Indication and results of re-implantation of a cochlear implant Nucleus from the company Cochlear to the Synchrony from the company Medel in a patient

Introduction Should there be a basic indication for implantation of a CI with easy MRT CI?

Case presentation: A 22-year-old female patient with congenital profound hearing loss bilateral suffers from facial paresis and anacusis on the left side during surgery of an epidermoid in the CPA. In addition, a pituitary microadenoma on the left side was found. In cases of progressive sensorineural hearing loss, a CI is implanted on the right side. In the course of the disease a recurrence of the epidermoid in the left side of the CPA is observed.

MRIs and laboratory tests are performed regularly to monitor the course of the disease. With each MRI, the patient complains of severe pain and magnetic dislocation, which must be surgically corrected. Without the CI, the patient with SSD shows a hearing loss of 120-130dB between 0.5-4kHz. The hearing gain with the CI is good with an ABK of 30-40dB, a Freiburg speech audiometry of 65 %  at 65dB, 85 %  at 70dB and 100 %  at 80dB and OLSA at 65dB and 70dB of 99 % , adapl. OLSA +2.0dB.

An extension of the MRI controls is refused in case of complaints (hirsutism, irregular menstrual cycle, ...) of the patient.

Therapy and course: The young full-time working patient takes the risk and gets an easy MRI CI implanted. After explantation of the CI, MRI and reimplantation follow. After 4 months she has an ABK of 30-40dB with a Freiburg speech audiometry of 55 %  at 55dB, 100 %  at 65dB and 80dB. The regular 6-12 month MRI checks are performed without any problems.

Discussion Is it medically justifiable for patients to do without the easy MRT CI, which is common up to 3 Tesla MRT? Can young people, who are expected to need an MRI in the course of their lives, do without an easy MRI-CI?

Poster-PDF A-1439.pdf

Publication History

Article published online:
13 May 2021