Periauricular peripheral nerve field stimulation for neuropathic pain in the setting of cochlear implant treatment: A case report of simultaneous application

Introduction Cochlear implants (CI) are an established and proven method of auditory rehabilitation. In addition, neuromodulation systems such as peripheral nerve field stimulation (PNFS) for treating neuropathic pain are gaining increasing importance. To date, there is limited information regarding the concurrent use of these implanted systems and potential electromagnetic interferences. In this context, this case report addresses the simultaneous use of cochlear implants and peripheral nerve field stimulation.

Material and methods A 57-year-old patient bilaterally supplied with cochlear implants developed severe retroauricular pain in the access area of the CI implantation four weeks postoperatively, in the sense of a neuropathic pain syndrome. After unsuccessful medical and physiotherapeutic therapy, a permanent PNFS system with 2 periauricular electrodes (Boston WaveWriter R16) was implanted following positive diagnostic infiltration and outpatient PNFS testing.

Results The initial setting of the PNFS system resulted in a good and long-term reduction in pain intensity on the Visual Analog Scale (VAS) from 8/10 to 4/10 with a positive stimulation effect. The postoperative hearing impression was also not affected by the PNFS implantation.

Conclusion This case report demonstrates that the simultaneous use of cochlear implants and peripheral nerve field stimulation in the CI access area appears to be possible without complications and disruptive interactions. Therefore, this method may be considered as an option for chronic neuropathic pain management.

Publication History

Article published online:
19 April 2024