Biomaterial Database

Revision cochlear implantation for facial nerve stimulation in otosclerosis. 2006

Marek Polak, and S Arif Ulubil, and Annelle V Hodges, and Thomas J Balkany

University of Miami Ear Institute, Miami, FL, USA. marek.polak@softhome.net

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. METHODS Retrospective analysis. METHODS Academic tertiary referral center. METHODS 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. METHODS 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. METHODS 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.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010040	Otosclerosis	Formation of spongy bone in the labyrinth capsule which can progress toward the STAPES (stapedial fixation) or anteriorly toward the COCHLEA leading to conductive, sensorineural, or mixed HEARING LOSS. Several genes are associated with familial otosclerosis with varied clinical signs.	Otospongiosis,Otoscleroses,Otospongioses
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086	Reoperation	A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.	Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D003054	Cochlear Implants	Electronic hearing devices typically used for patients with normal outer and middle ear function, but defective inner ear function. In the COCHLEA, the hair cells (HAIR CELLS, VESTIBULAR) may be absent or damaged but there are residual nerve fibers. The device electrically stimulates the COCHLEAR NERVE to create sound sensation.	Auditory Prosthesis,Cochlear Prosthesis,Implants, Cochlear,Auditory Prostheses,Cochlear Implant,Cochlear Prostheses,Implant, Cochlear,Prostheses, Auditory,Prostheses, Cochlear,Prosthesis, Auditory,Prosthesis, Cochlear
D005155	Facial Nerve Diseases	Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation.	Acquired Facial Neuropathy,Cranial Nerve VII Diseases,Facial Myokymia,Facial Neuropathy,Geniculate Ganglionitis,Cranial Nerve VII Disorders,Facial Nerve Disorders,Facial Nerve Motor Disorders,Facial Nerve Sensory Disorders,Facial Neuritis,Familial Facial Neuropathy,Motor Disorders, Facial Nerve,Sensory Disorders, Facial Nerve,Seventh Cranial Nerve Diseases,Acquired Facial Neuropathies,Disease, Facial Nerve,Diseases, Facial Nerve,Disorder, Facial Nerve,Disorders, Facial Nerve,Facial Myokymias,Facial Nerve Disease,Facial Nerve Disorder,Facial Neuritides,Facial Neuropathies,Facial Neuropathies, Acquired,Facial Neuropathies, Familial,Facial Neuropathy, Acquired,Facial Neuropathy, Familial,Familial Facial Neuropathies,Ganglionitides, Geniculate,Ganglionitis, Geniculate,Geniculate Ganglionitides,Myokymia, Facial,Myokymias, Facial,Neuritides, Facial,Neuritis, Facial,Neuropathies, Facial,Neuropathies, Familial Facial,Neuropathy, Facial,Neuropathy, Familial Facial
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D014057	Tomography, X-Ray Computed	Tomography using x-ray transmission and a computer algorithm to reconstruct the image.	CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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