Radomska Katarzyna, Sadkowska Sandra, Gostyński Marcin, Lubkowski Michał, Biernawska Jowita, Bubieńczyk Filip, Zacha Sławomir
Department of Otolaryngology, Pomeranian Medical University, Szczecin, Poland.
University Clinical Hospital no1, Pomeranian Medical University, Szczecin, Poland.
J Int Adv Otol. 2025 May 26;21(3):1-7. doi: 10.5152/iao.2025.241873.
Surgery of the thoracic and lumbar spine must employ monopolar electrical coagulation due to the necessity of bleeding control because alternative methods have too many limitations. The use of such electrocoagulation in cochlear implant (CI) users carries a high risk of damaging the assistive listening device. The objective of this paper is to present the management of 2 CI system users with advanced spinal curvature who required surgical treatment for scoliosis. A review of the literature was conducted on the use of medical procedures based on the conduction of electrical potentials within CI users. This paper presents 2 cases of surgery for spinal deformity in children who use CI. The precautions employed with regard to the utilization of monopolar coagulation are delineated. In neither case was damage to the CIs identified, despite the utilization of monopolar coagulation. A review of the literature revealed 415 documented instances of CIs being exposed to electrical current flow, of which 2 resulted in damage to the device. One case involved a patient who was defibrillated during cardiac arrest, while the other was related to dental pulp measurements on cadaveric teeth. Although monopolar electrocoagulation is considered a high-risk procedure for patients with CIs, this paper demonstrates that such procedures can be performed safely with appropriate precautions. It seems reasonable to conduct further experimental studies aimed at developing safe protocols to minimize the risk of damage to CI, ensuring that patients can undergo necessary medical procedures.
由于控制出血的必要性，胸腰椎手术必须使用单极电凝，因为其他方法有太多局限性。在人工耳蜗（CI）使用者中使用这种电凝有损坏辅助听力设备的高风险。本文的目的是介绍2例患有严重脊柱侧弯且需要进行脊柱侧弯手术治疗的CI系统使用者的处理情况。基于CI使用者体内电位传导对医疗程序的使用进行了文献综述。本文介绍了2例使用CI的儿童脊柱畸形手术病例。阐述了使用单极电凝时采取的预防措施。尽管使用了单极电凝，但两例均未发现CI受损。文献综述显示有415例记录在案的CI暴露于电流的情况，其中2例导致设备损坏。1例涉及心脏骤停时接受除颤的患者，另1例与尸体牙齿的牙髓测量有关。尽管单极电凝被认为是CI患者的高风险手术，但本文表明，采取适当的预防措施可以安全地进行此类手术。开展进一步的实验研究以制定安全方案，将CI受损风险降至最低，确保患者能够接受必要的医疗程序，似乎是合理的。
