After Kara Zerr’s appointment at Mass General for Children (MGfC), her mother, Kindal, pushed her out in her stroller. Suddenly, Kara put her arms out to the side, prompting Kindal to stop the stroller in its tracks. A helicopter was whirring overhead. Kara hopped out of the stroller and looked up, spinning in circles to try to find the source of this new sound. Kara saw the helicopter pass by and sat back down in her stroller, her curiosity fulfilled.


The October day that the helicopter passed overhead was when Kara had her auditory brainstem implant (ABI) activated. Kara, 3, was born deaf with no cochlea (part of the inner ear with nerves that produce the ability to hear) or auditory (hearing) nerves on either side of her head. Just three months earlier, in July 2014, a team of neurosurgeons and otolaryngologists from MGfC and the Massachusetts Eye and Ear Infirmary (MEEI) put the ABI in Kara’s brain, granting her the gift of hearing.

“Kara wasn’t eligible for a cochlear implant because she didn’t have a cochlea or auditory nerves on both sides of her head,” said Kindal, of Oregon City, Ore. “The only option that could help her was the ABI, but the only place that offered it at the time was a hospital in Italy.”

After eight months of research and exploring all options, Kindal was referred to Daniel Lee, MD, director of the Pediatric Otology Center and the Wilson Auditory Brainstem Implant Program at MGfC and MEEI.

“I called Dr. Lee’s office on a Wednesday and they happened to have a cancellation that Friday,” said Kindal. “I booked our flight and off we went. Just a few months later, we flew back for her surgery.”

The ABI looks similar to a cochlear implant on the outside, but works differently on the inside, said Lee. “On the inside, a wire is surgically implanted into the brain that sends signals to the auditory, or hearing, part of the brain. It basically does the work of the nerves that Kara was born without.”

At home, Kara is now learning to make connections between sounds and objects and people. “I remember one day I turned on the garbage disposal, not thinking much of it, and Kara came running into the kitchen,” said Kindal. “She began frantically touching everything to figure out where that sound was coming from. When she touched the countertop and felt the vibrations from the garbage disposal, she smiled and calmly walked out of the room. She was able to make the connection between that object and the sound it made.”

Since having her ABI activated, Kara is developing like a typical 3-year-old in terms of growth and learning language. “The first thing I said to her when her ABI was activated was, ‘Hi Kara, I love you.’ She smiled at me and it was just so heartwarming and overwhelming,” said Kindal. “Now she’s in preschool twice a week and they use American Sign Language and spoken language with her. She’s making great progress. None of this would be possible without her care team at MGfC and MEEI.”