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Delayed-onset facial nerve paresis following cochlear implantation: case report and literature review

  • R Lawrence (a1), E Jeffs (a1) and DEH Hartley (a1) (a2)
Abstract
Objective

Facial nerve paresis is rare following cochlear implantation. Mechanisms underlying delayed-onset facial paresis are poorly understood. This paper describes the case of a patient who developed facial nerve paresis three years after implantation. A literature review was performed with the aim of identifying any similar cases.

Methods

The patient case is reported, and the literature reviewed using PubMed, Embase and Ovid databases.

Results

The literature review revealed that the vast majority of delayed-onset facial nerve paresis cases occur within the first month of implantation. Only two other cases occurring years after device implantation were identified. Although potential causative factors have been suggested, as in our case this phenomenon may be idiopathic.

Conclusion

Prognosis for recovery of late-onset facial nerve paresis seems promising, despite the unfortunate requirement for device explantation in all previous cases including our own.

Copyright
Corresponding author
Author for correspondence: Dr Rachael Lawrence, Department of Otolaryngology, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK E-mail: rachael.lawrence@nottingham.ac.uk
Footnotes
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Dr R Lawrence takes responsibility for the integrity of the content of the paper

Footnotes
References
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1Thom, JJ, Carlson, ML, Olson, MD, Neff, BA, Beatty, CW, Facer, GW et al. The prevalence and clinical course of facial nerve paresis following cochlear implant surgery. Laryngoscope 2013;123:1000–4
2Alzharni, F, Lenarz, T, Teschner, M. Facial palsy following cochlear implantation. Eur Arch Otorhinolaryngol 2016;273:4199–207
3Fayad, JN, Wanna, GB, Micheletto, JN, Parisier, SC. Facial nerve paralysis following cochlear implant surgery. Laryngoscope 2003;113:1344–6
4Tarkan, Ö, Tuncer, Ü, Özdemir, S, Sürmelioğlu, Ö, Çetik, F, Kiroğlu, M et al. Surgical and medical management for complications in 475 consecutive pediatric cochlear implantations. Int J Pediatr Otorhinolaryngol 2013;77:473–9
5Benatti, A, Castiglione, A, Trevisi, P, Bovo, R, Rosignoli, M, Manara, R et al. Endocochlear inflammation in cochlear implant users. Case report and literature review. Int J Pediatr Otorhinolaryngol 2013;77:885–93
6Sullivan, FM, Swan, IRC, Donnan, PT, Morrison, JM, Smith, BH, McKinstry, B et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med 2007;357:1598–607
7Engström, M, Berg, T, Stjernquist-Desatnik, A, Axelsson, S, Pitkäranta, A, Hultcrantz, M et al. Prednisolone and valaciclovir in Bell's palsy: a randomized double-blind, placebo-controlled, multicentre trial. Lancet Neurol 2008;7:9931000
8Hato, N, Yamada, H, Kohno, H, Matsumoto, S, Honda, N, Gyo, K et al. Valacyclovir and prednisolone treatment for Bell's palsy: a multicenter, randomized, placebo-controlled study. Otol Neurotol 2007;28:408–13
9Quant, EC, Jeste, SS, Muni, RH, Cape, AV, Bhussar, MK, Peleg, AY. The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis. BMJ 2009;339:b3354
10Lockhart, P, Daly, F, Pitkethly, M, Comerford, N, Sullivan, F. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2009;(4):CD001869
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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