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van de Heyning P, Mertens G, Topsakal V, de Brito R, Wimmer W, Caversaccio MD, Dazert S, Volkenstein S, Zernotti M, Parnes LS, Staecker H, Bruce IA, Rajan G, Atlas M, Friedland P, Skarzynski PH, Sugarova S, Kuzovkov V, Hagr A, Mlynski R, Schmutzhard J, Usami SI, Lassaletta L, Gavilán J, Godey B, Raine CH, Hagen R, Sprinzl GM, Brown K, Baumgartner WD, Karltorp E. Two-phase survey on the frequency of use and safety of MRI for hearing implant recipients. Eur Arch Otorhinolaryngol 2021; 278:4225-4233. [PMID: 33788034 PMCID: PMC8486706 DOI: 10.1007/s00405-020-06525-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/26/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phases, aimed to evaluate the safety and performance of MRI scans for individuals with a HI manufactured by MED-EL (MED-EL GmbH, Innsbruck, Austria). METHODS A survey was developed and distributed in two phases to HEARRING clinics to obtain information about the use of MRI for recipients of MED-EL devices. Phase 1 focused on how often MRI is used in diagnostic imaging of the head region of the cochlear implant (CI) recipients. Phase 2 collected safety information about MRI scans performed on HI recipients. RESULTS 106 of the 126 MRI scans reported in this survey were performed at a field strength of 1.5 T, on HI recipients who wore the SYNCHRONY CI or SYNCHRONY ABI. The head and spine were the most frequently imaged regions. 123 of the 126 scans were performed without any complications; two HI recipients experienced discomfort/pain. One recipient required reimplantation after an MRI was performed using a scanner that had not been approved for that implant. There was only one case that required surgical removal of the implant to reduce the imaging artefact. CONCLUSION Individuals with either a SYNCHRONY CI or SYNCHRONY ABI from MED-EL can safely undergo a 1.5 T MRI when it is performed according to the manufacturer's safety policies and procedures.
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Affiliation(s)
| | - Griet Mertens
- ENT Department, Antwerp University Hospital (UZA), Edegem/Antwerp, Belgium
| | - Vedat Topsakal
- ENT Department, Antwerp University Hospital (UZA), Edegem/Antwerp, Belgium
| | - Ruben de Brito
- Hospital for Rehabilitation of Cranio-Facial Anomalies, Bauru-Sao Paulo, Brazil
| | - Wilhelm Wimmer
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Marco D Caversaccio
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Stefan Dazert
- Bochum St. Elisabeth University Hospital, Bochum, Germany
| | | | - Mario Zernotti
- Córdoba Sanatorium Allende, Servicio de Otorrinolaryingologia (Servicio ORL), Córdoba, Argentina
| | - Lorne S Parnes
- London Health Sciences Center-University Hospital, London, Ontario, Canada
| | - Hinrich Staecker
- Department of Otorinolaryngology, Kansas University Center for Hearing and Balance Disorders, Kansas City, USA
| | - Iain A Bruce
- Pediatric ENT Department, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gunesh Rajan
- University of Western Australia, Crawley, Perth, Australia.,Department of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - Marcus Atlas
- Ear Sciences Center, Lions Hearing Clinic, Subiaco, Australia
| | - Peter Friedland
- Ear Sciences Center, Lions Hearing Clinic, Subiaco, Australia
| | - Piotr H Skarzynski
- Institute of Sensory Organs, Nadarzyn/Kajetany, Poland.,Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Serafima Sugarova
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Vladislav Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Robert Mlynski
- Universität Rostock "Otto Körner", Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Rostock, Germany
| | | | | | | | | | - Benoit Godey
- Centre Hospitalier Universitaire (CHU) de Rennes, Rennes, France
| | | | - Rudolf Hagen
- Würzburg ENT University Hospital, Würzburg, Germany
| | | | - Kevin Brown
- UNC Ear and Hearing Center at Chapel Hill School of Medicine, Chapel Hill, NC, USA
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Adverse events in pediatric cochlear implant patients undergoing magnetic resonance imaging. Int J Pediatr Otorhinolaryngol 2021; 140:110547. [PMID: 33310425 DOI: 10.1016/j.ijporl.2020.110547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the prevalence and nature of adverse events in magnetic resonance imaging (MRI) of pediatric cochlear implant (CI) patients. METHODS Retrospective chart review at a tertiary pediatric hospital. CI patients who underwent MRI from 2004 through 2019 were identified via our internal radiology database. Comorbidities, CI model, age at MRI, number of MRIs, type of MRIs, indication for MRIs, precautions taken for MRIs, quality of MRIs, anesthesia during MRIs, patient language abilities, and adverse events were recorded from the electronic medical record. The literature was reviewed, and our results were compared to those of previous similar series. RESULTS From 2004 to 2019, 12 pediatric patients (17 ears) with CIs underwent 22 MRIs. 12 MRIs were performed in CI patients with retained internal magnet. 4/22 MRIs resulted in morbidity; 2 patients experienced pain requiring MRI abortion, 1 experienced magnet rotation requiring surgical replacement, and 1 underwent operative removal of the magnet prior to the scan with surgical replacement thereafter. 19/22 MRIs were performed to evaluate the brain; 17/22 of the radiologic reports noted limitation of evaluation due to artifact. 18/22 MRIs required the administration of anesthesia. 9 of the 22 MRI events involved 2 patients whose CIs had been without internal magnet in anticipation of future MRI requirement. CONCLUSIONS Adverse events affecting pediatric patients with CI can occur as a result of MRI, despite appropriate precautions. Safety requires consideration of factors unique to a pediatric hearing-impaired population. Clinicians must remain informed on best practices and manufacturer recommendations.
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First MRI With New Cochlear Implant With Rotatable Internal Magnet System and Proposal for Standardization of Reporting Magnet-Related Artifact Size. Otol Neurotol 2020; 40:883-891. [PMID: 31219967 DOI: 10.1097/mao.0000000000002269] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report on the first known magnetic resonance imaging (MRI) with a new cochlear implant (CI) with rotatable internal magnet system, to review the literature on MRI in cochlear implantees, and to advocate for standardization of reporting magnet-related artifact size. STUDY DESIGN Case report and review of literature. SETTING Tertiary care hospital. RESULTS A patient with congenital rubella and bilateral profound hearing loss was incidentally found to have a petroclival meningioma. After resection and radiosurgery, she underwent cochlear implantation with the Advanced Bionics HiRes Ultra 3D device (Advanced Bionics LLC, Valencia, CA) with rotatable internal magnet system, due to need for imaging surveillance of residual meningioma. During 1.5 T MRI brain scan without a head wrap, she experienced no adverse events. The images obtained were adequate for visualization of residual tumor. Implant recipients with non-rotatable magnets who undergo MRI, with or without recommended head wrap, may suffer various complications. All images in patients with retained internal magnets are subject to magnet-related artifact, but reports regarding its size are variable and lack detail on how measurements are made. CONCLUSIONS MRI in patients with a new CI device with rotatable magnet system may be performed without discomfort or device dislodgement at 1.5 T, even without a head wrap, though external magnet replacement may require multiple attempts due to internal magnet realignment. Despite significant artifact, the structure of interest may still be visualized for accurate diagnosis. Measuring magnet-related artifact size should be standardized by reporting artifact in radii at the image level of maximal signal loss.
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