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 cases this can lead to a decrease in performance. The aim of this work was to review the epidemiologic, clinical aspects, and performance results in a group of FNS after cochlear implantation. It was conducted a retrospective chart review of 448 adult patients, all implanted between 1985 and 2016. Speech perception tests results were statistically analysed, using non-parametric tests. We registered a group of 13 patients with FNS, contributing to a prevalence of 2.9%. The causes of hearing loss in this group varied between otosclerosis, Menière's disease, head trauma, and idiopathic cause. Six cases were managed by changing the programming strategy and the other seven required the deactivation of the affected electrodes. Statistical evaluation showed no statistically significant difference between the performance results of the groups with and without FNS. In this series, the overall incidence of FNS was consistent with the literature. Our study supports the current idea that FNS can frequently be eliminated by changing programming strategies or deactivating the involved electrodes, without affecting the implant's performance.
Background: Cystic fibrosis (CF) is a worldwide disease occurring mostly in caucasians. It is an autosomal recessive disorder that leads to a malfunction of CF transmembrane conductance regulator (CFTR). These mutations cause an ionic disorder on the body fluids and a modification on its consistency. Affects multiple parts of the body and rhinosinusitis is a common manifestation of the upper airway affection. Material and methods: This retrospective study performed a statistical analysis of the prevelence of chronic rhinosinusitis with polyposis, genotipe and mortality in 30 children under 18 years with cystic fibrosis followed in the CF unit of Coimbra University Hospital. Results: The mean age of this study was 12,9 years. Phenylalanine deletion at position 508 (F508delF508del) was the most prevalent genotype (66,7%). Females patients had an higher prevalence of morbidities, however male patients had an higher mortality rate 20% comparing to 6,7%. Nasal polyposis was present only in the living ones with F508delF508del genotype. ENT (ear, nouse and throut) symptons and an abnormal ENT examination were mostly observed in F508delF508del genotype. Conclusions: CF is a lifelong disease that requires long-term surveillance and compliance. The involvement of the lower airway is prevalent in young chlidren. The uper airway symptoms becomes more important with disease progression. Nasal poliposis is prevalent on the older ones with F508delF508del genotype. In this kind of patients with persistent symptoms, who have failed medical management, are often considered appropriate candidates for functional endoscopic surgery.
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