Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study

Abstract Background When performing magnetic resonance imaging (MRI) in patients with a cochlear implant (CI), complication rates vary widely in the literature. The primary objective of this retrospective study was to determine the prevalence of complications, in particular magnet dislocation, in pa...

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Main Authors: Robin Rupp, Matthias Balk, Matti Sievert, Victoria Leibl, Stephan Schleder, Moritz Allner, Heinrich Iro, Ulrich Hoppe, Joachim Hornung, Antoniu-Oreste Gostian
Format: Article
Language:English
Published: SAGE Publishing 2023-04-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:https://doi.org/10.1186/s40463-023-00633-w
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author Robin Rupp
Matthias Balk
Matti Sievert
Victoria Leibl
Stephan Schleder
Moritz Allner
Heinrich Iro
Ulrich Hoppe
Joachim Hornung
Antoniu-Oreste Gostian
author_facet Robin Rupp
Matthias Balk
Matti Sievert
Victoria Leibl
Stephan Schleder
Moritz Allner
Heinrich Iro
Ulrich Hoppe
Joachim Hornung
Antoniu-Oreste Gostian
author_sort Robin Rupp
collection DOAJ
description Abstract Background When performing magnetic resonance imaging (MRI) in patients with a cochlear implant (CI), complication rates vary widely in the literature. The primary objective of this retrospective study was to determine the prevalence of complications, in particular magnet dislocation, in patients with CI undergoing 1.5 Tesla (T) MRI. As a secondary objective, the prevalence of magnet dislocation for specific cochlear implant device types was elaborated. Methods In a single-center retrospective study, all patients with a cochlear implant presenting for an MRI examination at 1.5 T at our institution between January 1st, 2010 and December 31st, 2020 were included. Implants with axial and diametrical magnets were included in the study. MRI safety measures were applied before imaging. The prevalence of complications was evaluated. Magnet dislocation rates were calculated for device types with at least 20 MRI exposures. Results During the study period, 196 MRI examinations were performed in a total of 128 patients, accounting for 149 different implants (21 implanted bilaterally) with a total of 231 implant exposures to MRI (average 1.69 ± 1.57; min. 1, max. 12). Complications were reported in 50 out of 231 cochlear implant exposures (21.6%). Magnet dislocation occurred in a total of 27 cases (11.7%). Dislocation rates were 29.6% for the Cochlear® CI500 series (24 dislocations from 81 exposures), 1.1% for the Cochlear® CI24RE series (1 from 87) and 0% for the MED-EL® Synchrony (0 from 36). The dislocation rate for the CI500 was significantly higher than for the CI24RE (χ2 (1) = 26.86; p < 0.001; ϕ = 0.40) or the Synchrony (χ2 (1) = 13.42; p < 0.001; ϕ = 0.34). Conclusions For 1.5 T MRI, the risk of magnet dislocation ranges from 0 to 29.6% and depends on the CI device type. Implants with a diametrical magnet can be considered potentially MRI-safe, whereas in CIs with axial magnets, the CI500 is at high risk of magnet dislocation. Therefore, apart from a strict indication for an MRI and adherence to safety protocols, post-MRI follow-up examination to rule out magnet dislocation is recommended. Graphical Abstract
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spelling doaj-art-e111b317fa594f7ebae4949fbbd08a3e2025-08-20T03:26:00ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162023-04-015211910.1186/s40463-023-00633-wRisk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective studyRobin Rupp0Matthias Balk1Matti Sievert2Victoria Leibl3Stephan Schleder4Moritz Allner5Heinrich Iro6Ulrich Hoppe7Joachim Hornung8Antoniu-Oreste Gostian9Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. ElisabethDepartment of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU)Abstract Background When performing magnetic resonance imaging (MRI) in patients with a cochlear implant (CI), complication rates vary widely in the literature. The primary objective of this retrospective study was to determine the prevalence of complications, in particular magnet dislocation, in patients with CI undergoing 1.5 Tesla (T) MRI. As a secondary objective, the prevalence of magnet dislocation for specific cochlear implant device types was elaborated. Methods In a single-center retrospective study, all patients with a cochlear implant presenting for an MRI examination at 1.5 T at our institution between January 1st, 2010 and December 31st, 2020 were included. Implants with axial and diametrical magnets were included in the study. MRI safety measures were applied before imaging. The prevalence of complications was evaluated. Magnet dislocation rates were calculated for device types with at least 20 MRI exposures. Results During the study period, 196 MRI examinations were performed in a total of 128 patients, accounting for 149 different implants (21 implanted bilaterally) with a total of 231 implant exposures to MRI (average 1.69 ± 1.57; min. 1, max. 12). Complications were reported in 50 out of 231 cochlear implant exposures (21.6%). Magnet dislocation occurred in a total of 27 cases (11.7%). Dislocation rates were 29.6% for the Cochlear® CI500 series (24 dislocations from 81 exposures), 1.1% for the Cochlear® CI24RE series (1 from 87) and 0% for the MED-EL® Synchrony (0 from 36). The dislocation rate for the CI500 was significantly higher than for the CI24RE (χ2 (1) = 26.86; p < 0.001; ϕ = 0.40) or the Synchrony (χ2 (1) = 13.42; p < 0.001; ϕ = 0.34). Conclusions For 1.5 T MRI, the risk of magnet dislocation ranges from 0 to 29.6% and depends on the CI device type. Implants with a diametrical magnet can be considered potentially MRI-safe, whereas in CIs with axial magnets, the CI500 is at high risk of magnet dislocation. Therefore, apart from a strict indication for an MRI and adherence to safety protocols, post-MRI follow-up examination to rule out magnet dislocation is recommended. Graphical Abstracthttps://doi.org/10.1186/s40463-023-00633-wCochlear implantMagnetic resonance imagingComplicationMagnet dislocationMagnet repositioningCI24RE
spellingShingle Robin Rupp
Matthias Balk
Matti Sievert
Victoria Leibl
Stephan Schleder
Moritz Allner
Heinrich Iro
Ulrich Hoppe
Joachim Hornung
Antoniu-Oreste Gostian
Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
Journal of Otolaryngology - Head and Neck Surgery
Cochlear implant
Magnetic resonance imaging
Complication
Magnet dislocation
Magnet repositioning
CI24RE
title Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
title_full Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
title_fullStr Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
title_full_unstemmed Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
title_short Risk of magnetic resonance imaging-induced magnet dislocation for different types of cochlear implants: a single-center retrospective study
title_sort risk of magnetic resonance imaging induced magnet dislocation for different types of cochlear implants a single center retrospective study
topic Cochlear implant
Magnetic resonance imaging
Complication
Magnet dislocation
Magnet repositioning
CI24RE
url https://doi.org/10.1186/s40463-023-00633-w
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