Objectives: To systematically review the prevalence and risk factors of inadvertent facial nerve stimulation (FNS) after cochlear implant (CI) surgery. And to report the different management strategies used for reducing and resolving FNS.Data Source: Web of Science, Scopus, PubMed, Cochrane Library, and Virtual Health Library (VHL) of the World Health Organization (WHO).Review Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) on studies that reported FNS as a complication after CI. A comprehensive electronic search strategy was used to identify the relevant articles. We extracted the data on the prevalence of FNS after CI activation, the reported grades, and the management strategies. The number of associated electrodes; cause of deafness; co‐anomalies; and duration of hearing loss and their relationships with FNS were also studied.Results: Twenty‐one relevant articles were included in this review. The prevalence of FNS among the CI populations was 5.29% (175/3306 patients). Among those whose ages were reported, 58.3% (95/163) were adults, and 41.7% (68/163) were pediatrics. Modifying the different fitting parameters was the most used strategy, as it successfully resolved FNS in 85.5% of the patients (142/166). The second commonly used management strategy was surgical intervention (reimplantation or explantation), which was reported in seven studies for 23 patients.Conclusion: FNS after CI activation could be controlled and resolved with many advances that range from readjusting the fitting parameters to surgical intervention. However, further studies are required to validate the efficacy of each management strategy and its impact on patients' performance. Our findings demonstrate that CI recipients with FNS could still benefit from the CI devices and their FNS could be controlled.

Cochlear implantation has emerged as a transformative intervention in addressing profound hearing loss, offering a paradigm shift in auditory rehabilitation for individuals with restricted auditory function. Throughout its history, the understanding of contraindications for cochlear implant (CI) surgery has evolved significantly. This review comprehensively analyzes the chronological advancements in the understanding of CI contraindications, examining studies conducted from historical timelines to the present. Recent research has revealed significant developments in the field, prompting a reevaluation of established criteria and resulting in expanded indications for CI. The chronological evolution of contraindications underscores the transformative nature of the field, offering potential improvements in outcomes and enhancing the quality of life for individuals with profound hearing loss. In conclusion, this narrative review emphasizes the dynamic nature of the field, where the reevaluation of contraindications has created new opportunities and broader indications for CI. The emerging prospects, including improved outcomes and enhanced quality of life, hold promise for individuals with profound hearing loss.

This study aimed to validate the role of 3D segmentation in measuring the volume of the vestibular aqueduct (VAD), and the inner ear, and to study the correlation between VAD volume and VAD linear measurements at the midpoint and operculum. The correlation with other cochlear metrics was also studied. We retrospectively recruited 21 children (42 ears) diagnosed with Mondini dysplasia (MD) plus enlarged vestibular aqueduct (EVA) from 2009 to 2021 and who underwent cochlear implantation (CI). Patients’ sociodemographic data were collected, and linear cochlear metrics were measured using Otoplan. Vestibular aqueduct width and vestibular aqueduct and inner ear volumes were measured by two independent neuro-otologists using 3D segmentation software (version 4.11.20210226) and high-resolution CT. We also conducted a regression analysis to determine the association between these variables and CT VAD and inner ear volumes. Among the 33 cochlear implanted ears, 13 ears had a gusher (39.4%). Regarding CT inner ear volume, we found that gender, age, A-value, and VAD at the operculum were statistically significant (p-Value = 0.003, <0.001, 0.031, and 0.027, respectively) by regression analysis. Moreover, we found that Age, H value, VAD at the midpoint, and VAD at the operculum were significant predictors of CT VAD volume (p-Value < 0.04). Finally, gender (OR: 0.092; 95%CI: 0.009–0.982; p-Value = 0.048) and VAD at the midpoint (OR: 0.106; 95%CI: 0.015–0.735; p-Value = 0.023) were significant predictors of gusher risk. Patients’ gusher risk was significantly differentiated by gender and VAD width at the midpoint.

The objective of this study is to review our experience with simultaneous bilateral cochlear implantation (BiCI) in adults, and assess its feasibility. This could shorten the time required to regain binaural hearing, prevent social isolation, and potentially eliminate the need for hearing aids, as seen with sequential BiCI. A retrospective study was conducted involving adult patients who received simultaneous BiCI at our center between 2010 and 2023. The feasibility of simultaneous BiCI was assessed through postoperative clinical evaluations, outpatient visits, discharge status, and the acceptance of device fitting. Twenty-seven patients underwent simultaneous BiCIs. Their mean age was 37 years, comprising 59.3% males and 40.7% females. Out of the included patients, 51.9% had childhood-onset hearing loss, while 29.6% developed hearing loss later in life. Causes of hearing loss included meningitis 7.4%, trauma 11.1%, non-specific high-grade fever 11.1%, and Brucellosis infection 3.7%. Labyrinthine ossificans (LO) was present in 7.4%, and retrofenestral otospongiosis in 3.7%. The post-operative period and initial outpatient visit were uneventful for 88.8% and 81.5% of patients, respectively. Intraoperative complications were absent in 96.2% of cases. Simultaneous BiCI is feasible in adults without major intraoperative complications or troublesome recovery periods, offering potential benefits by reducing the number of surgeries and hospital admissions compared to the sequential method.

This retrospective study examined mastoid defects resulting from cochlear implant (CI) surgery and their potential for spontaneous regrowth across different age groups. Spontaneous closure of mastoid defects has been observed in certain CI patients during revision surgery or through post-operative temporal bone computer tomography (TB-CT). The analysis encompassed 123 CI recipients, comprising 81.3% children and 18.7% adults, who underwent post-operative TB-CT scans. Using image adjustment software, the study measured mastoid defect areas and found a significant reduction in children's defects between the initial and subsequent scans. Notably, mastoid defect areas differed significantly between children and adults at both time points. Furthermore, the analysis revealed significant correlations between mastoid defect areas and the age at implantation as well as the time elapsed since the CI surgery and the first CT scan. This study provides valuable insights for evaluating CI patients scheduled for revision surgery by assessing potential surgical challenges and duration. Furthermore, it may have a pivotal role in evaluating patients who experience postauricular swelling subsequent to CI surgery.