External magnet displacement in cochlear implants: causes and management.

OBJECTIVE

To evaluate the complication of external magnet displacement in cochlear implant patients.

STUDY DESIGN

Retrospective case review of patients at a tertiary academic medical center.

PATIENTS

Eleven patients were identified with postoperative magnetic retention difficulties after cochlear implantation.

INTERVENTIONS

Skin flap thickness test, hair shaving over the magnet site, elastic headband usage, and skin flap thinning or revision were the primary interventions used.

MAIN OUTCOME MEASURES

Qualitative reports of magnet retention difficulty noted in patient records during audiologic and device programming follow-up visits.

RESULTS

Follow-up ranged from 2 to 4 years from the date of implantation. Interventions included initial conservative measures (e.g., shaving hair, wearing headband). Four patients required flap thinning surgery; of these, 3 showed marked improvement. Almost all patients in this series were overweight or obese.

CONCLUSION

Patients with external magnet retention difficulties can present a challenge to users of cochlear implants and their providers. Conservative measures will alleviate the issue in many cases. Skin flap thinning is a viable option for those patients whose magnet retention difficulties do not resolve with conservative treatments. However, extra vigilance must be given to the skin flap in all cases to monitor the effects of both conservative and nonconservative measures because overcorrection may risk skin breakdown.