title: How safe is diathermy in patients with cochlear implants?
abstract: BACKGROUND
  Cochlear implants are surgically inserted electrical devices that enable severely or profoundly deaf individuals to interpret sounds from their environment and communicate more effectively. As a result of their electrical nature, they are susceptible to electromagnetic  interference and can be damaged by excessive electrical energy. Surgical diathermy is one source of such potentially damaging energy. The British Cochlear Implant Group guidelines advise that monopolar diathermy should not be used in the head and neck region in patients with cochlear implants  and that bipolar diathermy should not be used within 2cm of the implant (http://www.bcig.org.uk/site/public/current/safety.htm).
  
  
  METHODS
  A questionnaire was provided to 36 surgeons working in different specialties in the head and neck region, inquiring as to their knowledge of the safety  considerations when using diathermy in cochlear implant patients. Thirty-five surgeons provided responses.
  
  
  RESULTS
  Overall, 77% of the respondents were unaware of the existence of published guidelines. Even when given an option to seek advice, 11% erroneously felt it was safe to use monopolar  diathermy above the clavicles with a cochlear implant in situ and 49% felt that there was no restriction on the use of bipolar diathermy.
  
  
  CONCLUSIONS
  There is a significant deficit in the knowledge of safe operating practice in the rapidly expanding population of patients with cochlear  implants which threatens patient safety. Through this publication we aim to increase awareness of these guidelines among members of the surgical community and this paper is intended to act as a point of reference to link through to the published safety guidelines.
authors.affiliation: The South of England Cochlear Implant Centre, UK. steveframpton@doctors.org.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: Frampton
authors.forename: H
authors.initials: H
authors.lastname: Ismail-Koch
authors.forename: T E
authors.initials: TE
authors.lastname: Mitchell
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003054:Cochlear Implants; D000075202:Contraindications; D004564:Electrocoagulation; D004598:Electrosurgery; D013502:General Surgery / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D011475:Prosthesis Failure; D011795:Surveys and Questionnaires