Severe and persistent facial nerve stimulation after cochlear implantation in a patient with cochlear–facial dehiscence: a case report

Chen, Jingyuan; Chen, Biao; Zhang, Lifang; Li, Yongxin

doi:10.1177/03000605211057823

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…In 2020, Camerin and coworkers presented a case of cochlear-facial dehiscence detected after cochlear implantation 7 . Most recently, Chen reported a case of cochlear-facial dehiscence causing facial nerve stimulation after cochlear implantation 8 . Consequently, an extremely limited amount of data exists about the true symptomatology of cochlear-facial nerve dehiscence in the medical literature at the time of this publication.…”

Section: Discussionmentioning

confidence: 99%

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A CT Radiologic Assessment of the Incidence of Cochlear–Facial Dehiscence and the Thickness of Bone between the Cochlea and Facial Nerve among Normal Temporal Bones

Nayeri,

Gopen

2024

J Neurol Surg B Skull Base

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Cochlear-facial dehiscence is a relatively new diagnosis which occurs when the bony partition between the labyrinthine segment of the facial nerve and the cochlea is dehiscent. This is considered one of several third window lesions which produce varying degrees of auditory and vestibular symptoms. Imaging studies have identified a consistently higher incidence of cochlear-facial dehiscence when compared to the only histopathologic study present in the literature. This research effort adds to the literature using uniform CT scan images across over 226 ears (114 patients) to identify the radiographic incidence of cochlear-facial dehiscence in normal patients without ear pathology or symptoms. This study identified an incidence of 18.1% of the ears analyzed having dehiscence without any correlation to age or gender. When dehiscence was not identified, the mean thickness of bone between the cochlea and the facial nerve was 0.60 +/- 0.24mm.

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Section: Discussionmentioning

confidence: 99%

“…7 Most recently, Chen et al reported a case of CFD causing facial nerve stimulation after cochlear implantation. 8 Consequently, an extremely limited amount of data exist about the true symptomatology of cochlearfacial nerve dehiscence in the medical literature at the time of this publication.…”

Section: Discussionmentioning

confidence: 99%

A CT Radiologic Assessment of the Incidence of Cochlear–Facial Dehiscence and the Thickness of Bone between the Cochlea and Facial Nerve among Normal Temporal Bones

Nayeri,

Gopen

2024

J Neurol Surg B Skull Base

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“…En casos de malformaciones, es probable que la ENF ocurra en la mayoría de los electrodos (Kim et al 2018). A su vez, las malformaciones del propio nervio facial también aumentan las posibilidades de ser estimulado por el IC (Chen et al, 2021). Así también, su incidencia puede ser elevada en casos de fracturas de hueso temporal (Espahbodi et al, 2015).…”

Section: Incidencia Relaciones Anatómicas Y Etiológicasunclassified

Abordaje clínico de la estimulación facial en implantes cocleares

Rosanigo

Vecchio²,

Ausili

2022

Auditio

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El implante coclear es actualmente uno de los dispositivos de rehabilitación neurosensoriales más exitosos. El mismo brinda la posibilidad de escuchar en personas con hipoacusias severas a profundas que obtienen limitado acceso a los sonidos con amplificación acústica. Sin embargo, existen complicaciones luego de su implantación, entre las cuales se encuentra la estimulación indeseada del nervio facial. Entre los principales detrimentos que produce la estimulación del nervio facial se encuentran los movimientos involuntarios de cara o cuello, molestia o dolor al usar el implante, entre otros. En algunos casos esto sucede sólo en algunos contactos, pero también puede presentarse en la mayoría o incluso todos los canales de estimulación. El actual abordaje clínico de este problema recurre principalmente a diferentes cambios en la programación del dispositivo. Los recursos para reducirlo abarcan desde cambios en el tipo y modo de la estimulación eléctrica, hasta considerar la reimplantación en casos complejos. El presente artículo describe el problema de la estimulación facial y sus posibles causas, como así también detalla las soluciones clínicas que existen en la actualidad. Por último, se discuten nuevos abordajes y potenciales líneas de investigación.

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“…6 Dehiscence between the cochlea and facial nerve canal (FNC) is also a causative factor for FNS, as it acts as a pathway of inadvertent electrical impulses. 7 It is also well-established that a high correlation exists between the electrodes causing symptoms and those that are radiographically closest to the FNC. 8 As such, both (1) identification of the electrode closest to the labyrinthine segment of the FNC and (2) accurate evaluation of the osseous ridge between the cochlea and the FNC could potentially help guide future treatment strategies in CI patients.…”

Section: Introductionmentioning

confidence: 99%

Co-Registration of pre- and post-Operative images after cochlear Implantation: A proposed technique to Improve cochlear visualization and localization of cochlear electrodes

et al. 2022

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Background and Purpose After cochlear implantation, metallic artifact can obscure nearby structures on CT images, which is problematic in patients with facial nerve stimulation (FNS). This study evaluated the usefulness of co-registered pre- and post-operative examinations to evaluate the cochlear implant and adjacent structures. Materials and Methods A retrospective review was completed of consecutive patients that underwent CT imaging of the temporal bone before and after placement of a cochlear implant. Two blinded neuroradiologists independently reviewed all available examinations. All examinations were assessed for the presence or absence of dehiscence of the osseous ridge between the cochlea and facial nerve canal (FNC). Pre-operative and fused pre- and post-operative examinations were compared in their ability to visualize the osseous ridge using a 5-point Likert scale (ranging from 1 = unfused images were substantially superior to 5 = fused images were substantially superior). The electrode closest to the FNC were noted. Results Of 34 included patients, 13 (38.2%) were female and 21 (61.8%) were male; average age was 72.2. Seven patients (20.6%) had frank dehiscence between the cochlea and FNC. Fused images were superior to the post-operative study alone for assessing the integrity of the osseous partition between the cochlea and FNC and for reducing artifact from the electrode array (average Likert scores for both reviewers were 4.4 and 4.7). There was good agreement between reviewers in noting electrode closest to the FNC (concordance correlation coefficient=0.82). Conclusions Following cochlear implantation, co-registered pre- and post-operative CT images are superior to conventional images in assessing the anatomic relationship between the cochlea and FNC.

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Severe and persistent facial nerve stimulation after cochlear implantation in a patient with cochlear–facial dehiscence: a case report

Cited by 7 publications

References 18 publications

A CT Radiologic Assessment of the Incidence of Cochlear–Facial Dehiscence and the Thickness of Bone between the Cochlea and Facial Nerve among Normal Temporal Bones

A CT Radiologic Assessment of the Incidence of Cochlear–Facial Dehiscence and the Thickness of Bone between the Cochlea and Facial Nerve among Normal Temporal Bones

Abordaje clínico de la estimulación facial en implantes cocleares

Co-Registration of pre- and post-Operative images after cochlear Implantation: A proposed technique to Improve cochlear visualization and localization of cochlear electrodes

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