title: Monopolar cautery and adverse effects on cochlear implants.
abstract: OBJECTIVE
  The use of monopolar cautery has been widely regarded as a contraindication in the setting of a cochlear implant because of presumed risk to the implant device. There are very limited data to support this contraindication.
  
  
  OBJECTIVE
  (1) To evaluate the effects of monopolar cautery on cochlear implant devices. (2) To determine whether monopolar cautery changes the endocochlear temperature in an implanted cochlea.
  
  
  METHODS
  Sixteen cochlear implants from 3 manufacturers (Advanced Bionics LLC, Cochlear Americas Ltd, and Med-El Ltd) were implanted into 2 unembalmed, fresh cadavers. Monopolar cautery was applied to either the tongue or abdomen at coagulation settings of 10 W or 50 W for 30 minutes. Impedance and integrity testing were performed before, during, and after 30 minutes of cautery. The temperature in the endocochlear perilymph was measured during cautery. After explantation, devices were returned to the manufacturer for an in-depth "failure" analysis according to each manufacturer's current protocol evaluating explanted devices.
  
  
  METHODS
  Basic science laboratory, tertiary medical center.
  
  
  METHODS
  Cadaveric study.
  
  
  METHODS
  Application of monopolar cautery to implanted cochlear implants in a cadaveric model.
  
  
  METHODS
  (1) Changes to the implanted devices either during electrocautery or following failure analysis. (2) Changes in the intracochlear temperature.
  
  
  RESULTS
  No change in impedance, integrity testing, or failure analysis occurred at any cautery setting when applied to either the oral cavity or abdomen. The temperature of the cochlea did not increase with up to 30 minutes of cautery at a setting of 50 W. Comprehensive device analysis did not show any evidence of device damage at the conclusion of the study.
  
  
  CONCLUSIONS
  Monopolar cautery did not produce detectible damage to any of the cochlear implant devices or produce detectible temperature change in the cochlea at low or high levels of cautery in the oral cavity in this experimental model.
authors.affiliation: Department of Otorhinolaryngology, Louisiana State University, New Orleans, USA. ajeyak@lsuhsc.edu
authors.forename: Anita
authors.initials: A
authors.lastname: Jeyakumar
authors.forename: Meghan
authors.initials: M
authors.lastname: Wilson
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Sorrel
authors.forename: J Benjamin
authors.initials: JB
authors.lastname: McIntire
authors.forename: Dara D
authors.initials: DD
authors.lastname: Jones
authors.forename: Todd M
authors.initials: TM
authors.lastname: Brickman
authors.forename: Moises
authors.initials: M
authors.lastname: Arriaga
mesh_terms: D000005:Abdomen; D002102:Cadaver; D002425:Cautery / Q000009:adverse effects*; D003054:Cochlear Implants; D019544:Equipment Failure Analysis; D006801:Humans; D010498:Perilymph; D013696:Temperature; D014059:Tongue