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Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Cochlear implant and delayed facial palsy.
Shawn Thadathil Joseph1, Rajesh Vishwakarma, Mukesh Kumar Ramani
1Department of Otorhinolaryngology, Head & Neck Surgery, Government Medical College & Sir T Hospital, Bhavnagar, Gujarat, India, PIN-364001. shawndr@gmail.com
Cochlear Implants International
|February 6, 2009
Summary
Delayed facial palsy after cochlear implantation can occur due to viral reactivation, especially in patients with pre-existing viral antibodies. Early recognition and treatment with antivirals and steroids improve recovery.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Diseases
Background:
- Delayed facial nerve palsy (DFNP) following cochlear implant (CI) surgery presents diagnostic and therapeutic challenges.
- DFNP can lead to functional, aesthetic, emotional, and medico-legal concerns.
- Understanding the mechanisms of DFNP is crucial for effective management.
Observation:
- A case of DFNP post-CI in a patient with pre-operative positive viral antibody markers is presented.
- Literature review indicates viral reactivation as a significant cause of DFNP.
- Herpes simplex virus reactivation is a key concern in patients with positive viral markers.
Findings:
- Postulated mechanisms for DFNP include neural edema, vasospasm, and viral reactivation.
- Positive pre-operative viral antibody markers, combined with clinical presentation, suggest viral reactivation.
- Patients with positive viral markers are more susceptible to DFNP from viral reactivation.
Implications:
- Corticosteroids, antiviral agents, and physiotherapy can expedite and enhance recovery from DFNP.
- Experienced surgical teams and pre-operative imaging minimize direct facial nerve trauma.
- Proper surgical irrigation reduces the risk of neural edema.