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Published on: January 9, 2019
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Factors Influencing Aberrant Facial Nerve Stimulation Following Cochlear Implantation: A Systematic Review and
Adam Van Horn1, Chistopher Hayden2, Anthony D Mahairas1
1Department of Otolaryngology-Head and Neck Surgery, University of Kentucky Medical Center.
Summary
Aberrant facial nerve stimulation (AFNS) after cochlear implantation occurs in 5.6% of patients. Lateral wall electrodes and otosclerosis increase AFNS risk, but reprogramming is often successful.
Area of Science:
- Otorhinolaryngology
- Neurosurgery
- Biomedical Engineering
Background:
- Aberrant facial nerve stimulation (AFNS) is a potential complication following cochlear implantation.
- Understanding the incidence and risk factors for AFNS is crucial for optimizing patient outcomes.
Purpose of the Study:
- To systematically evaluate the existing literature on the rate of aberrant facial nerve stimulation (AFNS) after cochlear implantation.
- To identify factors associated with AFNS and assess management strategies.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, Cochrane, Web of Science).
- Eligible studies published in English were included for meta-analysis if they contained paired data.
- Data extraction and bias assessment were performed independently by three investigators using the NIH Study Quality Assessment Tool.
Main Results:
- Thirty-seven articles comprising 5,694 patients were analyzed, revealing an overall AFNS rate of 5.6%.
- Lateral wall electrode arrays showed a significantly higher odds ratio for AFNS (OR=3.92) compared to perimodiolar electrodes.
- Cochlear implant recipients with otosclerosis (OR=13.73) or cochlear malformations exhibited higher AFNS rates (28% and 26% respectively).
Conclusions:
- Array type and underlying cochlear pathology are significant factors associated with AFNS.
- Reprogramming the implant, potentially with electrode deactivation, is a successful management strategy for AFNS.
- Further research is necessary to understand AFNS mechanisms and develop strategies to mitigate its impact on hearing outcomes.
