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

Fahd Ali Alharbi, Martin Spreng, Peter Rolf Issing

.

DOI: 10.4236/ijcm.2012.31014                

Abstract

We had a case of 75-year old man with a history of progressive hearing loss on both side 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. After increasing the pulse width and changing the stimulation mode, there was no facial nerve stimulation. However there was a deterioration in hearing and speech understanding. CT of the temporal bone showed good position of the implant electrodes und cochleomeatal scintigraphy (CMS) showed a highly positive activity with suspicion of otosclerosis, although the medical history was negative for otosclerosis. The FNS was managed with cochlea reimplantation and advanced programming techniques. FNS in cochlear implant patients may be managed through reimplantation and advanced programming techniques.

Keywords

Facial Nerve Stimulation, Cochlea Implant, Reimplantation, Otosclerosis

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	R. Ramsden, L. Rotteveel, D. Proops, S. Saeed, A. Von Olphen and E. Mylanus, “Cochlear Implantation in Otosclerotic Deafness,” In: W. Arnold and R. Hausler, Eds., Otosclerosis and Stapes Surgery. Adv Otorhinolaryngol, Vol. 65, Karger, Basel, 2007, pp. 328-334.
[2]	B. P. Weber, T. Lenarz, R. D. Battmer, R. Hartrampf, M. C. Dahm and B. Dietrich, “Otosclerosis and Facial Nerve Stimulation,” The Annals of Otology, Rhinology & Laryngology, Vol. 16, 1995, pp. 445-447.
[3]	R. Battmer, J. Pesch, T. Stover, A. Lesinski-Schiedat, M. Lenarz and T. Lenarz, “Elimination of Facial Nerve Stimulation by Reimplantation in Cochlear Implant Subjects,” Otology and Neurotolgy, Vol. 27, No. 7, 2006, pp. 918-922. doi:10.1097/01.mao.0000235374.85739.c6
[4]	J. H. Ahn, S. H. Oh, J. W. Chung and K. S. Lee, “Facial Nerve Stimulation after Cochlear Implantation According to Types of Nucleus 24-Channel Electrode Arrays,” Acta Oto-Laryngologica, Vol. 129, No. 6, 2009, pp. 588-591. doi:10.1080/00016480802325965
[5]	S. Mass, M. Bance, M. O’Driscoll, D. Mawman and R. T. Ramsden, “Explantation of a Nucleus Multichannel Cochlear Implant and ReImplantation into the contralateral Ear. A Case Report of a New Strategy,” The Journal of Laryngology and Otology, Vol. 110, No. 9, 1996, pp. 881- 883
[6]	M. Polak, A. Ulubil, A. V. Hodges and T. J. Balkany, “Revision Cochlear Implantation for Facial Nerve Stimulation in Otosclerosis,” Archives of Otolaryngology Head & Neck Surgery, Vo. 132, No. 4, 2006, pp. 398-404. doi:10.1001/archotol.132.4.398
[7]	A. W. Langmann, S. M. Quigley, J. T. Heffernan and C. Brazil, “Use of Botulinum Toxin to Prevent Facial Nerve Stimulation Following Cochlear Implantation,” The Annals of Otology, Rhinology & Laryngology, Vol. 166, 2005, pp. 426-428.
[8]	S. R. Gold, V. Miller, D. B. Kamerer and C. A. Koconis, “Fluoride Treatment for Facial Nerve Stimulation Caused by Cochlear Implants in Otosclerosis,” Otolaryngology Head and Neck Surgery, Vol. 119, No. 5, 1998, pp. 521- 523. doi:10.1016/S0194-5998(98)70116-0