Surgical Versus Noninvasive Manual Repositioning After Cochlear Implant Partial Magnet Dislocation

Area of Science:

• Otolaryngology
• Neurosurgery
• Medical Imaging

Background:

• Partial magnet dislocation (PMD) of the internal magnet in cochlear implants (CI) can occur after magnetic resonance imaging (MRI).
• Treatment options for PMD include surgical magnet repositioning (SMR) and noninvasive manual magnet repositioning (MMR).

Purpose of the Study:

• To compare the success rates, CI downtime, and complication rates of SMR and MMR for treating PMD in CI patients.
• To determine the optimal treatment strategy for PMD caused by MRI.

Main Methods:

• A single-center retrospective study included 51 cases of PMD in 42 CI patients treated between 2007 and 2022.
• SMR was the primary treatment until June 2019, after which MMR was introduced as a primary or secondary treatment.

Main Results:

• MMR demonstrated a high success rate (95% in 20 cases), while SMR was successful in 32 cases.
• MMR resulted in significantly shorter times from diagnosis to treatment, repositioning to CI reactivation, and total CI downtime compared to SMR.
• MMR was associated with significantly fewer complications (0%) compared to SMR (25%).

Conclusions:

• Noninvasive MMR is a highly effective treatment for PMD in CI patients, offering superior outcomes to SMR.
• MMR should be considered the first-line treatment for MRI-induced PMD, with SMR reserved for cases where MMR fails.