Two-phase survey on the frequency of use and safety of MRI for hearing implant recipients.

PURPOSE: Magnetic resonance imaging (MRI) is often used to visualize and diagnose soft tissues. Hearing implant (HI) recipients are likely to require at least one MRI scan during their lifetime. However, the MRI scanner can interact with the implant magnet, resulting in complications for the HI recipient. This survey, which was conducted in two phases, aimed to evaluate the safety and performance of MRI scans for individuals with a HI manufactured by MED-EL (MED-EL GmbH, Innsbruck, Austria). METHODS: A survey was developed and distributed in two phases to HEARRING clinics to obtain information about the use of MRI for recipients of MED-EL devices. Phase 1 focused on how often MRI is used in diagnostic imaging of the head region of the cochlear implant (CI) recipients. Phase 2 collected safety information about MRI scans performed on HI recipients. RESULTS: 106 of the 126 MRI scans reported in this survey were performed at a field strength of 1.5 T, on HI recipients who wore the SYNCHRONY CI or SYNCHRONY ABI. The head and spine were the most frequently imaged regions. 123 of the 126 scans were performed without any complications; two HI recipients experienced discomfort/pain. One recipient required reimplantation after an MRI was performed using a scanner that had not been approved for that implant. There was only one case that required surgical removal of the implant to reduce the imaging artefact. CONCLUSION: Individuals with either a SYNCHRONY CI or SYNCHRONY ABI from MED-EL can safely undergo a 1.5 T MRI when it is performed according to the manufacturer's safety policies and procedures.

Successful application and timing of a remote network for intraoperative objective measurements during cochlear implantation surgery.

OBJECTIVE: To determine the time needed to remotely perform a set of intraoperative measurements during cochlear implantation surgery and to compare it to the time needed to perform the same measurements in theatre. DESIGN: Prospective two-arm study comparing a local with a remote measurement setting. Three intraoperative measurements (Impedance Field Telemetry (IFT), evoked compound action potential (ECAP) and evoked stapedius reflex test (eSRT)) were performed with the audiologist present in the operating theatre (i.e. locally) or with the audiologist in his/her office (i.e. remotely). The time needed to complete the measurements, in total and individually, were measured and compared. STUDY SAMPLE: Fifty cochlear implant recipients, aged 0.7-48 years Results: IFT, ECAP and eSRT were performed successfully in all participants. Comparing locally and remotely performed measurements, IFT did not differ significantly, ECAP threshold or slope did not differ significantly differ in any single channel and eSRT measurements did not differ significantly except for in one of six channels. Remote measurements took 8.6 min less to perform than did local measurements (10.04 vs. 18.64 min); a significant difference (p < 0.001). CONCLUSIONS: Using a remote network connection for intraoperative objective measurements is an efficient and safe way to perform measurements during cochlear implantation surgery.

Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide.

OBJECTIVES: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation. METHODS: The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children? SUMMARY: The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.

The Mi1000 CONCERTO PIN cochlear implant: An evaluation of its safety and stability in adults and children.

Conclusion The study demonstrates the medium-term stability and safety of the CONCERTO PIN cochlear implant. The use of the CONCERTO PIN proved to be suitable for the use of a surgical technique without the need for suture fixation and resulted in short surgery duration and a low medium-term complication rate. Objective The primary aim was to provide data on medium-term safety and stability of the CONCERTO PIN cochlear implant in adults and children, and to collect feedback on the surgical technique used, which involved no drilling and no suture fixation. The secondary aim was to analyze surgery duration. Methods Implantation was performed using minimally invasive surgery. During surgery, data on the surgical procedure was collected by the attending surgeons or a designee. Safety and stability of the CONCERTO PIN were assessed at first fitting (1 month after implantation) and 6 months after first fitting. Results Ninety-nine patients were implanted with a CONCERTO PIN implant and one patient with a CONCERTO implant. The CONCERTO PIN implants implanted during this study were immobilized by pins and a tight periosteal pocket. The mean (± SD) surgery duration was 27:52 (± 9:19) min.

Quality standards for bone conduction implants.

CONCLUSION: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. OBJECTIVES: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. METHOD: To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. RESULTS: Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.