Clinical Trial: Auditory Brainstem Implant (ABI) in Children With No Cochleae or Auditory Nerves

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Auditory Brainstem Implant (ABI) in Children With No Cochleae or Auditory Nerves

Brief Summary: This study is a feasibility study of the Nucleus 24 ABI in children without NF2. It will be conducted as a repeated-measures, single subject experiment in order to accommodate the known variability in cochlear implant clinical results. Data obtained in the course of this study will be compared with the existing published outcome data from children with normal hearing and with cochlear implants (CIs). These comparisons may provide additional useful information about the progress of ABI subjects' performance over time. Also, this may allow the results of the current study to be utilized to design future pivotal studies of the device in the pediatric population.

Detailed Summary:

The purpose of this study is to evaluate the clinical safety and efficacy of the Nucleus™ 24 Auditory Brainstem Implant (ABI) in pediatric patients who do not have Neurofibromatosis Type 2 (NF2); specifically, children with total hearing loss due to severe cochlear anomalies, cochlear nerve disorders or failed cochlear implantation. These conditions can include: developmental or acquired cochlear nerve deficiency (CND), cochlear aplasia, post-meningitis cochlear ossification, or cochlear malformation. This study proposes to implant up to 10 pre-linguistic young children (18 mos to 5 yrs. of age) and up to 10 post-linguistic children (<21 yrs of age) with the Nucleus 24 Multichannel ABI in an attempt to demonstrate safety of the surgical procedure and device stimulation and the potential for auditory benefit beyond that experienced with a CI. These children would not qualify for the Nucleus ABI device, as their etiology is not an approved indication such as neurofibromatosis Type 2(NF2). Further, these children do not benefit from conventional hearing aids or cochlear implants.

Two groups of children will be included: Group 1 will include prelingiustic deaf children ages 18 months - 5 years and Group 2 will include postlinguistic deaf children < 21 years of age. Post-operative evaluations will be conducted at the initial activation and at 1, 3, 6, 12, 18, 24, 30, and 36-month intervals post-activation in order to demonstrate the emergence of open-set speech perception abilities prior to study cessation. Experience in the CI literature has shown that a minimum of 2 years of device usage is required for children with pre-lingual hearing impairment to develop some open-set speech perception abilities. While Group 2 is post-linguistic and some may have had significant hearing prior to becoming deaf, the same time intervals will be used for consistency. Blinding or
Sponsor: New York University School of Medicine

Current Primary Outcome: ABI Device Complications [ Time Frame: 5 Years from date of surgery ]

Study participants will be monitored on a case-by-case basis for ongoing or unanticipated medical complications. Adverse events will be tracked on a case-by-case basis and recorded at the time of occurrence and followed up at resolution. Any adverse events will be reported to the NYUSOM IRB. Should there be concern for the safety of the subjects because of their participation in the study by the investigators or the IRB, the study would be halted at least temporarily and a detailed discussion with the investigators and the IRB would be undertaken.


Original Primary Outcome: Same as current

Current Secondary Outcome: Audiologic Performance with ABI (Hearing, Speech and Language Assessments) [ Time Frame: 36 months from date of surgery ]

The following audiometry and speech perception tests will be administered as age-appropriate:

  • Detection audiogram, aided and unaided individual ears
  • IT-MAIS or MAIS
  • LING 6 sound test
  • ESP Low Verbal or Standard- MLV @ 50dB HL
  • PB-k words and phonemes- MLV @ 50dB HL
  • MLNT- recorded @ 60dB SPL
  • LNT- recorded @ 60dB SPL
  • HINT-C- 2 lists of 10 @ 60dB SPL
  • CNC- 50 words @ 60dB SPL

Each child will receive speech/language intervention using the Comprehensive Assessment of Spoken Language (CASL, Elizabeth Carrow-Woolfolk, 1999) The following tests will be administered when appropriate:

  • The Oral and Written Language Scales (OWLS)
  • Goldman-Fristoe Test of Articulation
  • The Peabody Picture Vocabulary Test (PPVT)
  • The Rossetti Infant-Toddler Language Scale
  • Pre-School Language Scale, (PLS-5)
  • The Expressive Vocabulary Test, 2nd Ed
  • The Peabody Picture Vocabulary Test, 4th Ed


Original Secondary Outcome: Same as current

Information By: New York University School of Medicine

Dates:
Date Received: November 28, 2014
Date Started: May 2014
Date Completion: July 2018
Last Updated: October 4, 2016
Last Verified: October 2016