Imaging and Operative Precautions in Patients with Cochlear Implants — A Case Report with Comprehensive Literature Review
Refereed conference paper presented and published in conference proceedings


摘要Introduction: A 16-year-old girl with cochlear implant underwent preoperative computed tomography (CT) whole spine and posterior spinal fusion for scoliosis correction in Prince of Wales Hospital in late 2016. Issues of imaging modalities (magnetic resonance imaging [MRI] vs. CT) and perioperative cauterisation were raised in view of possible implant complications.

Methods: Studies were searched through PubMed using keywords including cochlear implant, MRI, complication and cauterisation / electrosurgery. Journals of all years, written in English and with institutional access to manuscript were included.

Results: MRI examination was identified the main cause of magnet dislocation of cochlear implants, and was reported even in 1.5-Tesla scanners, which most models were proven compatible with. Conventional preventive measures like compressive hand bandages were found not adequately protective. All 3 cochlear implant manufacturers (Cochlear Americas, Med-El, Advanced Bionics) advised against monopolar cautery. Application in head-and-neck region was not advised, where bipolar is preferred, but not within the vicinity of the implant (>1 cm).

Discussion and Conclusion: Complications of cochlear implants after MRI was a major concern. It is best to seek alternative imaging modalities. If MRI must be performed, be alerted and inform patients that complications may still occur even on employing 1.5-Tesla machines and preventive measures. Increasing head tilt away from implant during MRI and removing magnet before MRI are alternative measures to decrease demagnetisation risks. Regarding operations, bipolar cautery is generally more preferred, and avoid high levels and close proximity to the implant. However, concrete evidence is still lacking as most were cadaveric studies due to ethical issues.
著者KH Li, ALH Hung, TP Lam, JCY Cheng, BKW Ng
會議名稱Hong Kong Orthopaedic Association 37th Annual Congress 2017
會議地點Hong Kong
會議論文集題名The Proceedings of the Hong Kong Orthopaedic Association 37th Annual Congress 2017
出版地Hong Kong
頁次129 - 129

上次更新時間 2018-08-06 於 15:04