title: Cochlear implant magnet extrusion with subsequent surgical replacement and restoration of full implant use without the need for device explantation.
abstract: OBJECTIVE
  We recount the unusual case of a young boy whose removable cochlear implant magnet extruded through the skin after becoming displaced after several episodes of direct but minor head trauma. This article outlines a course of clinical management that  resulted in the successful re-implantation of a new magnet without infective sequelae and the need for device explantation.
  
  
  METHODS
  The child presented with recurrent erythema and swelling at the implant site. In retrospect, subtle magnet displacement was not  readily identified on initial imaging. The external magnet required an increase in strength while local swelling settled, but subsequently had to be reduced as the magnet was drawn gradually to the skin surface. Full extrusion took place, but in the absence of any obvious infection, the site  healed quickly.
  
  
  METHODS
  The external device was retained with a self-adhesive disc for 1 year, during which time the patient was observed closely for signs of local infection. The child was subsequently admitted for surgical re-exploration and insertion  of a new magnet. Care was taken to re-establish the integrity of the fibrous pocket that surrounded the cochlear implant.
  
  
  CONCLUSIONS
  This uneventful intervention was followed by the resumption of full and unimpaired implant use. At the time of this article submission, the  child is now 5 years post-extrusion and continues to do well in full-time education.
authors.affiliation: ORL-HNS, Dalhousie University, Halifax, Nova Scotia, Canada. dyohn@dal.ca
authors.forename: Damien Chandler
authors.initials: DC
authors.lastname: Yohn
authors.forename: Heather
authors.initials: H
authors.lastname: Maessen
authors.forename: David P
authors.initials: DP
authors.lastname: Morris
mesh_terms: D002648:Child; D019929:Cochlear Implantation; D003054:Cochlear Implants / Q000009:adverse effects*; D020878:Device Removal; D004890:Erythema / Q000209:etiology; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D059346:Magnets; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure