Facial nerve paralysis following cochlear implant surgery.
OBJECTIVE
Facial nerve paralysis is a rare but devastating complication of cochlear implant surgery. The aims of the study were to define the incidence of facial nerve paralysis in our series and understand possible mechanisms of injury.


METHODS
Retrospective chart review and case reports.


METHODS
Charts were reviewed of all 705 patients implanted between 1980 and 2002 at the authors' institutions to identify those with postoperative facial nerve weakness and determine incidence. For patients with facial nerve weakness, onset, degree, and timing of paralysis were noted; clinical findings were correlated to operative report findings. The method of treatment was noted, and the final facial nerve function outcome was recorded.


RESULTS
Five patients (one child and four adults) were found to have postoperative facial nerve weakness, for an incidence of 0.71%. This complication was delayed in all cases, ranging from 18 hours to 19 days postoperatively. All patients were treated with steroids or steroids combined with antiviral medication, and all ultimately recovered normal facial function.


CONCLUSIONS
In the study series, the incidence of facial nerve paralysis following cochlear implant surgery was 0.71%. Possible mechanisms of injury included heating injury and viral reactivation. All patients presented with a delayed facial nerve paralysis and did recover normal facial nerve function.
Fayad
Jose N
JN
Department of Otolarynology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, The New York-Presbyterian Hospital, New York, New York 10021, USA. jfayad@hei.org
Wanna
Georges B
GB
Micheletto
Jennifer N
JN
Parisier
Simon C
SC
D000328:Adult; D000368:Aged; D019929:Cochlear Implantation / Q000009:adverse effects*; D005158:Facial Paralysis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies