No Adverse Events from Monopolar Electrosurgery Use in Patients with Cochlear Implants

What is the safety profile of monopolar electrosurgery (MES) in patients with cochlear implants (CIs)?

BOTTOM LINE

No adverse events resulted from MES use in patients with CIs.

BACKGROUND: Monopolar electrosurgery is a versatile tool used to accomplish incision, dissection, or homeostasis during surgical procedures. Theoretically, MES use carries a risk of diversion of its electrosurgical current to existing implanted devices such as CIs; however, there is little reported evidence that substantiates CI device damage caused by MES.

STUDY DESIGN: Retrospective case series.

SETTING: Tertiary referral center.

SYNOPSIS: Researchers conducted a database search for patients who received CI surgery and other major surgeries between January 2009 and December 2021. They identified 35 patients who experienced 63 unique MES exposure events, with CI in vivo. Ten of the patients had bilateral CIs. Nine of the exposure events involved surgeries above the clavicle. The most common types of surgery included abdominal, thoracic/breast, spine, lower extremity orthopedic or vascular surgeries, and head and neck surgeries. Pre- and immediate postoperative speech recognition scores were not significantly different for patients using either consonant-nucleus-consonant or AzBio. Audiology and otolaryngology notes did not report any adverse events for any patient related to MES use. Overall findings showed that patients with CI are known to undergo surgery with MES, even in the head and neck, suggesting a lack of knowledge on contraindications to MES use in CI recipients.

CITATION: Cass ND, Lindquist NR, Bennett ML, et al. Monopolar electrosurgery with cochlear implants. Laryngoscope. 2023;133:933-937.