Cochlear implants and MRI safety

 Magnetic resonance imaging (MRI) is a medical imaging technique used to photograph structures in the body. MRI scanners use strong magnetic fields and radio waves (radiofrequency energy) to produce images.  If the patient has Implants that contain metal or magnets, the implant can move or twist in the patient's body, causing discomfort, pain or injury. You need to be aware of this risk and make sure that healthcare providers and MRI technicians are aware of your implant so that while performing an MRI scan, they take proper precautions. Also, radio waves from an MRI scanner can cause the implant to heat up. This is why it is important to ensure that the cochlear implant is MRI compatible first.

 Patient's Cochlear Implant Card:

After a cochlear implant is surgically placed, the patient or caregiver will receive an implant card as in the following example of a hypothetical MRI condition. This card contains important information about implant and MRI safety. Each type of cochlear implant has specific recommendations for performing MRI exams. Healthcare providers and MRI technologists should always follow the recommendations and directions for use from the manufacturer of the cochlear implant. 

MRI and cochlear implant safety: Cochlear implants have different ratings for MRI safety. while they have the implant. Conditional MRI means that the patient can have an MRI scan under certain conditions. For example, some newer cochlear implants that are MRI-induced are designed so that the implant magnet can rotate and realign in place. The magnet in the cochlear implant reduces the torsional forces on the implant and the surrounding tissue when it is exposed to the magnetic field of the MRI scanner. Some MRI-related cochlear implants may require surgical removal of the magnet before an MRI can be performed.  For other MRI-related cochlear implants, splint / ba-ageing kits may be available from the manufacturer for use during MRI.

When using these kits, it is important to use the kit designed for the cochlear implant and to follow the manufacturer's instructions. 

Cochlear Implant and MRI Adverse Events When a patient with a cochlear implant receives an MRI scan, adverse events may occur. Adverse events may include: pain during or post the scan, inflammation or breakdown of the skin over the implant magnet, a surgical procedure to change the position or replace the implant magnet after the scan, a surgical procedure to replace the cochlear implant as the device failed later after the scan, post-infection surgery for any of the above reasons. The frequency with which this type of event occurs is unknown and depends on the cochlear implant, surgical placement, and the MRI technique used for the scan.

Recommendations for Patients and Caregivers:

Know the brand and model of the cochlear implant. Always carry the implant card given to you with you. If you do not have an implant card, contact the manufacturer for one. If you need an MRI, inform the doctor's department. Doctor and MRI technician about your implant and share the information on the implant card. 

Recommendations for Healthcare Providers and MRI Technologists:

 Follow the MRI instructions from the manufacturer of the patient's cochlear implant. Ensure the static magnetic field strength (e.g. 0.2 T, 1.5 T, 3.0T) of the scanner is compatible with the implant. Some cochlear implants require surgical removal of the magnet before the scan and replacement of the magnet after the scan. Instructions can be found on the device label, on the manufacturer's website, or in both. Consider other types of imaging if clinically appropriate. Bandage kits for use with the patient's specific cochlear implant Follow the manufacturer's directions for use. Do not use any other bandage that is not designed for this purpose. There are some implants that contain hearing impairment magnets that are not cochlear implants. Examples of this are bone conduction or bone-anchored hearing aids or middle ear implants. Follow the manufacturer's instructions for this use.

The most important thing to follow up on is to report any adverse reactions to a cochlear implant. If the patient experiences any severe discomfort, immediately inform the healthcare professionals and technologists. Reporting these incidents can help better understand and study the risks associated with the use of these medical devices and implement changes for the better.

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