Neuromodulation Systems in the Setting of Cochlear Implant Treatment Based on Case Reports and Literature Review

Friederike Weise; Katharina Schaumann; Simone Volpert; Philipp J Slotty; Jan Vesper; Thomas Klenzner

doi:10.1016/j.neurom.2024.10.001

Neuromodulation Systems in the Setting of Cochlear Implant Treatment Based on Case Reports and Literature Review

Neuromodulation. 2024 Nov 22:S1094-7159(24)01191-7. doi: 10.1016/j.neurom.2024.10.001. Online ahead of print.

Authors

Friederike Weise¹, Katharina Schaumann², Simone Volpert², Philipp J Slotty³, Jan Vesper³, Thomas Klenzner²

Affiliations

¹ Department of Otorhinolaryngology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany. Electronic address: friederike.weise@med.uni-duesseldorf.de.
² Department of Otorhinolaryngology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
³ Department of Functional Neurosurgery and Stereotaxy, Center for Neuromodulation, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.

PMID: 39580742
DOI: 10.1016/j.neurom.2024.10.001

Abstract

Objectives: Cochlear implants are an established and proved method for auditory rehabilitation. In addition, neuromodulation systems for treating severe movement and pain disorders are gaining importance. To date, there is limited information regarding the concurrent use of the various implanted systems and potential electromagnetic interferences. In this case series, we assess the simultaneous use of cochlear implants and neuromodulation systems such as deep brain stimulation (DBS), occipital nerve stimulation (ONS) and peripheral nerve field stimulation (PNFS) on the basis of three retrospectively investigated case reports from our clinic.

Materials and methods: Case 1 is a patient aged 30 years with preexisting DBS system (Medtronic Activa RC, Medtronic, Dublin, Ireland) for idiopathic dystonia, who underwent cochlear implantation for severe-to-profound hearing loss. Cases 2 and 3 are patients aged 72 and 57 years, respectively, with cochlear implants in whom a neuropathic pain syndrome developed postoperatively. After unsuccessful medical and physiotherapeutic therapy, implantation of an ONS stimulator (Nuvectra-Algovita system, Plano, TX) and a permanent PNFS system with two periauricular electrodes (Boston Scientific WaveWriter R16, Marlborough, MA) was performed.

Results: In all three cases, the fitting parameters of the cochlear implant and the postoperative hearing impression were not affected. In the first case, the patient achieved speech understanding of 65% at 65 decibels sound pressure level (dB SPL) in the Freiburg monosyllabic test three months after surgery. In the second and the third case, speech comprehension remained good after ONS and PNFS intervention. DBS stimulation could be continued without complications and the occurrence of neurologic symptoms. Furthermore, a good and long-term reduction in pain intensity was achieved by implanting the ONS stimulator and the PNFS system.

Conclusion: This case series shows that the simultaneous use of cochlear implants and other neuromodulation systems seems possible without complications and disruptive interactions.

Keywords: Cochlear implant; deep brain stimulation; electromagnetic interferences; occipital nerve stimulation; peripheral nerve field stimulation.

Publication types

Review