Which Intervention is best in patient operated for bilateral acoustic neuroma for hearing rehabiliation:

Ans.: A (Brainstem hearing implant) "Closure of perforation of pars tensa of the tympanic membrane is called myringoplasty"- P.L Dhingra 5th/416AUDITORY BRAINSTEM IMPLANT (ABJ) P.L. Dhingra 5th/ 141"This implant is designed to stimulate the cochlear nuclear complex in the brainstem directly by placing the implant in the lateral recess of the fourth ventricle. Such an implant is needed when CN VI If has been severed in surgery of vestibular schwannoma. In these cases, cochlear implants are obviously of no use""In unilateral acoustic neuroma, auditory brainstem implant (ABI) is not necessary as hearing is possible from the contralateral side but in bilateral acoustic neuroma as neurofibromatosis -2, rehabilitation is required by ABI"COCHLEAR IMPLANT PL. Dhingra 5th/l38-39It is an electronic device for person who have severe to profound sensorineural hearing loss & who cannot benefit from hearing aidsEa rly age at i m plementatio n ensures better result & ch ild ren can be implemented at 12 months of ageMethods of Aural Rehabilitation P.L. Dhingra 5th/138-39I. InstrumentalHearing aids: conventional hearing aids. Bone anchored hearing aids(BAHA) & Implantable hearing aids &Implants: Cochlear implant & auditory brainstem implant (ABI)Assistive devices for the deafII TrainingSpeech(lip) readingAuditory trainingSpeech conversationIMPLANTS style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif"> 15/ v03p115.pdfCochlear Implant can be used in patients with sensorineural hearing loss on the side contralateral to the acoustic tumorwho have a functionally intact cochleovestibular nerve on that side. Patient must also have anadequate surviving spiral ganglion cell population on the side of implantation, if it is to be successful.Often of no help on the affected side, since the cochleovestibular nerve is usually functionallycompromised during the surgical removal of the lesion. However, in rare cases when the nerve is leftfunctionally intact but the cochlea is left damaged, the cochlear implant has been used successfully.Auditory# Brainstem Implant is currently used only in patients with NF-2 and is always implanted simultaneously with tumorremoval (usually during excision of the patient's second tumor). It is useful in patients who have hadboth cochleovestibular nerves sacrificed, since this implant stimulates the cochlear nuclear complexin the brainstem directly