PATIENTS WITH COCHLEAR IMPLANTS IN THE OR – ISSUES AND CONCERNS
Abstract
Safety standards for patients with cochlear implants are difficult to find. Safety standards are, in fact, constantly evolving as more information becomes available. This article provides an overview of current philosophies and guidelines for most medical/surgical interventions, with emphasis on the operating room environment, as indicated by the three manufacturers authorized to market cochlear implants in Canada.
References
NIH consensus conference. Cochlear implants in
adults and children. JAMA 1995;274:1955-61.
Balkany T, Hodges AV, Luntz M. Update on
cochlear implantation. Otolaryngol Clin North
Am 1996;29:277-89.
Burgio P. Safety considerations of cochlear
implantation. Otolaryngol Clin North Am
;19:237-47.
Webb RL, Clark GM, Shepherd RK, Franz BK,
Pyman BC. The biologic safety of the Cochlear
Corporation multiple-electrode intracochlear
implant. Am J Otol 1988;9:8-13.
Clark G. Cochlear implants in children: safety
as well as speech and language. Int J Pediatr
Otorhinolaryngol 2003;67 Suppl 1:S7-20.
Gamble R. Info for CI. Personal
communication. In: Blakley B, ed., 2008.
Physician's Package insert for Nucleus 24
cochlear implants with Contour or contour
Advance electrode. Melbourne, Australia:
Cochlear Corporation, 2005:2-3.
O.R. Support Notes 4.14.2003
www.bionicear.com: Advanced Bionics, 2003:23.
Shepherd RK, McCreery DB. Basis of electrical
stimulation of the cochlea and the cochlear
nucleus. Adv Otorhinolaryngol 2006;64:186-205.
Ralston A, Stevens G, Mahomudally E,
Ibrahim I, Leckie E. Cochlear implants: response
to therapeutic irradiation. Int J Radiat Oncol Biol
Phys 1999;44:227-31.
Klenzner T, Lutterbach J, Aschendorff A,
Pedersen P, Stecker M, Laszig R. The effect of
large single radiation doses on cochlear implant
function: implications for radiosurgery. Eur Arch
Otorhinolaryngol 2004;261:251-5.
Klenzner T, Knapp F, Rohner F, von
Wallenberg E, Mauch H, Pedersen P, Aschendorff
A, Laszig R, Lutterbach J. Influence of ionizing
radiation on nucleus 24 cochlear implants. Otol
Neurotol 2005;26:661-7.
www.arthrocare.com. Plasma Knife /
Coblation. Austin, TX: Arthrocare Corporation,
Antonelli PJ, Baratelli R. Cochlear implant
integrity after adenoidectomy with Coblation and
monopolar electrosurgery. Am J Otolaryngol
;28:9-12.
Aurora RN, Casey KR, Kristo D, Auerbach S,
Bista SR, Chowdhuri S, Karippot A, Lamm C,
Ramar K, Zak R, Morgenthaler TI. Practice
parameters for the surgical modifications of the
upper airway for obstructive sleep apnea in
adults. Sleep 2010;33:1408-13.
Chou CK, McDougall JA, Can KW. Absence
of radiofrequency heating from auditory implants
during magnetic resonance imaging.
Bioelectromagnetics 1995;16:307-16.
Gubbels SP, McMenomey SO. Safety study of
the Cochlear Nucleus 24 device with internal
magnet in the 1.5 Tesla magnetic resonance
imaging scanner. Laryngoscope 2006;116:865-71.
DeLuca SA, Castronovo FP, Jr. Hazards of
magnetic resonance imaging. Am Fam Physician
;41:145-6.
Obler R, Kostler H, Weber BP, Mack KF,
Becker H. Safe electrical stimulation of the
cochlear nerve at the promontory during
functional magnetic resonance imaging. Magn
Reson Med 1999;42:371-8.
Weber BP, Goldring, J.E., Koestler, H.,
Tziviskos, G., Battmer, R., Lenarz, T. Magnetic
Resonance Imaging Compatibility Testing of the
Clarion 1.2 Cochlear Implant. AmJ Otol
;19:584-90.
Dyer RK, Jr., Nakmali D, Dormer KJ.
Magnetic resonance imaging compatibility and
safety of the SOUNDTEC Direct System.
Laryngoscope 2006;116:1321-33.
Sonnenburg RE, Wackym PA, Yoganandan N,
Firszt JB, Prost RW, Pintar FA. Biophysics of
cochlear implant/MRI interactions emphasizing
bone biomechanical properties. Laryngoscope
;112:1720-5.
Fritsch MH, Mosier KM. MRI compatibility
issues in otology. Curr Opin Otolaryngol Head
Neck Surg 2007;15:335-40.
