Revision cochlear implantation for facial nerve stimulation in otosclerosis.

نویسندگان

Marek Polak

S Arif Ulubil

Annelle V Hodges

Thomas J Balkany

چکیده

OBJECTIVE To find if patients experiencing postsurgical facial nerve stimulation caused by underlying disease process (ie, otosclerosis) can improve their hearing performance with their cochlear implant by reimplantation and by an optimal programming strategy. DESIGN Retrospective analysis. SETTING Academic tertiary referral center. PATIENTS Two cochlear otosclerosis patients with resistant facial nerve stimulation (FNS). Both patients were initially implanted with Nucleus 22 devices (Cochlear Corporation, Englewood, Colo) and they developed FNS after a period of use. Owing to the decreasing number of active electrodes, concurrent decreases in speech understanding occurred. INTERVENTIONS Various programming approaches were used to address the FNS. Both subjects ultimately received Nucleus 24 devices. One was reimplanted in the same ear, and the other was implanted in the opposite ear. Both have been followed up for 8 months following the reimplantation. MAIN OUTCOME MEASURES Cochlear implant programming levels, cochlear implant performance, and facial nerve stimulation. RESULTS The FNS was managed for more than 3 years through optimized programming. However, the FNS progressed until performance dropped below acceptable levels. Reimplantation was believed to be the only option for improvement. After reimplantation and programming, both subjects showed immediate improvement in speech discrimination. One user increased his consonant-nucleus-consonant word score from 12% preoperatively to 42%, and the other's performance increased from 0% to 86%. CONCLUSIONS Our results suggest that having more programming options with newer devices is critical in otosclerotic or ossified users who experience FNS. Also, reimplantation may be a useful tool to improve performance.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Facial Nerve Stimulation Can Improve after Cochlear Reimplantation and Postoperative Advanced Programming Techniques: Case Report

We had a case of 75-year old man with a history of progressive hearing loss on both sides who implanted with a Nucleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to complaint of right facial twitching when his cochlear implant was active. Despite undergoing numerous alterations in his implant programming, facial nerve stimulation (FNS) persisted. A...

متن کامل

Evolution of otosclerosis to cochlear implantation.

INTRODUCTION Otosclerosis is an osteodystrophy of the labyrinthine capsule producing conductive hearing loss. If the process invades the cochlea, a sensorineural hearing loss usually takes place. The cochlear implant is a good alternative in these patients. OBJECTIVE To ascertain the behaviour of cochlear implantation in otosclerosis. MATERIAL AND METHODS We reviewed a database of 250 patie...

متن کامل

Surgical Results and Complications of Cochlear Implantation in Far-Advanced Otosclerosis.

OBJECTIVE To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS AND METHODS This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri- and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had bee...

متن کامل

Facial nerve stimulation after cochlear implantation: our experience

Facial nerve stimulation (FNS) after cochlear implant activation is a well-known side effect, with an incidence rate raging between 1% and 14.9%. Some causes of deafness have been associated with a higher incidence of this entity, however, there is still no consensus regarding its pathophysiological mechanisms. Although FNS can be solved with changes in speech processor programming, in some cas...

متن کامل