Facial nerve stimulation after upgrade

[Paulo Cruz]

Hello,

Let me start by introducing myself.

My name is Paulo Cruz, I'm 53 and live in Sintra, Portugal.

On 2011, I was submitted to a cochlear implant surgery, which was sucessful
and changed my life by restoring my hearing to a point where I could have a normal life,
both with my family and professionally.

After the normal process of adaptation and fittings, my restored hearing
reached a level where I could hear well in most situations, and I even
began to enjoy listening to music again.

Some initial fittings resulted in a excessive stimulation of the facial nerve,
provoking pain and numbness, but these were properly revised and corrected.

In the last few years I have not experienced facial nerve stimulation,
even when exposed to loud or discomfortable sounds.

Unfortunately, things have changed since a couple of months.

On August 11, I went back to the hospital to initiate the process
of replacing my old Opus 2 processor with a new Sonnet 2 processor.

As usual, we took the oportunity to adjust the fitting a bit.
I learned that there had been a new software or firmware update since the last 
time I've been there.

The new fitting proved to be extremely discomfortable and painful,
so I went back to my old fitting, which had been saved in program 2.

To my surprise, even the old fitting was now causing facial nerve stimulation and pain.

I lowered the volume two steps and scheduled a new fitting session, which
happened in the following week.

This time I was surprised with the new processor, which meanwhile became available.
I returned home with a new processor, new fitting, and was told that a 3/4 weeks
period of adaptation would be required to get used to the new processor.

I got quickly used to the new processor and fitting. The sound quality improved
a lot, specially the music which was now much more clear and rich.

Unfortunately, the pain and numbness were still there.

I tried to identify the frequencies contributing to this feeling and
returned once more to the hospital (their generosity and solicitude seems to be endless).

We created a new fitting where these frequencies have been lowered.
I was hoping that this would have settled the issue, but, as it seems, the problem persists.

I am now living with a lowered (two steps) version of my old fitting.
Even then, I still feel pain and numbness after exposure to quite normal sounds,
like my grandson playing, dogs barking, etc...

So, I'm here to ask you if there is something we might have missed, some clue that you might have
that would help me to once again enjoy a clear and rich hearing without pain.

It would be great to clarify if the change to the fitting software I mentioned above may be behind this,
and if there is a way to revert this change...

Any help would be appreciated. Feel free to ask me anything, I'll try to give you
as much information as I can.

Many thanks!

[Mary Beth]

@Paulo Cruz

Welcome to HearPeers!

I experienced something very similar when upgrading from OPUS2 to Sonnet.  Here is what worked for me.

 

We created brand new MAPs for Sonnet instead of transferring the OPUS 2 MAPs.

We tested each electrode threshold instead of using default thresholds.

Then we set MCLs.

After a lot of time and energy it became very clear that my Sonnet MAPs were going to have to be different from my OPUS2 MAPs.

I hope you can get comfortable, great sounding Sonnet 2 MAPs soon.  Consider requesting an Omni mic program in one program slot.  Be sure to create that Omni mic setting MAP like above so it is not overstimulating.

 

Keep us posted.

[Kara of Canada]

I have had some similar experience. Loud sounds were causing a twitching eye and was piercing in my head. So my issue was that my regular Audi had been away for two years. At my implant centre bilateral is rare. I was seeing new Audi’s and they didn’t really have experience with me. (Everything with me is unique!) so finally my regular Audi came back and we went back to mappings from two years ago. With some new adjustments I am actually doing well with it. The sounds were very dull and quiet for two to three days. I also had programs that had increased volume. I needed to retrain my brain. Things are getting back to a “normal” feeling or should I say hearing. Lol 

[Paulo Cruz]

Hi Mary Beth and Kara,

Thank you so much for your replies.

I guess I'll take your advices: start over with new maps and give it some time to train my brain to a slightly lower volume...

I'll keep you posted.

[Mary Beth]

@Paulo Cruz

I did need new MAPs instead of adjustments of my OPUS2 MAPs but I did not end up with quieter sounding MAPs.  The new MAPs sound plenty loud but do not produce non auditory sensations.

[Paulo Cruz]

Hi @Mary Beth It's good to know that. I'll start with new maps and see how it goes!

[Asher kim]

Hi I  had a problem  with  mapping from the first  I had eye twitching, dizziness and pain sadly it's  all electrodes  so they can't  turn any off.

I  have triphasic  mapping  which  helps a lot . Have they tried  the triphasic with you?

[Kara of Canada]

For me they turned down the high setting. So there’s a default setting for all maps. You can get them customized to fit your needs. I have since not had any issues. 

[Mary Beth]

@Asher kim

triphasic is great for non auditory stim issues .  I know a few other people who use it.  Great that Med-El offers that option.  I think Med-El may be the only brand that offers triphasic pulses.

[Kim]

1 hour ago, Mary Beth said:

@Asher kim

triphasic is great for non auditory stim issues .  I know a few other people who use it.  Great that Med-El offers that option.  I think Med-El may be the only brand that offers triphasic pulses.

Yes it's  made a big difference for me before the triphasic  my map was too quiet as we couldn't turn the electrodes up without  pain.  It's  still not at full volume  but it's plenty  good enough. 

[Enegra]

On 7/28/2022 at 8:20 PM, Mary Beth said:

triphasic is great for non auditory stim issues .  I know a few other people who use it.  Great that Med-El offers that option.  I think Med-El may be the only brand that offers triphasic pulses.

Oticon Medical's implants have triphasic stimulation, but looking how the company has been sold, it might be the end of their CIs. I spoke once with an audiologist who really liked programming that kind of stimulation, apparently it is adjusted using different parameters than biphasic.

I had once a program with the triphasic stimulation to see if my face would stop reacting to sounds, but that wasn't it. It was also a quick conversion from my normal map, so it felt quite off, much softer in some areas, which I didn't like. And that was already with the MCLs upped from default, so it's interesting how doing the switch without adjusting makes it a lot softer.

[Mary Beth]

@Enegra

Several years ago I read an article about Med-El’s triphasic pulses written by an audiologist who had experience switching a user from biphasic to triphasic pulses.  He explained that it is like initial activation in that it takes several fittings to bring things up to a stable MAP again.  If I come across it, I will post a link.

[Mary Beth]

@Enegra

https://blog.medel.pro/triphasic-pulses-for-facial-nerve-stimulation/#

[Enegra]

@Mary Beth Thank you for the link, interesting read!

[Sakin]

I also had some problems after upgrading from opus 2 to sonnet 2.  In Sonnet 2, the sounds were very loud and my left upper tooth (canine tooth) was aching.  I had to meet with my audiologist twice for this.  My audiologist made some adjustments to the programming, turned the volume down a bit so everything was back to normal.  I am very happy now, there are no problems.  My suggestion is keep talking to your audiologist, he will definitely find a solution.