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Robotic Cochlear Implantation for Direct Cochlear Access
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Magnetic resonance imaging after cochlear implants.

Naif Bawazeer1, Hella Vuong2, Sophie Riehm3

  • 1Department of Otolaryngology-Head & Neck Surgery, Umm Al-Qura University, Saudi Arabia.

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Summary

Cochlear implants (CIs) can cause adverse events during MRI scans, including magnet displacement and pain. Careful patient positioning and protective measures are crucial to mitigate risks during magnetic resonance imaging with CIs.

Keywords:
Cochlear implantMRIRisk

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Area of Science:

  • Otolaryngology
  • Radiology
  • Biomedical Engineering

Background:

  • Cochlear implants (CIs) are generally MRI-compatible up to 3 Tesla (T).
  • Despite compatibility, risks of adverse events like implant displacement during MRI exist.
  • Literature reports include cases of accidents with compatible CI systems.

Purpose of the Study:

  • To report adverse events in patients with cochlear implants undergoing MRI.
  • To highlight the importance of safety protocols during MRI examinations for CI patients.

Main Methods:

  • Retrospective case series of six patients with cochlear implants who underwent MRI.
  • Detailed reporting of three cases experiencing adverse events.
  • Analysis of MRI artifacts across different imaging sequences.

Main Results:

  • Three patients experienced adverse events: magnet displacement with partial demagnetization, total demagnetization requiring reimplantation, and severe pain disrupting the scan.
  • 3D MRI angiography produced the smallest artifacts.
  • Diffusion and T2 FLASH sequences resulted in the largest artifacts.

Conclusions:

  • Supervised patient transfer into the MRI scanner by specialists is essential.
  • Maintaining a specific angle (≤90°) between implant and MRI magnetic fields (B0) is critical.
  • Recommendations include using an "arrow drawing" for orientation and employing protective splints with bandaging to prevent magnet displacement.