Article

Facial nerve stimulation after cochlear implantation according to types of Nucleus 24-channel electrode arrays.

Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Acta oto-laryngologica (Impact Factor: 0.98). 09/2008; 129(6):588-91. DOI:10.1080/00016480802325965
Source: PubMed

ABSTRACT In this study, we concluded that electrode design and location did not have a high level of influence on the prevalence of facial nerve stimulation (FNS) in normal cochleae.
To analysis the prevalence of FNS after cochlear implantation with Nucleus 24-channel devices according to types of electrodes arrays.
We retrospectively analyzed medical and mapping records of 394 patients who received cochlear implants (CIs) manufactured by Cochlear Corporation from April 1999 to March 2007.
In all, 23 of 394 (5.8%) patients had FNS (CI24M 4 of 39 [10.3%], CI24RCS 9 of 192 [4.7%], CI24RST 9 of 21 [42.9%], and CI24RECA 1 of 87 [1.1%]). In addition, 4 of 324 (1.2%) patients with normal cochleae complained of FNS (CI24M 1 of 33 [3.0%], CI24RCS 2 of 173 [1.2%], and CI24RECA 1 of 71 [1.4%]). There was no difference between straight and perimodiolar electrode arrays in patients with normal cochleae. In addition, when comparing two types of Contour electrodes, Contour Advance (soft-tip) electrodes offered significantly lower incidence of FNS than Contour electrode arrays. We could manage these patients with methods such as decrease of C-level, selective channel turning off, and changes of mapping strategies.

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    ABSTRACT: We had a case of 75-year old man with a history of progressive hearing loss on both sides who implanted with a Nu-cleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to complaint of right fa-cial twitching when his cochlear implant was active. Despite undergoing numerous alterations in his implant program-ming, 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 pa-tients may be managed through reimplantation and advanced programming techniques.
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