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Toddler Responds to Sound After Auditory Brainstem Implant at CHLA

Los Angeles Medical Team Performs California’s First Auditory Brainstem Implant Surgery on Toddler at Children’s Hospital Los Angeles, Part of Only NIH-funded Study of Device’s Safety and Use In Young Children

3-year-old Canadian boy hears for first time after device activation at Keck Medicine of USC.

A Los Angeles team of scientists and surgeons reported that sounds registered in the brain of a deaf Canadian boy for the first time after doctors activated a hearing device that had been surgically implanted in his brainstem at Children's Hospital Los Angeles (CHLA).

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In May, Auguste became the first toddler in California to undergo an auditory brainstem Implant procedure, and the first child in the U.S. to have the surgery in a U.S. Food and Drug Administration trial funded by a National Institutes of Health clinical trial grant.

"When tiny pulses of electric current were delivered to his brain, Auguste lifted his head, indicating he had heard a sound."

On June 12, the device was activated with positive results at the University of Southern California (USC). “There are hundreds of kids in the U.S. who can benefit from an ABI surgery and these children would otherwise never hear or develop speech in their lives,” says pediatric neurosurgeon Mark Krieger, CHLA’s Billy and Audrey Wilder Chair, Division of Neurosurgery, who serves as the lead investigator of the CHLA portion of the clinical trial and is an associate professor of clinical neurological surgery at USC. “We are using leading-edge technology to make a difference.”

The surgery and the device activation and future behavioral study are part of a 5-year clinical trial in which 10 devices will be implanted in deaf children under the age of five. The goal is to establish safety and efficacy protocols for the surgery and subsequent behavioral mapping procedures that doctors in the United States can then later utilize once the surgery is approved for children in the U.S.

Auguste was the first child accepted into the Los Angeles study and the first young child to undergo the ABI surgery in California when the procedure was performed May 6 at CHLA. Thirty-six days later at USC, his parents watched as an audiologist activated the device implanted in Auguste’s brainstem. When tiny pulses of electric current were delivered to his brain, Auguste lifted his head, indicating he had heard a sound.

Auguste has been deaf since birth. At 22 months, he underwent a bilateral cochlear implant, which uses electrodes to stimulate auditory nerves, but the device didn’t provide him the ability to hear sound because he didn’t have a cochlear or hearing nerve. Auguste traveled with his parents, Sophie and Christophe, from Montreal to undergo the ABI surgery at CHLA and to participate in the clinical trial. During the six-hour procedure, surgeons made an incision by his right ear and removed his right cochlear implant. The ABI device has two parts – an external processor with a microphone and a transmitter that transforms sound into electrical signals to an internal receiver that is part of the electrode array. The array is placed on the cochlear nucleus of the brainstem. The procedure is considered revolutionary because it stimulates neurons directly at the human brainstem, bypassing the hearing nerve and inner ear entirely.

The Los Angeles study, co-led by Keck School of Medicine of USC audiologist Laurie Eisenberg, Ph.D., and House Clinic surgeon Eric Wilkinson, M.D., is the only one in the U.S. to be supported by the NIH. The surgical team that performed the procedure at CHLA included Wilkinson and House Clinic neurosurgeon Marc Schwartz, MD, and Krieger, CHLA’s chief of medical staff. Both Schwartz and Wilkinson are on the surgical staff at CHLA and are research scientists at the Huntington Medical Research Institutes. Attending the surgery was also Vittorio Colletti of the University of Verona Hospital, Verona, Italy, who has performed the most ABI surgeries on children overseas and is a collaborator on the study.