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Case Report
Successful cochlear implantation in a patient with preexisting bilateral deep brain stimulation: A case report with two-year follow-up
1 Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA
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Nirmal Thapa
MD, Clinical Assistant Professor, Program Director, Medical Otolaryngology Fellowship, Section Chief, Otology and Neurotology–Lateral Skull Base Surgery, Department of Surgery, Division of Otorhinolaryngology– Head and Neck Surgery, University of Florida College of Medicine-Jacksonville, 653 West 8th Street, Jacksonville, FL 32209,
USA
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Article ID: 100023Z18NT2026
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Thapa N, Rabadi MJ, Jabour CG, Goodlett EA, Lieberman RB, Wasoff AL. Successful cochlear implantation in a patient with preexisting bilateral deep brain stimulation: A case report with two-year follow-up. J Case Rep Images Otolaryngol 2026;5(2):11–15.ABSTRACT
Introduction: Cochlear implantation (CI) in patients with preexisting bilateral deep brain stimulation (DBS) systems is rarely performed because of concerns regarding electromagnetic interference, device malfunction, telemetry disruption, and intraoperative safety. We report the successful cochlear implantation of a patient with bilateral ventral intermediate nucleus (VIM) DBS, with two years of clinical and audiologic follow-up demonstrating sustained outcomes without DBS-related complications.
Case Report: A 79-year-old man with progressive bilateral sensorineural hearing loss and medically refractory essential tremor treated with staged bilateral VIM DBS underwent right cochlear implantation after obtaining limited benefit from hearing aids. Preoperatively, right hearing-aid testing demonstrated consonant-nucleus-consonant (CNC) word recognition of 16% and an AzBio score of 33%. Right cochlear implantation was performed using a Cochlear Americas CI632 electrode array. Full electrode insertion was achieved, with normal intraoperative neural response telemetry and no surgical complications. Postoperatively, speech perception improved substantially, with CNC word recognition increasing to 74% at five months and 70% at nine months. Bimodal AzBio sentence scores were 84% at five months and 72% at nine months. During two years of follow-up, there were no episodes of DBS malfunction, telemetry interference, programming difficulty, or cochlear implant device failure.
Conclusion: Cochlear implantation can be safely performed in patients with preexisting bilateral DBS systems with careful perioperative planning and device management. This case adds to the limited literature by demonstrating successful cochlear implantation in a patient with established bilateral VIM DBS, including successful intraoperative device testing, substantial postoperative improvement in speech perception, and sustained compatibility between the cochlear implant and DBS systems over two years of follow-up.
Keywords: Cochlear implant, Deep brain stimulation, Essential tremor, Sensorineural hearing loss
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Acknowledgments
AI was used to edit the manuscript.
AI tool used: ChatGPT (OpenAI), GPT-5.5. I certify that AI was used only for language and grammar assistance. All facts, data, and records presented in the manuscript are the authors’ own intellectual contribution, and no part of the facts, data, and records presented in the manuscript are generated using AI tools.
Nirmal Thapa - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marissa J Rabadi - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Cayce G Jabour - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Elizabeth A Goodlett - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Rachel B Lieberman - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published
Amanda L Wasoff - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Drafting the article, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Nirmal Thapa et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
