We had a case of 75-year old man with a history of progressive hearing loss on both side who implanted with a Nucleus 24 Contour Advance in the right ear. After 4 years from implantation, the patient started to complaint of right facial twitching when his cochlear implant was active. Despite undergoing numerous alterations in his implant programming, facial nerve stimulation (FNS) persisted. After increasing the pulse width and changing the stimulation mode, there was no facial nerve stimulation. However there was a deterioration in hearing and speech understanding. CT of the temporal bone showed good position of the implant electrodes und cochleomeatal scintigraphy (CMS) showed a highly positive activity with suspicion of otosclerosis, although the medical history was negative for otosclerosis. The FNS was managed with cochlea reimplantation and advanced programming techniques. FNS in cochlear implant patients may be managed through reimplantation and advanced programming techniques.
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