Magnet displacement: a rare complication following cochlear implantation.

The purpose of this paper is to describe cases which reported complication after cochlear implantation in children: displacement of magnet from the receiver pocket, possibly aided by the use of magnetic toys. We observed magnet displacement in two female children from the same family and in one male child. Age at implantation was 23, 51, and 24 months, respectively. Magnet displacement occurred at 37, 16, and 32 months, respectively after the initial surgery. The magnets were replaced under general anaesthesia and we did not observe recurrent magnet dislodgement. Measurements indicated that forces required to remove the magnet from its pocket were not greater than those exerted by magnetic toys or the magnet used in the external sender coil. Although magnet displacement is not common after cochlear implantation, it is a major complication in children where subsequent general anaesthesia and surgery are necessary to replace the magnet. Therefore, we propose that pockets for removable magnets of cochlear implants used in children should be redesigned to increase forces to remove the magnet or that removable magnets not be used at all.

Obesity as a risk factor for primary spontaneous rhinoliquorrhea.

OBJECTIVE: To determine whether obesity is a potential risk factor of primary spontaneous cerebrospinal fluid rhinorrhea (CSFR). DESIGN: Retrospective study. SETTING: University hospital. PATIENTS AND METHODS: The clinical data of 79 patients diagnosed with CSFR who had been treated at our hospital between 1991 and 2001 were assessed. The data of 61 (77%) of 79 cases were complete and could be used for this study. Patients were segregated according to the cause of their CSFR: 21 (34%) due to head trauma, 14 (23%) due to previous surgery, 7 (11%) due to congenital malformation, and 2 (3%) due to tumor adjacent to the anterior cranial fossa. Of the 61 subjects, 17 (28%) had CSFR without any detectable reason. This group was therefore designated as primary spontaneous CSFR. The body mass indexes (BMIs) of all patients were compared and statistically evaluated. RESULTS: The mean BMI (calculated as weight in kilograms divided by the square of height in meters) of the 17 patients with primary spontaneous CSFR was 34.87, which was significantly higher (P<.001) than the mean BMI of the other 44 patients (28.53). The mean BMI of the group of patients with CSFR due to previous surgery or trauma was significantly lower than the BMI of the group with primary spontaneous CSFR (P<.003), whereas in relation to the group afflicted with tumors and malformations, only a tendency (P<.28) was found. CONCLUSION: Our data suggest that obese patients are at an increased risk to develop primary spontaneous CSFR.