Surgical Versus Noninvasive Manual Repositioning After Cochlear Implant Partial Magnet Dislocation

Objectives: To compare surgical magnet repositioning (SMR) and noninvasive manual magnet repositioning (MMR) as treatments for partial magnet dislocation (PMD) of the internal magnet in a cochlear implant (CI) caused by magnetic resonance imaging (MRI). The primary objective was the success rate, while the secondary objectives were total postinterventional CI downtime and complications. Methods: This single-center retrospective study was conducted at a tertiary referral medical center. Patients with CI treated for PMD between January 1, 2007 and September 30, 2022 were included. SMR served as primary treatment until June 2019 and as secondary treatment after the introduction of MMR. Results: A total of 51 cases of PMD were observed in 42 patients and 43 devices (18 ♀; 24 ♂; 12 with bilateral CI). MMR was performed successfully in 19 out of 20 cases (95%), while 32 cases were managed successfully by SMR. The median age at first magnet repositioning was 53.8 years (minimum 19 years, maximum 93 years). When MMR was performed, the mean time from diagnosis to treatment (0.5 ± 1.5 days vs 9.8 ± 7.6 days; P < .01), the mean time from repositioning to CI reactivation (1.4 ± 4.3 days vs 13.1 ± 6.7 days; P < .01), and the mean total CI downtime (1.9 ± 4.8 days vs 22.9 ± 11.9 days; P < .01) were significantly shorter compared to SMR. Significantly fewer complications were experienced with MMR [n = 0 (0%) vs n = 8 (25%); P = .04]. Conclusion: In case of PMD caused by MRI, noninvasive MMR shows a high success rate with a shorter total CI downtime as well as a lower complication rate compared to SMR. Therefore, MMR should be considered as first line treatment with SMR as a second option in case of failure.