Neurofibromatosis Type 2 Clinical Trial
Official title:
Compassionate Use Arm - ABI541 Auditory Brainstem Implant for Neurofibromatosis Type 2 Patients With Deafness
The Nucleus 24 Auditory Brainstem Implant (ABI) is the only FDA approved device for restoration of meaningful hearing in Neurofibromatosis Type 2 (NF2) patients. This device has been discontinued, meaning that there is no commercially approved device currently available. The replacement model, the ABI541 (an unapproved device), is being investigated in ongoing clinical trials. A compassionate use arm of a clinical trial allows patients with NF2 to be implanted with this new ABI.
Currently, the Nucleus 24 (ABI24M) Auditory Brainstem Implant (ABI) is approved for use in
individuals 12 years of age or older who have been diagnosed with Neurofibromatosis Type 2
(NF2). Implantation may occur during first or second side tumor removal or in patients with
previously removed vestibular schwannomas bilaterally. As the ABI24M is now obsolete, there
is currently no commercially approved device available to restore useful hearing in patients.
While the manufacturer of the device is pursuing commercial approval of the ABI541, it is
anticipated that it may be several months or years before final approval. However, it is
preferable to place the device at the time of tumor removal while the patient has an open
craniotomy site, thereby avoiding a second surgery and its associated risks solely for the
purpose device implantation. In addition, placement of an ABI at the time of tumor removal
optimizes auditory rehabilitation, providing critical auditory sensations that may more
effectively maintain auditory pathways. The FDA approved a compassionate use arm for an
ongoing clinical trial to permit implantation of the ABI541 in up to 10 NF2 patients.
Patients will undergo pre-operative evaluation for ABI surgery. Those who are appropriate for
surgery will undergo a procedure for implantation of the ABI541. As per manufacturer
protocol, the parameters of the ABI541 including adjustment of electrode sensitivities and
activation of specific electrodes will be completed at each follow-up visit post-operatively.
This process involves adjustment of device parameters by a trained audiologist who
subsequently administers audiologic tests to confirm optimal activation of the ABI541.
All audiologic testing and assessments represent the standard of care. These post-operative
follow-up appointments will occur at 4-12 weeks, three, six, and twelve months, and
biannually thereafter. Timing of these appointments may vary by as much as four weeks prior
to or after the planned follow-up date (e.g. between 2-4 months for the 3 month follow-up).
Unscheduled visits will be taken in the Otology clinic as needed to address any concerns
patients may have regarding the use of their Nucleus ABI541.
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