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Skin breakdown over cochlear implants: prevention of a magnet site complication
Adrian L James1, Sam J Daniel, Lara Richmond
1Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, Toronto, ON.
Insights
Skin inflammation around cochlear implant magnets is common in children. Most cases resolve by reducing magnet strength, but temporary device discontinuation or antibiotics may be needed for severe reactions.
Area of Science:
- Otolaryngology
- Pediatric Audiology
Background:
- Cochlear implants are vital for hearing restoration in children.
- Skin reactions at the implant magnet site can impact device use and patient comfort.
Purpose of the Study:
- To investigate the prevalence and characteristics of skin inflammation around cochlear implant magnet sites in pediatric patients.
Main Methods:
- A postal survey was conducted among 232 children who received cochlear implants.
- Data collected included the timing and severity of skin inflammation near the magnet.
Main Results:
- 27% of children experienced skin erythema at the magnet site.
- Reactions were more common in younger children (average age 2.8 years).
- Most cases resolved with reduced magnet strength; some required antibiotics or temporary device cessation, with two instances of skin ulceration.
Conclusions:
- Skin inflammation is a frequent complication in pediatric cochlear implant recipients.
- Management involves reducing magnet strength, temporary device discontinuation if needed, and antibiotics for cellulitis to prevent infection.
- Prompt management is crucial to ensure continued implant function and prevent complications.
Objective:
To determine the prevalence of inflammation of the skin around the magnet of cochlear implants.
Method:
A postal survey of 232 children implanted at The Hospital for Sick Children, Toronto, detailing the timing and severity of skin inflammation near the magnet.
Results:
Sixty-three children (27%) had at least one episode of skin erythema at the magnet site. In most cases, this resolved after reducing magnet field strength. Nine children stopped wearing the device briefly, and five were treated with antibiotics. Skin ulceration occurred in two cases. No surgical treatment was required. Reactions tended to occur in younger children (2.8 vs 4.3 years; p = .002, Mann-Whitney rank sum test).
Conclusions:
Skin inflammation commonly occurs in children between magnets of the transmitter and receiver coils of a cochlear implant. If inflammation fails to resolve after loosening the magnet, use of the implant should be discontinued temporarily. Antibiotics should be prescribed for cellulitis to prevent an implant-threatening infection.