types of experts — otolaryngological surgeons, brain surgeons and speech therapists. The complex operation is being performed today in only a small number of medical centers around the world.
After a series of tests disclosed that the child had no auditory nerve and that a cochlear implant was not sufficient, it was decided to perform the surgery with the participation of experts from NYU with whom Shaare Zedek regularly cooperates. No details on the boy were provided.
The surgery itself was carried out in several stages. In the first part, the approach to the brain stem was opened by an otolaryngological surgeon, and then the neurosurgeon located the correct position. The implant, similar in shape to a tiny brush, was placed on the brain stem. The clinicians performed electrophysiological tests to ensure that the implant was in the optimal position for maximum auditory benefit and did not stimulate other areas (such as nearby motor areas).
“The opening of the neurosurgical department at Shaare Zedek allows us to perform complex and multidisciplinary actions that we could not perform in the past,” said Dr. Ronen Peretz and Prof. Jean-Yves Sichel, who headed the Israeli team that worked with the NYU team. “The addition of Dr. Nevo Margalit, who is an expert in surgery in the base of the brain, made it possible to access the brain stem and perform the implant,” he added.
The operation was successful, and after the placement of the implant, appropriate electrical responses were received. The boy recovered well and was released home.
After a few weeks, initial operation and mapping were carried out, and a long rehabilitation process began. The doctors who participated are very optimistic that the child’s ability to speak and communicate with his surroundings will improve over time.
Very moving!