Cochlear implant patients are at risk for magnet displacement, pain and discomfort during magnetic resonance imaging (MRI), according to a report published in the November 20 online edition of JAMA Otolaryngology-Head & Neck Surgery. The cochlear implant (CI), a medical device that can help patients with severe to profound hearing loss, is currently utilized by about 300,000 people worldwide. Unfortunately, CI patients can have difficulties while undergoing an MRI because of exposure of the CI’s internal magnet to the strong electromagnetic field of MRI. There have been previous reports of adverse events, according to background in the study.

Researcher Bo Gyung Kim, MD, PhD, of the Soonchunhyang University College of Medicine, South Korea, and co-authors reviewed the medical records of 18 cochlear implant patients who had MRIs between 2003 and 2014 at a single center. Of the patients, 16 underwent MRI in a 1.5-T scanner and two patients had an MRI in a 3.0-T scanner. The MRIs included 12 brain scans and 18 scans of other areas of the body.

Of the 18 patients, 13 completed their MRI scan without complications (25 of 30 scans). However, five cochlear implant patients fitted with protective head bandages could not complete their MRI because of pain or magnet displacement. Another patient experienced magnet polarity reversal. Hearing-related performance was unaffected in three CI patients who had major adverse events associated with MRI scanning.

“Our data clearly demonstrate that a significant proportion of patients experienced discomfort or pain during the MRI process and were unable to complete the scans,” the authors noted. “Therefore, in addition to device safety and image quality, patient comfort should be considered when performing MRI procedures.”

“Kim et al have reinforced a strong lesson for us all, that what may be considered safe by some may well be unsafe or unacceptable to others,” said Emanuel Kanal, MD, of the University of Pittsburgh Medical Center, in a related commentary on the pros and cons of MRI in cochlear implant recipients. “Their reminder to consider not just mere safety, but also morbidity and acceptability to the patient, is refreshing indeed. This should be added to our list of considerations prior to determining any risk-benefit assessment and patient scan recommendations regarding exposure of patients with implants to MRI environments.”

 

Correspondence regarding the study may be directed to co-author Jae Young Choi, MD, PhD, at: jychoi@yuhs.ac.

Source:JAMA Otolaryngology-Head & Neck Surgery, Soonchunhyang University College of Medicine 

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