Photo caption: Danny, Jacquelyn and Savannah Lee who became the first child in the country to receive an auditory brainstem implant (ABI).
There’s new hope for hearing with the introduction of three new hearing surgeries now being offered to young patients at Children’s Hospital at London Health Sciences Centre (LHSC).
Over the past year, a multidisciplinary team became the first in Canada to perform a paediatric auditory brainstem implant (ABI) and the first in North America to robotically insert a paediatric cochlear implant. They also brought care closer to home by adding the Oticon implant, an established bone conduction hearing device, to their surgical portfolio. “London Health Sciences Centre was the first HEARRING Centre of Excellence in Canada, so it’s only natural we continue leading the way with innovative treatments,” says Dr. Sumit Agrawal, head of LHSC’s department of otolaryngology – head and neck surgery.
“We’re thrilled to have expanded our surgical offerings to include the most up to date, cutting edge options, including the ABI, robotic cochlear and Oticon implants. Together, we’re making hearing more accessible for thousands of patients who need us most.”
Savannah’s story
Having been born without hearing, Savannah Lee, then one year old, became the first child in the country to receive the ABI when she underwent the procedure in July 2024. Today, she remains only one of two paediatric patients in Canada who have had their hearing restored because of this ground-breaking surgery.
The diagnosis and early intervention
When Savannah was born on January 3, 2023, her parents, Jacquelyn and Danny Lee, noticed she wasn’t responding to sound and that one of her ears looked different. After inconclusive tests through Ontario’s Infant Hearing Program, further testing at Children’s Hospital revealed she had an inner ear malformation and lacked a cochlear nerve, making traditional hearing treatments ineffective.
Devastated but determined, her parents explored every option. While Savannah wasn’t eligible for a cochlear implant, her care team offered a groundbreaking alternative: a pediatric auditory brainstem implant (ABI) — a first in Canada. Though the surgery was risky, it gave Savannah a chance to hear.
“Despite the risks, learning there was a new surgery we could try was a breath of fresh air,” says Danny. “We were told that if this was five years ago, Savannah would have to go through life without hearing, but today, Dr. Bajin was preparing to do ground-breaking procedure right here in London. We had no idea what ABI even stood for, but the bottom line was it could potentially give her the gift of sound, so we said yes.”
The surgery and activation
A few months later, Savannah underwent a four-hour surgery led by Dr. Demir Bajin and a team of specialists, including otolaryngologists, a neurosurgeon, and an audiologist, with support from MED-EL engineers flown in from Austria. The procedure went well, but the next critical step was activating the implant, which was placed in a delicate part of the brain.
About a month later in the Paediatric Critical Care Unit, the device was successfully activated. The moment Savannah heard her first sound was one Danny, Jacquelyn and Savannah’s care team will never forget: Someone off to the side clapped their hands and Savannah detected it and turned her head.
“Words can’t describe how emotional and overwhelming it was being there and watching her face as the device was turned on,” says Jacquelyn. “I thought, ‘Oh my gosh, my baby can hear,’ and then my mind went to, ‘Wow, this means she’ll be able to live her life more safely because she’ll be able to hear things like oncoming cars.’ I think that’s when just how miraculous this was really sunk in.”
Savannah today
Fast forward to today and Savannah is thriving. She can hear sufficiently and is playing and learning like other children her age. She may still have some hearing challenges as she grows up, but access to sound provided by the implants provides Savannah with opportunities that she wouldn't otherwise have.
Earlier this year, Savannah received a cochlear implant in her left ear. She now has what her care team describes as the “best of both worlds” – an ABI on one side and a cochlear implant on the other. Together, these two hearing technologies allow Savannah to localize sounds, hear better in noisy environments and experience improved audibility.
Jacqueline and Danny say Savannah’s hearing implants have really bolstered her independence. She’s resilient, independent and excelling with language, which would not have been possible without her ability to hear.
Auditory brainstem implants (ABI)
“Auditory brainstem implants (ABI) are typically used for patients who cannot benefit from traditional cochlear implants due to the absence of or damage to their cochlear nerve, which is the part of the inner ear that is responsible for sending hearing signals to the brain,” explains Dr. Bajin, who has extensive clinical and research experience with ABIs.
ABIs bypass the cochlear nerve entirely and directly stimulate the brainstem to create auditory sensations. They work by converting sounds into electrical signals, which the implant sends to the brainstem, allowing the patient to perceive sound.
Thanks to Dr. Bajin’s rare expertise, Savannah was the first paediatric patient in the country to receive one. He is currently the only surgeon in Canada who performs paediatric ABIs, making LHSC the single referral centre for children across the country who could benefit from this type of implant.
“This technology is a game-changer,” says Dr. Bajin. “It feels amazing to be able to provide a solution for children like Savannah who would otherwise never be able to hear, and I’m confident her case will pave the way for other kids across Canada to access this same technology in the future.”
Robotic cochlear implants
LHSC completed North America’s first paediatric robotic cochlear implant surgery in February 2025, thanks to the generosity of London Health Sciences Foundation donors. The procedure was led by Drs. Agrawal, Bajin and Parnes using a specialized robot called the OTODRIVE, which was bought from Austrian manufacturer MED-EL.
Cochlear implants are designed for individuals with hearing loss resulting from absent or damaged cochlear structures. They work by bypassing damaged parts of the inner ear and directly stimulating the cochlear nerve with electrical signals from a special 28-millimeter-long electrode that is inserted.
“We know that if the electrode is inserted too quickly or with too many stops and starts, the inner ear structure can become damaged, so the speed and steadiness of every millimeter matters,” explains Dr. Agrawal. “Our ability to insert them robotically means we can now perform these procedures more safely and with less risk.”
Oticon implants
LHSC began offering the Oticon implant, a type of bone conduction hearing device, in March 2024. While the technology is not new, this is the first time LHSC has received permanent funding to offer the implant to patients who aren’t suitable candidates for other types of hearing devices. Patients were previously referred to other areas of province for this procedure.
The Oticon implant is a small abutment that is implanted on the skull. For patients without an ear canal, it works by sending vibrations through the bone directly to the inner ear. They tend to be more effective than external hearing aids, which require frequent adjustments and can cause sound to be lost as it transfers.
“We’re excited to have brought this care close to home,” says Dr. Peng You, otolaryngologist at LHSC. “A lot of our families say they feel relieved they no longer have to travel elsewhere and feel empowered by all the choices they now have at LHSC. For us physicians, that’s what it’s really all about – being able to provide the right care, to the right patient, at the right time.”