Migirov Lela, Wolf Michael
Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel. migirovl @ gmail.com
ORL J Otorhinolaryngol Relat Spec. 2013;75(1):1-5. doi: 10.1159/000346239. Epub 2013 Jan 30.
Recent advances in cochlear implants (CIs) and in magnetic resonance imaging (MRI) techniques have led to increasing numbers of implanted patients who have undergone brain MRIs for various reasons. This paper first describes the surgical procedure for removing the magnet before an MRI and its subsequent reinsertion immediately afterwards in a CI recipient.
After the administration of local anesthesia, the magnet was removed by a surgical incision made along the posterior margin of the receiver-stimulator. The flap was elevated and the capsule over the implant was incised. The magnet was removed, maintained under sterile conditions and reinserted immediately after the completion of the 1.5-Tesla MRI.
The patient was able to wear her device immediately after surgery. Large CI-associated artifacts were observed on the MRIs irrespective of sequences. The function of the device was not altered by either the MRI or the surgical procedure.
The proposed surgical incision that follows the posterior margins of the receiver-stimulator allows the wearing of the device immediately after the surgical procedure. An MRI has limited diagnostic value for lesions located on the implanted side due to unavoidable artifacts, even after the magnet has been removed.
人工耳蜗（CI）和磁共振成像（MRI）技术的最新进展导致越来越多因各种原因接受脑部MRI检查的植入患者。本文首先描述了在MRI检查前取出磁体的手术过程以及随后立即在人工耳蜗接受者中重新插入磁体的过程。
在局部麻醉后，通过沿接收器刺激器后缘做的手术切口取出磁体。掀起皮瓣，切开植入物上方的包膜。取出磁体，在无菌条件下保存，并在1.5特斯拉MRI检查完成后立即重新插入。
患者术后立即能够佩戴其装置。无论采用何种序列，MRI上均观察到与人工耳蜗相关的大量伪影。该装置的功能未因MRI或手术操作而改变。
沿接收器刺激器后缘的建议手术切口允许术后立即佩戴该装置。即使在磁体取出后，由于不可避免的伪影，MRI对植入侧病变的诊断价值有限。
