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Facial palsy following cochlear implantation
Farid Alzhrani1, Thomas Lenarz2, Magnus Teschner2
1King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University, Riyadh, Saudi Arabia. Faz1420@hotmail.com.
Summary
Cochlear implantation via the facial recess approach poses a minimal risk of facial nerve (FN) palsy. Most cases of FN palsy are temporary, with a high recovery rate, especially for delayed onset.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Risk Assessment
Background:
- The facial nerve (FN) is anatomically vulnerable during cochlear implantation, particularly with the posterior tympanotomy approach.
- Facial nerve palsy (FNP) can be a complication of cochlear implantation surgery.
Purpose of the Study:
- To evaluate the incidence and characteristics of facial nerve palsy (FNP) following cochlear implantation using the mastoidectomy and posterior tympanotomy (facial recess) approach.
- To assess the risk factors, severity, and outcomes of FNP in this patient cohort.
Main Methods:
- Retrospective analysis of a cochlear implant patient database from 2000 to 2012.
- Inclusion criteria: patients who developed FNP post-cochlear implantation.
- Data collected: FNP type, severity (House-Brackmann grade), onset time, intraoperative findings, and need for revision surgery.
Main Results:
- An overall FNP incidence of 0.76% (26/3403) was observed.
- Delayed onset FNP (0.62%) was more common than immediate onset (0.15%).
- Most FNP cases were House-Brackmann grade III or IV, with an 80.8% overall recovery rate, higher in delayed onset cases.
Conclusions:
- Cochlear implantation via the facial recess approach presents a minimal risk of facial nerve palsy.
- Facial nerve palsy following cochlear implantation is predominantly a transient condition with a favorable prognosis.
- Surgical technique and anatomical considerations are crucial in minimizing FN injury risk.
