The importance of postoperative 3D imaging in patients with inner ear anomaly and cochlea implantation - a case report

Introduction Facial nerve stimulation is a rare complication after cochlea implantation. The more precise, multidimensional pre- and postoperative imaging as well as the choice of electrodes adapted to the anatomical conditions has led to a reduction in this complication in recent years.

Case report At our CI center, a 23-year-old man with congenital severe hearing loss presented himself with facial nerve stimulation after electrode change of a cochlea implant on the left side at the age of nine for co-assessment. After the electrode was changed, a trans-orbital x-ray examination was performed for postoperative position control revealing a properly spiraled up electrode with correct projection in the temporal bone. Different electrode settings with a weakening of the stimulation led to a reduction in the symptoms, but this at the expense of subjectively poorer speech understanding.

We performed a Dyna-CT with 3D reconstruction for a more precise assessment. Although the electrode was spiraled up properly, the three-dimensional imaging revealed its dislocation from the anatomically altered cochlea and showed its contact to the facial nerve. Based on the CT images we could identify the electrodes 6-9 as responsible for facial nerve co-stimulation and could subsequently deactivate them. This resulted in immediate freedom of the facial hemispasm upon sound perception.

Discussion The case presented here underlines the importance of two- and three-dimensional postoperative imaging, especially in the case of anatomical anomalies. The cause of the facial co-stimulation could have been identified and remedied much earlier.

Poster-PDF A-1119.pdf

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021