From the Department of Otolaryngology Head & Neck Surgery (Alahmadi), Ministry of Health, from the Head and Neck Skull Base Health Centre (Alghamdi), from the Department of Otology and Skull Base Surgery (Badr), King Abdullah Medical City, Makkah; from the Department of Otolaryngology, Neurotology & Skull Base Surgery (Alenzi), King Abdullah Ear Specialist Center, King Saud University, Riyadh, from the Department of Otolaryngology, Neurotology & Cochlear Implant (Alsheikh), Royal Commission Hospital, Jubail, Kingdom of Saudi Arabia; and from the Faculty of Medicine (Morra), AlAzhar University, Cairo, Egypt.
Saudi Med J. 2021 Aug;42(8):813-824. doi: 10.15537/smj.2021.42.8.20210294.
To systematically review the occurrence of magnet or receiver/stimulator displacement following cochlear implant (CI) placement complication and evaluate the existing literature on this topic.
A systematic literature search was conducted using PubMed, Scopus, Web of Science, Virtual Health Library (VHL), and Cochrane Library. Original studies reporting cases of magnet or receiver-stimulator migration occurring as a complication after CI placement were included. The quality of the included studies was evaluated using the National Institutes of Health Quality Assessment Tool for observational studies and CARE checklist for case studies.
A total of 36 studies, including 6469 patients, were included. Magnet migration was reported in 82 (1.3%) patients, while receiver/stimulator was reported in 4 (0.1%) cases. The cause of magnet migration was identified in 78 cases; MRI-induced movement was the most frequently reported cause (n=43, 55.1%), followed by head trauma (n=25, 32.1%). A total of 20 studies involving 35 patients with magnet migration performed skull radiography to diagnose magnet migration. Revision/exploratory surgery with surgical repositioning or replacement was the most frequent management procedure (n=46).
Further research on magnet pocket design and standard protocols for MRI in CI users is needed. Early diagnosis of magnet migration and instant referral to specialized CI centers is necessary for proper management and prevention of major complications. PROSPERO REG. NO. CRD: 42020204514.
系统回顾 Cochlear 植入（CI）后并发症发生时磁铁或接收器/刺激器移位的发生情况，并评估该主题的现有文献。
使用 PubMed、Scopus、Web of Science、Virtual Health Library（VHL）和 Cochrane Library 进行系统文献检索。纳入报告 CI 后并发症发生时磁铁或接收器-刺激器迁移病例的原始研究。使用 NIH 观察性研究质量评估工具和 CARE 病例研究检查表评估纳入研究的质量。
共纳入 36 项研究，包括 6469 名患者。82 名（1.3%）患者出现磁铁迁移，4 名（0.1%）患者出现接收器/刺激器迁移。78 例明确了磁铁迁移的原因；MRI 诱导的运动是最常报道的原因（n=43，55.1%），其次是头部外伤（n=25，32.1%）。共有 20 项涉及 35 名磁铁迁移患者的研究使用颅骨 X 线摄影诊断磁铁迁移。最常见的治疗方法是翻修/探查手术伴外科复位或更换（n=46）。
需要进一步研究磁铁口袋设计和 CI 用户 MRI 的标准方案。早期诊断磁铁迁移并立即转介至专门的 CI 中心对于适当的管理和预防主要并发症是必要的。PROSPERO 注册号：CRD：42020204514。
