소아 전농 환자에서 인공 와우 이식 수술 후에 발생하는안면 신경 연축의 임상 양상 및 해결 방안

Abstract

Background and Objectives：Facial nerve stimulation (FNS) as a complication of cochlear implantation can produce significant discomfort, limit effective use of cochlear implant, and require extensive reprogramming in some patients. The purpose of this study is to review the clinical features of children with FNS after cochlear implantation and to discuss its possible solutions. Subjects and Method：Thirteen children who had FNS after cochlear implantation were included. Their medical records were reviewed retrospectively regarding the presence of inner ear anomaly (IEA), the programming techniques for cochlear implant, timing and progression of FNS, and the management of it. Results：Ten out of 13 children (76.9%) with FNS had IEA. In those 10 patients with IEA, FNS appeared within 6 months from the operation and showed a tendency of being relevant to all electrodes. Authors used four methods to eliminate FNS. They included (a) turning off the specific electrodes when FNS seems related to some specific electrodes, (b) changing the coding strategy or the programming mode, which proved not to be effective, (c) reducing the C-level, which resulted in severe narrowing of dynamic range as well as a relative control of FNS, and (d) surgical exploration in specific cases. Conclusion：FNS after CI is at greater risk for IEA. FNS in those cases can interfere with the progression of speech development. This should be sufficiently informed of the parents of CI candidates with IEA preoperatively. Surgical exploration can be reserved for elimination of FNS in specific cases. (Korean J Otolaryngol 2006;49:371-7)