Facial nerve aberrations encountered during cochlear implantation.
CONCLUSIONS
In patients with cochleovestibular malformations, surgeons should always consider the possibility of an aberrant course or shape of the facial nerve (FN). In our series, the majority of cases could be successfully implanted without major complications through careful handling of the FN and ossicles.


OBJECTIVE
To assess the frequency, type, and surgical implications of FN aberrations encountered during cochlear implantation (CI).


METHODS
Medical records and radiologic findings of 972 patients who underwent CI from 1988 to 2009 were reviewed retrospectively. Radiologic and intraoperative findings demonstrating malformations of the FN, ossicles, and inner ear were evaluated. Intraoperative events and postoperative FN outcome were reviewed.


RESULTS
Seven patients (0.7%) had an aberrant course or shape of the FN during CI. All these patients were pediatric. Four showed abnormal anterior or inferior location of the vertical segment, two had a bifurcated horizontal or vertical segment, and one had an inferiorly located horizontal segment. All seven patients displayed combined malformations of the cochlea and had malformed or missing ossicles. CIs were successfully performed via the facial recess approach and cochleostomy. There was no postoperative FN paralysis except in one case with immediate iatrogenic FN paralysis that recovered completely 1 month after FN decompression.
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Korea.
Jae-Jin
JJ
Song
Joo Hyun
JH
Park
Jeong Hun
JH
Jang
Jun Ho
JH
Lee
Seung Ha
SH
Oh
Sun O
SO
Chang
Chong Sun
CS
Kim
D002648:Child; D002675:Child, Preschool; D003051:Cochlea / Q000002:abnormalities; D019929:Cochlear Implantation; D003054:Cochlear Implants; D004429:Ear Ossicles / Q000002:abnormalities; D005154:Facial Nerve / Q000002:abnormalities*; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000002:abnormalities