# Paediatric auditory brainstem implant: How we do it

## TL;DR

This paper describes a surgical technique for implanting auditory brainstem implants in children with severe hearing loss who cannot use cochlear implants.

## Contribution

The paper introduces novel technical modifications to improve the safety and effectiveness of pediatric ABI surgery.

## Key findings

- A detailed surgical approach for ABI implantation in children is outlined.
- Technical modifications are proposed to reduce complications and enhance outcomes.
- ABI provides sound awareness for children ineligible for other hearing solutions.

## Abstract

The auditory brainstem implant (ABI) is a surgically implanted neuroprosthetic that may be used in the management of profound hearing loss in paediatric patients that are ineligible for cochlear implantation, primarily due to anatomical constraints.

We describe our technique for the implantation of a paediatric ABI. Surgical steps include post auricular incision, the creation of a periosteal flap, subperiosteal pocket and bony recess for the device, retrosigmoid craniotomy, placement of the electrodes adjacent to the cochlear nucleus and multi-layer closure. We highlight novel technical modifications to reduce the risk of complications and optimise outcomes.

Paediatric auditory brainstem implants offer the possibility of sound awareness to patients with profound hearing loss that would not benefit from cochlear implantation or other hearing aid solutions.

The online version contains supplementary material available at 10.1007/s00701-025-06762-7.