5-Year-Old Hears Again After Rare Brainstem Implant At AIIMS

When two-year-old Varun (name changed) lost his hearing after a severe attack of meningitis, his parents were shattered. The lively toddler, who once responded to every sound, suddenly fell silent. His parents were told that the infection had damaged not only the toddler's cochlea but also the hearing nerves, making him unsuitable for a conventional cochlear implant.

Just when hope seemed to fade, doctors at the All India Institute of Medical Sciences (AIIMS), Delhi, offered a rare solution—the institute’s first Auditory Brainstem Implant (ABI), a sophisticated device that interacts with the brain, stimulating electrical impulses to it.

“The boy had normal hearing until meningitis caused severe damage to his inner ear. The cochlea turned into bone (ossification process), leaving no scope for a cochlear implant. After detailed evaluation, we determined that only an Auditory Brainstem Implant (ABI) could help,” said Dr. Kapil Sikka, Professor at the ENT Department, AIIMS Delhi.

After meticulous planning involving neurosurgeons, the surgery was carried out, led by Professor Rakesh Kumar, head of the ENT department, Dr. Poonam Sagar, and audiologist and speech therapist Shivani Agarwal, and guided by international ABI expert Dr. Robert Behr, a neurosurgeon at University Medicine Marburg Campus, Fulda, Germany.

Dr. Sikka explained that unlike a cochlear implant, an ABI bypasses the damaged inner ear and directly stimulates the hearing centers in the brainstem. Reserved for rare and complex cases, the surgery marked a first for AIIMS.

Nearly 18 months after the operation and continuous speech therapy, Varun has begun recognizing everyday sounds and attempting clearer words. His progress has been “steady and encouraging,” said Shivani, emphasizing that rehabilitation and follow-up are as important as surgery for making patients hearing-enabled. “Also, speech therapy is most essential after a cochlear or ABI implant. It usually continues for up to three years, depending on the child’s learning pace and grasping ability,” she said.

For families of children once considered beyond help, the country’s premier research and health institution, AIIMS, brings a ray of hope, offering cost-effective treatment and the promise that silence need not be permanent.

The ABI surgery is critical for children between the ages of one to three who are born deaf. The surgery can be performed starting at the age of one, and best results can be seen up to age three, said Dr. Sikka.

While cochlear implant surgery costs around ₹5 lakh at government hospitals, the ABI device costs around ₹15 lakhs. However, for kids with profound hearing loss, the ABI device remains a costly affair as, at present, there is no government scheme to cover the cost of the implant in government hospitals.

Prof. Kumar said, “Varun was lucky that he got treatment at the early stage. But unfortunately, as hearing loss is a hidden disability, families delay seeking help.”

He warned against the common belief that a child will “start speaking late.” Babies usually babble “mama” or “dada” by five to six months. If a child does not respond to sound or misses speech milestones by seven to nine months, early evaluation is crucial, he said.

Professor Kumar also stressed universal neonatal hearing screening which, he said, is a quick, painless, and safe procedure conducted within 1–2 days of a baby's birth to detect potential hearing loss early. If the baby does not pass, it often means they were restless or had temporary ear blockage, but follow-up testing is essential, he said.

On its part, since 2021, AIIMS has implemented universal newborn hearing screening using ABR (BERA) testing. Experts estimate that 6–7% of Indians have some degree of hearing loss, much of it preventable or treatable. Congenital hearing loss affects about 0.2% of newborns.