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Difference Between Auditory Brainstem Implant and Cochlear Implant

What is auditory brainstem implant and cochlear implant?

Auditory brainstem implant (ABI) is very similar to a cochlear implant. However, the main difference is that instead of sending sounds to the cochlea, the ABI makes the sounds travel to the brainstem’s hearing region. Whereas the cochlear implant device transmits the hearing information directly to the brain by stimulating the auditory nerve. 


Both are devices used for helping people who have hearing issues. 

Auditory brainstem implant 

An auditory brainstem implant (ABI) is a surgically implanted device in the brain of a person who is deaf (whose auditory nerves damaged) The device provides a sensation of sound to a deaf person.

Cochlear implant

A cochlear implant is a tiny, surgically implanted, complex electronic device that aids in offering a sensation of sound to an individual who has moderate-to-profound sensorineural hearing loss, or is profoundly deaf. The implant consists of; (1) The implant (inside the body) and (2) The Speech Processor (outside the body). The device sits just under the skin behind the ear by an Ear, Nose and Throat surgeon

Difference between auditory brainstem implant and cochlear implant


Auditory brainstem implant

An auditory brainstem implant (ABI) is a surgically implanted device in the brain of a person who is deaf (whose auditory nerves damaged) The device provides a sensation of sound to a deaf person.

Cochlear implant

It is as device that gives actual ability to hear. It ensures hearing of high frequency sounds.


Auditory brainstem implant

  • Enhances sound awareness
  • Helps recognize environmental sounds like vehicle horns, barking of dog and ringing of phone
  • Improve the ability to differentiate and detect women vs men voice; kid vs adult voice etc
  • Enhances lip reading ability which would aid in improving face-to-face communication 

Cochlear implant

  • Most perceive loud, medium and soft sounds
  • Many understand speech without lip-reading
  • Many can make telephone calls
  • Adults often benefit immediately
  • Many can watch TV more easily
  • Some can enjoy music (piano or guitar, for example) 


Auditory brainstem implant

Meningitis, dizziness and pain, facial nerve weakness, leaks of fluid found in the brain and spine, and dizziness.

Cochlear implant

  • Injury to the facial nerve 
  • Meningitis 
  • Cerebrospinal fluid leakage 
  • Perilymph fluid leak 
  • Infection of the skin wound
  • Blood or fluid collection at the site of surgery
  • Attacks of dizziness or vertigo
  • Tinnitus, which is a ringing or buzzing sound in the ear
  • Taste disturbances 
  • Numbness around the ear
  • Reparative granuloma 

People with a cochlear implant:

  • May hear sounds differently
  • May lose residual hearing
  • May have unknown and uncertain effects
  • May not hear as well as others 
  • May not be able to understand language well
  • May have their implant fail
  • May not be able to upgrade 
  • May not be able to have some medical examinations and treatments
  • May damage their implant
  • May find them expensive
  • Will have to use it for the rest of life
  • May have lifestyle changes 
  • Will have to be careful of static 
  • Have less ability to hear 
  • May develop irritation 
  • Can’t let the external parts get wet
  • May hear strange sounds 


The points of difference between Auditory brainstem implant and Cochlear implant have been summarized as below:


What are Auditory Brainstem Implants and cochlear implants?

An auditory brainstem implant (ABI) is a surgically fitted device that offers hearing to people with hearing loss (from damage auditory nerves are lacking or damaged) who are unable to receive benefits from a hearing aid or cochlear implant. Cochlear implant is as device that gives actual ability to hear. It ensures hearing of high frequency sounds.

What are the two main differences between a hearing aid and a cochlear implant?

Hearing aids amplify sounds in order to get detected by damaged ears. Cochlear implants (a surgically implanted device) bypass damaged parts of the ear and directly stimulate the auditory nerve.

Hearing aids are less able to mitigate the impacts of background noise whereas cochlear implants are effectively able to mitigate the impacts of background noise. 

What are the two types of cochlear implant?

Cochlear makes 2 different types of implantable devices: a cochlear implant and a bone-anchored hearing aid (Baha).

  • A cochlear implant – a surgically implanted electronic device which enables restoration of the sensation of sound for people with profound hearing loss.
  • A bone-anchored hearing aid (Baha) – a technology that involves planting a surgically implanted prosthetic device with a small titanium fixture (osseointegrated titanium implant) implanted behind the ear.

How does an auditory brainstem implant work?

Auditory brainstem implants (ABIs) are auditory prostheses (a device that enhances the ability to hear or substitutes for it) initially developed to help patients who suffer from deafness with neurofibromatosis type 2 (NF2). The device bypasses the interior side of the ear and the auditory nerve. It applies an array of electrodes (a conductor through which electricity enters or leaves an object) to stimulate the hearing tracks on the brainstem directly.

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References :

[0]Colletti, L., Shannon, R., & Colletti, V. (2012). Auditory brainstem implants for neurofibromatosis type 2. Current opinion in otolaryngology & head and neck surgery, 20(5), 353-357.

[1]van der Straaten, T. F., Netten, A. P., Boermans, P. P. B., Briaire, J. J., Scholing, E., Koot, R. W., ... & Frijns, J. H. (2019). Pediatric auditory brainstem implant users compared with cochlear implant users with additional disabilities. Otology & Neurotology, 40(7), 936-945.

[2]Vesseur, A., Free, R., Snels, C., Dekker, F., Mylanus, E., Verbist, B., & Frijns, J. (2018). Hearing restoration in cochlear nerve deficiency: the choice between cochlear implant or auditory brainstem implant, a meta-analysis. Otology & Neurotology, 39(4), 428-437.

[3]Wong, K., Kozin, E. D., Kanumuri, V. V., Vachicouras, N., Miller, J., Lacour, S., ... & Lee, D. J. (2019). Auditory brainstem implants: recent progress and future perspectives. Frontiers in Neuroscience, 10.

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