title: The prevalence and clinical course of facial nerve paresis following cochlear implant surgery.
abstract: OBJECTIVE
  To describe the prevalence, clinical course, and outcomes of facial nerve paresis following cochlear implantation and to identify variables associated with poor definitive facial nerve function.
  
  
  METHODS
  Retrospective cohort study with systematic literature review.
  
  
  METHODS
  All patients who underwent cochlear implantation between January 1990 and December 2010 at a single tertiary academic referral center were reviewed. Data including clinical presentation, intraoperative findings, onset, severity, management, and outcomes of all patients who experienced facial nerve paresis following cochlear implantation were recorded.
  
  
  RESULTS
  Eight hundred eighty-eight cochlear implants (282 pediatric, 606 adult) were performed in 768 patients. Eleven patients with postoperative facial nerve paresis were identified. Ten patients (1.1%) developed delayed-onset paresis and had complete recovery within 6 months of surgery, whereas a single patient (0.1%) demonstrated immediate onset paresis and experienced incomplete return of facial nerve function. Seventeen additional cases were identified in the literature and were summarized.
  
  
  CONCLUSIONS
  Facial nerve paresis following cochlear implantation is rare. Most cases demonstrate a delayed onset and have complete recovery within months of surgery. Delayed onset facial nerve paresis following cochlear implantation heralds an excellent prognosis, whereas immediate onset facial paresis prognosticates a poorer outcome. In the absence of medical contraindications, corticosteroid therapy should be considered in facial paresis following cochlear implant surgery.
authors: Department of Otorhinolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota 55905, USA.
authors: Joshua J
authors: JJ
authors: Thom
authors: Matthew L
authors: ML
authors: Carlson
authors: Michael D
authors: MD
authors: Olson
authors: Brian A
authors: BA
authors: Neff
authors: Charles W
authors: CW
authors: Beatty
authors: George W
authors: GW
authors: Facer
authors: Colin L W
authors: CL
authors: Driscoll
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000009:adverse effects*; D015331:Cohort Studies; D005155:Facial Nerve Diseases / Q000453:epidemiology / Q000209:etiology*; D005158:Facial Paralysis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012075:Remission, Spontaneous; D012189:Retrospective Studies