Ultrasound-controlled manual magnet repositioning: a new therapy option of magnet dislocation in patients with cochlear implant

Introduction Magnet dislocation through MRI or trauma is a serious complication in patients with cochlear implant. Patients usually present clinically with swelling and pain around the implant and can develop skin lesions over the magnet. Usually an X-ray is performed for diagnosis followed by surgical magnet repositioning.

Interventions Patients with cochlear implant presenting at our institution between June 01, 2019 and November 13, 2020 were examined with ultrasound. In partial magnet dislocation, a manual repositioning maneuver was performed. For that, pressure was applied with the thumb in direction of the dislocated part of the magnet. Immediate success control was performed with postinterventional ultrasound.

Results Eleven patients presented with a partial magnet dislocation diagnosed by pre-interventional ultrasound (n = 11 magnets; 4 ?; 8 right-sided implants; 64.0  ±  20.4 years). All magnets were repositioned manually. The magnets were successfully repositioned at the first attempt in eight out of eleven patients. Two patients required a second and one patient a third attempt of manual repositioning. Post-interventional ultrasound confirmed the entirely restored magnet position in all cases. CI reactivation was possible after 2.6  ±  5.8 days. During the mean follow-up period of 9.7  ±  6.2 months, no patient experienced any complication or recurrent dislocation of the respective magnet.

Conclusion Ultrasound-controlled manual magnet repositioning is a feasible and reliable method with a high success rate for partially dislocated CI magnets. Consequently, this therapeutic approach may spare the need for diagnostic x-ray examination as well as invasive surgical magnet repositioning. As a result, risk of impaired wound healing and implant infection is minimized.

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Publication History

Article published online:
13 May 2021