Background and Objectives: Electrode migration after cochlear implantation (CI) is a rare complication that accounts for 1to 15% of all revision surgery. This study is a systematic review of the literature for investigating the knowledge and approaches to the incidence of electrode migration after CI. Methods: A systematic electronic search of the literature was carried out using PubMed, Cochrane, Virtual Health Library, Scopus and Web of Science (ISI). All original articles that reported electrode migration after CI surgery were included. The Newcastle-Ottawa Scale and CARE checklist were utilized for the assessment of the risk of bias. Descriptive data analysis was performed using SPSS software. Results: A total of 26 studies including 4,316 patients were included. Out of them, 289 patients had electrode migration following CI. To diagnose electrode migration, traditional computed tomography scan was used in 13 studies, while cone-beam computed tomography was applied in three studies. In addition, electrode migration was detected during intraoperative exploration in eight studies. The most common presenting symptom was change in sound/poor performance (n = 43) followed by pain sensation (n = 15) and facial nerve stimulation (n = 10). Cholesteatoma was the most common associated pathology (n = 10) followed by infection (n = 9) and ossification of the basal turn of the cochlea (n = 8). Conclusion: Electrode migration is a major complication of CI and could be more common than previously thought. As it may occur with or without clinical complaints, long-term follow-up through routine radiological scanning is recommended. Further studies are warranted to identify the underlying mechanism of electrode extrusion and the appropriate fixation method.

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.

Objectives: The present literature review discusses the chronological evolution of Cochlear Implant (CI) activation and its definition among the relevant studies in the literature. In addition, the benefits of standardizing the early activation process in implantation centers worldwide are discussed. Methods: A comprehensive literature search was conducted in the major databases such as PubMed, Scopus, and Embase to retrieve all the relevant articles that reported early activation approaches following CI. Results: The evolution of the timing of early activation after CI has been remarkable in the past few years. Some studies reported the feasibility of early activation 1 day after the CI surgery in their users. Conclusions: Within the last decade, some studies have been published to report the feasibility and outcomes of its early activation. However, the process of early activation was not adequately defined, and no apparent guidelines could be found in the literature.

This study aimed to identify the association between different cochlear metrics, including the basal turn diameter (A-value), the basal turn width (B-value), and the height of the cochlea (H-value). We also reported an association between H-value and hearing outcomes with cochlear implants (CI). This is a retrospective study that included all patients who underwent CI procedures between 2012 and 2018 at a tertiary center and have; preoperative high-resolution computed tomography (CT) , normal cochlea, postoperative follow-up duration of at least 2 years, scores of the category auditory performance II (CAP-II), and speech intelligibility rating (SIR) scales. A total of 65 ears implanted with CI in 46 patients (24 boys and 20 girls; mean age of 7 (±10) years) fulfilled the inclusion criteria. We found significant positive correlations between A vs B, A vs H, and B vs H ( P -value = 0.008, 0.018, and 0.0039, respectively). We also found a significant positive relationship between A, B, and H values and cochlear duct length (CDL) ( P -value < 0.0001, 0.008, and 0.018, respectively). Finally, the H-value was significantly correlated with the SIR ( P -value = 0.027). However, its correlation with the CAP score was not statistically significant ( P -value = 0.62). Cochlear height significantly correlated with CDL and the other cochlear parameters. The variation in cochlear height can also affect speech outcomes in patients undergoing CI. Therefore, the H-value together with the other cochlear metrics should be adequately assessed preoperatively in CI patients.