The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on auditory brain stem implants.

  • Description

    This procedure is used to treat deafness caused by damage to the vestibulocochlear nerve due to tumours or surgery.

    In people with vestibulocochlear nerve damage, hearing is not improved by hearing aids or cochlear implants.

    Auditory brain stem implants are electrodes placed in a part of the brain (the cochlear nucleus) responsible for processing sound signals carried to it from the ear through the vestibulocochlear nerve. This nucleus lies in the lower part of the brain, called the brain stem.

    Removal of vestibulocochlear nerve tumours and placement of auditory brain stem implants is often done at the same time. The surgeon makes an incision in the skin of the side of the head, and removes some of the bone behind the ear. This exposes the tumour so that it can be removed and also allows access to the brain stem beneath it. Sometimes the surgeon approaches the brain stem through the back of the head.

    People with auditory brain stem implants wear an external receiver and speech processor. This device converts sounds into electrical signals, which are then sent to the implant.

  • OPCS4.6 Code(s)

    A09.1 Implantation of neurostimulator into brain 

    Z01.6 Tissue of brain stem

    When the removal of a vestibulocochlear nerve tumour is performed at the same time, this can be reflected by the addition of A29.5 Excision of lesion of acoustic nerve (viii).


    The NHS Classifications Service has advised NICE that currently these are the most suitable OPCS-4 codes to describe this procedure. The OPCS-4 classification is designed to categorise procedures for analysis and it is not always possible to identify a procedure uniquely.


    The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.

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