Facial Nerve Stimulation as a Complication of Cochlear Implantation

  • Ihab Sefien
  • Soha HamadaEmail author
Original Article


Facial nerve stimulation (FNS) can be considered as one of potential complications of the cochlear implant (CI) procedure. A number of conditions have been identified that appear to predispose patients to facial nerve stimulation. Facial nerve stimulation can frequently be resolved with minimal changes in speech processor fitting but this may lead to reduction in the outcome. To overcome the aberrant FNS after cochlear implantation with preservation of patient performance. A retrospective review has been made of the clinical features of 2 patients out of 175 children younger than 17 years of age consecutively implanted, from April 2014 to December 2017 (in the ENT Department at the National Hearing and Speech Institute, Egypt). These 2 patients developed post-implantation facial nerve stimulation. Changing the programming strategies help to overcome this complication. FNS is one of the most frequent complications of the CI procedure. It can produce significant discomfort, in some cases may lead to limiting the use of an implant. So, preoperative counseling of the patient and surgical planning, is essential to avoid such complication. The management of FNS requires awareness with programming techniques and, in some cases, surgical explantation or re-implantation.


Facial nerve stimulation Complication of CI Management of facial nerve stimulation with CI 



  1. 1.
    Cushing SL, Papsin BC, Gordon KA (2006) Incidence and characteristics of facial nerve stimulation in children with cochlear implants. Laryngoscope 116:1787–1791CrossRefGoogle Scholar
  2. 2.
    Kelsall DC, Shallop JK, Brammeier TG, Prenger EC (1997) Facial nerve stimulation after nucleus 22-channel cochlear implantation. Am J Otol 18:336–341Google Scholar
  3. 3.
    Cohen NL, Hoffman RA, Stroschein M (1988) Medical or surgical complcation related to the nucleus multichannel cochlear implant. Ann Otol Rhinol Laryngol 97:8–13CrossRefGoogle Scholar
  4. 4.
    Rayner MG, King T, Djalilian HR et al (2003) Resolution of facial stimulation in otosclerotic cochlear implants. Otolaryngol Head Neck Surg 129:475–480CrossRefGoogle Scholar
  5. 5.
    Rotteveel JC, Proop DW, Ramsden RT et al (2004) Cochlear implantation in 53 patients with otosclerosis: demographics, computed tomographic scanning, surgery, and complications. Otol Neurotol 25:943–952CrossRefGoogle Scholar
  6. 6.
    Bigelow DC, Kay DJ, Rafter KO et al (1998) Facial nerve stimulation from cochlear implants. Am J Otol 19:163–169CrossRefGoogle Scholar
  7. 7.
    Niparko JK, Oviatt DL, Coker NJ et al (1991) Facial nerve stimulation with cochlear implant. Otolaryngol Head Neck Surg 104:826–830CrossRefGoogle Scholar
  8. 8.
    Weber BP, Lenarz T, Battmer D et al (1995) Otosclerosis and facial nerve stimulation. Ann Otol Rhinol Laryngol Suppl 166:445–447Google Scholar
  9. 9.
    Muckle RP, Levine SG (1994) Facial nerve stimulation produced by cochlear implants in patients with cochlear otosclerosis. Am J Otol 15:394–398Google Scholar
  10. 10.
    Polak M, Ulubil SA, Hodges AV, Balkany TJ (2006) Revision cochlear implantation for facial nerve stimulation in otosclerosis. Arch Otolaryngol Head Neck Surg 132:398–404CrossRefGoogle Scholar
  11. 11.
    Firszt JB, Holden L, Reeder R, Skinner MW (2009) Speech recognition in cochlear implant recipients: comparison of standard HiRes and HiRes 120 sound processing. Otol Neurotol 30:146–152CrossRefGoogle Scholar
  12. 12.
    Brendel M, Buchner A, Kruger B, Frohne-Buchner C, Lenarz T (2008) Evaluation of the harmony sound processor in combination with the speech coding strategy HiRes 120. Otol Neurotol 29:199–202CrossRefGoogle Scholar
  13. 13.
    Oleson J, Lesh S, Gfeller K, Knutson J (2008) The effect of advanced Bionics’ HiRes 120 on self-report of music enjoyment. Poster presentation at the 10th international conference on cochlear implants and other implantable auditory technologies, April 10–12, San Diego, CAGoogle Scholar
  14. 14.
    Ross M, Lerman J (1970) A picture identification test for hearing-impaired children. J Speech Hear Res 13(1):44–53CrossRefGoogle Scholar
  15. 15.
    Smullen JL, Polak M, Hodges AV, Payne SB, Telischi FF, Balkany TJ (2005) Facial nerve stimulation after cochlear implantation. Laryngoscope 115:977–982CrossRefGoogle Scholar
  16. 16.
    Papsin BC (2005) Cochlear implantation in children with anomalous cochleovestibular anatomy. Laryngoscope 115:1–26CrossRefGoogle Scholar
  17. 17.
    Graham JM, Phelps PD, Micheals L (2000) Congenital malformation of the ear and cochlear implantation in children: review and temporal bone report of common cavity. J Laryngol Otol 114:1–14CrossRefGoogle Scholar
  18. 18.
    Kelsall DC, Shallop JK, Brammeier TG et al (1997) Facial nerve stimulation after nucleus 22-channel cochlear implantation. Am J Otol 18:336–341Google Scholar
  19. 19.
    Kempf HG, Johann K, Lenarz T (1999) Complication in pediatric cochlear implant surgery. Eur Arch Otorhinolaryngol 256:128–132CrossRefGoogle Scholar
  20. 20.
    Berrettini S, De Vito A, Bruschini L, Passetti S, Forli F (2011) Facial nerve stimulation after cochlear implantation: our experience. Acta Otorhinolaryngol Ital 31:11–16Google Scholar
  21. 21.
    Kumar A, Mugge R, Lipner M (1999) Surgical complication of cochlear implantation: a report of three cases and their clinical features. Ear Nose Throat J 78:913–919Google Scholar
  22. 22.
    Maas SF, O’Driscoll M, Mawman D et al (1996) Explantation of a nucleus multichannel cochlear implant a re-implantation into the contralateral ear. A case report of a new strategy. J Laryngol Otol 110:881–883CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.ENT DepartmentHearing and Speech InstituteGizaEgypt
  2. 2.Audiology DepartmentHearing and Speech InstituteGizaEgypt

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