Monopolar Cautery Use in Pediatric Cochlear Implant Users. (27th January 2023)

• Record Type: Journal Article
• Authors: Page, J. Cody; Chapel, A. Claire; Silva, Rodrigo C.; Sullivan, J. Connor; Sweeney, Alex D.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 168:Number 3(2023)
• Page Start: 478
• Page End: 483
• Publication Date: 2023-01-27
• Subjects: cochlear implant -- monopolar -- cautery -- electrocautery -- electrosurgery; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998221108051
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract: Objectives: To determine the incidence and impact of monopolar cautery use in a cohort of pediatric cochlear implant (CI) users. Study Design: Case series from a retrospective chart review and a systematic review of the literature. Setting: Tertiary academic referral center. Methods: CI patient charts from 2012 to 2021 were reviewed from a single pediatric hospital system to determine if monopolar cautery was used during a subsequent surgical procedure. In addition, a systematic review of the literature was performed to identify additional, relevant patients. Postoperative CI function was the primary outcome measure. Results: In total, 190 patients underwent a surgical procedure following cochlear implantation in a single pediatric hospital system. Fifteen patients (7.9%) and 17 distinct surgical procedures were identified in which monopolar cautery was used. Seven of these 17 cases (41.2%) involved the head and neck, and 10 were performed below the clavicles. No patients experienced a device failure or a decline in CI performance following surgery. A systematic review identified an additional 4 patients who underwent a surgery that used monopolar cautery following cochlear implantation, and no change in CI function was identified. Conclusions: The present study adds additional support to the notion that monopolar cautery does not necessarily injure CI functionality. While the most risk adverse strategy when planning a surgical procedure for a CI patient is to avoid monopolar cautery use altogether, the use of cautery should not immediately be associated with implant dysfunction.