Revision Cochlear Implantation for Facial Nerve Stimulation in Otosclerosis | Cochlear Implantation | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.239.157.140. Please contact the publisher to request reinstatement.
1.
Niparko  JKOviatt  DLCoker  NJSutton  LWaltzman  SBCohen  NL Facial nerve stimulation with cochlear implantation: VA Cooperative Study Group on Cochlear Implantation.  Otolaryngol Head Neck Surg 1991;104826- 830PubMedGoogle Scholar
2.
Muckle  RPLevine  SC Facial nerve stimulation produced by cochlear implants in patients with cochlear otosclerosis.  Am J Otol 1994;15394- 398PubMedGoogle Scholar
3.
Rayner  MGKing  TDjalilian  HRSmith  SLevine  SC Resolution of facial stimulation in otosclerotic cochlear implants.  Otolaryngol Head Neck Surg 2003;129475- 480PubMedGoogle ScholarCrossref
4.
Bigelow  DCKay  DJRafter  KOMontes  MKnox  GWYousem  DM Facial nerve stimulation from cochlear implants.  Am J Otol 1998;19163- 169PubMedGoogle ScholarCrossref
5.
Rotteveel  LJProops  DWRamsden  RTSaeed  SRvan Olphen  AFMylanus  EA Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications.  Otol Neurotol 2004;25943- 952PubMedGoogle ScholarCrossref
6.
Ruckenstein  MJRafter  KOMontes  MBigelow  DC Management of far advanced otosclerosis in the era of cochlear implantation.  Otol Neurotol 2001;22471- 474PubMedGoogle ScholarCrossref
7.
Weber  BPLenarz  TBattmer  RD  et al.  Otosclerosis and facial nerve stimulation.  Ann Otol Rhinol Laryngol Suppl 1995;166445- 447PubMedGoogle Scholar
8.
Kelsall  DCShallop  JKBrammeier  TGPrenger  EC Facial nerve stimulation after Nucleus 22-channel cochlear implantation.  Am J Otol 1997;18336- 341PubMedGoogle Scholar
9.
Ramsden  RBance  MGiles  EMawman  D Cochlear implantation in otosclerosis: a unique positioning and programming problem.  J Laryngol Otol 1997;111262- 265PubMedGoogle Scholar
10.
Toung  JSZwolan  TSpooner  TRTelian  SA Late failure of cochlear implantation resulting from advanced cochlear otosclerosis: surgical and programming challenges.  Otol Neurotol 2004;25723- 726PubMedGoogle ScholarCrossref
11.
Cohen  NLHoffman  RAStorschein  M Medical or surgical complications related to the nucleus multichannel cochlear implant.  Ann Otol Rhinol Laryngol Suppl 1988;1358- 13PubMedGoogle Scholar
12.
Vanpoucke  FZarowski  ACasselman  JFrijins  JPeeters  S The facial nerve canal: an important cochlear conduction path revealed by clarion electrical field imaging.  Otol Neurotol 2004;25282- 289PubMedGoogle ScholarCrossref
Original Article
April 2006

Revision Cochlear Implantation for Facial Nerve Stimulation in Otosclerosis

Author Affiliations

Author Affiliations: University of Miami Ear Institute, Miami, Fla.

Arch Otolaryngol Head Neck Surg. 2006;132(4):398-404. doi:10.1001/archotol.132.4.398
Abstract

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.

×