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Facial nerve paralysis following cochlear implant surgery
Jose N Fayad1, Georges B Wanna, Jennifer N Micheletto
1Department of Otolarynology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, The New York-Presbyterian Hospital, New York, New York 10021, USA. jfayad@hei.org
The Laryngoscope
|August 5, 2003
Summary
Facial nerve paralysis after cochlear implant surgery occurred in 0.71% of patients. This delayed complication, possibly due to heating or viral reactivation, resolved in all cases with treatment.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Facial nerve paralysis is a rare but serious complication following cochlear implant surgery.
- Understanding its incidence and mechanisms is crucial for patient safety and surgical technique refinement.
Observation:
- A retrospective chart review of 705 cochlear implant surgeries performed between 1980 and 2002 identified five cases of postoperative facial nerve weakness.
- The incidence of this complication was determined to be 0.71%.
Findings:
- Facial nerve paralysis presented with a delay, occurring 18 hours to 19 days postoperatively in all affected patients.
- Potential causes identified include thermal injury during surgery and viral reactivation.
- All five patients received treatment with steroids, with or without antiviral medication, leading to complete recovery of facial nerve function.
Implications:
- The study establishes a benchmark incidence for delayed facial nerve paralysis after cochlear implantation.
- Findings suggest that vigilance for delayed onset and prompt treatment with steroids are important for favorable outcomes.
- Further research into surgical techniques to minimize thermal injury and understanding viral reactivation could reduce the incidence of this complication.