Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Otolaryngol Head Neck Surg. 2024 Feb;170(2):505-514. doi: 10.1002/ohn.555. Epub 2023 Oct 9.
Comprehensively assess the prevalence of monopolar electrosurgery-related device complications among cochlear implant (CI) recipients.
Multifaceted retrospective review and survey.
Tertiary medical center.
Multifaceted approach including: (i) review of the current literature; (ii) historical review of institutional data from an academic, tertiary CI center; (iii) review of industry data provided by 3 Food and Drug Administration-approved CI manufacturers; and (iv) survey of high-volume CI centers.
Literature review identified 9 human studies, detailing 84 devices with 199 episodes of device-cautery exposure. From studies reporting on patients records, no implant showed evidence of damage after exposure. One cadaveric study using dental cautery reported 1 episode of device damage. Review of institutional records did not identify any CI damage in 84 instances of exposure. Data from the 3 major implant manufacturers showed a single report of damage that could be reasonably linked to monopolar electrosurgery, out of a possible 689,426 CIs. Last, a survey of 8 high-volume CI centers did not identify any adverse events associated with monopolar cautery.
These data estimate the risk of adverse device-related events or tissue injury to be extraordinarily low. Short of operating in immediate proximity to the CI (ie, the ipsilateral temporoparietal scalp), these data indicate that monopolar electrosurgery can be used in the body and the head-and-neck of CI recipients with nominal risk. These findings may guide decision-making in cases that are optimally or preferably performed with monopolar electrocautery and can be used to counsel CI patients following inadvertent exposures.
全面评估接受人工耳蜗植入（CI）患者中与单极电外科相关设备并发症的发生率。
多方面的回顾性研究和调查。
三级医疗中心。
采用多方面的方法，包括：（i）文献综述；（ii）来自学术性三级 CI 中心的机构数据的历史回顾；（iii）由 3 家获得食品和药物管理局批准的 CI 制造商提供的行业数据的审查；以及（iv）对大容量 CI 中心的调查。
文献综述确定了 9 项人体研究，详细介绍了 84 个设备，有 199 个设备与电灼暴露有关。从报告患者记录的研究中，没有发现任何植入物在暴露后出现损伤的证据。一项使用牙科电灼的尸体研究报告了 1 个设备损坏的病例。对机构记录的审查未发现 84 例暴露中有任何 CI 损伤。来自 3 家主要植入物制造商的数据显示，在可能的 689,426 例 CI 中，仅有 1 例可合理归因于单极电外科的损伤报告。最后，对 8 个大容量 CI 中心的调查未发现与单极电灼相关的任何不良事件。
这些数据估计不良设备相关事件或组织损伤的风险极低。除非在紧邻 CI 的位置（即同侧颞顶头皮）操作，否则这些数据表明可以在接受 CI 的患者的身体和头颈部使用单极电外科，风险极小。这些发现可以为那些使用单极电切术最优化或优选进行的病例提供决策指导，并可用于在意外暴露后对 CI 患者进行咨询。
