title: External magnet displacement in cochlear implants: causes and management.
abstract: OBJECTIVE
  To evaluate the complication of external magnet displacement in cochlear implant patients.
  
  
  METHODS
  Retrospective case review of patients at a tertiary academic medical center.
  
  
  METHODS
  Eleven patients were identified with postoperative magnetic retention difficulties after cochlear implantation.
  
  
  METHODS
  Skin flap thickness test, hair shaving over the magnet site, elastic headband usage, and skin flap thinning or revision were the primary interventions used.
  
  
  METHODS
  Qualitative reports of magnet retention difficulty noted in patient records during audiologic and device programming follow-up visits.
  
  
  RESULTS
  Follow-up ranged from 2 to 4 years from the date of implantation. Interventions included initial conservative measures (e.g., shaving hair, wearing headband). Four patients required flap thinning surgery; of these, 3 showed marked improvement. Almost all patients in this series were overweight or obese.
  
  
  CONCLUSIONS
  Patients with external magnet retention difficulties can present a challenge to users of cochlear implants and their providers. Conservative measures will alleviate the issue in many cases. Skin flap thinning is a viable option for those patients whose magnet retention difficulties do not resolve with conservative treatments. However, extra vigilance must be given to the skin flap in all cases to monitor the effects of both conservative and nonconservative measures because overcorrection may risk skin breakdown.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California 94143-0342, USA.
authors.forename: David
authors.initials: D
authors.lastname: Posner
authors.forename: Amanda
authors.initials: A
authors.lastname: Scott
authors.forename: Colleen
authors.initials: C
authors.lastname: Polite
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Lustig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D019929:Cochlear Implantation; D003054:Cochlear Implants; D007758:Ear, Inner / Q000601:surgery; D004868:Equipment Failure; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013524:Surgical Flaps