Indication and results of reimplantation of a cochlear implant nucleus of the company Cochlear to the synchrony of the company Medel in a female patient

Introduction Should there be a basic indication for the implantation of a CI with easy MRT CI in patients?

Case presentation A 22-year-old female patient with congenital high-grade hearing loss bds suffers facial paresis and left anacusis during surgery of an epidermoid in the KHBW. In addition, a pituitary microadenoma on the left is found. In progressive sensorineural hearing loss, a CI is implanted on the right side and a relapse of the epidermoid in the left side of the KHBW is observed.

Regular MRI examinations and laboratory checks are performed to monitor the course of the disease. During each MRI examination the patient complains of severe pain and 3 times magnetic dislocations occur, which have to be corrected surgically, despite the pressure bandage and discontinuation of the examinations. Without the CI, the patient with SSD has a residual hearing of 120-130dB between 0.5-4kHz. The hearing gain with the CI is good with an ABK of 30-40dB, a Freiburg speech audiometry of 65% at 65dB, 85% at 70dB and 100% at 80dB as well as an OLSA at 65dB and 70dB of 99%, adapl. OLSA +2.0dB.

Therapy and course Despite great concern about the good hearing gain, the young fully employed patient takes the risk after 7 months of dealing with the MDK and can be replanted. Already after 4 months an ABK of 30-40dB is available with a Freiburg speech audiometry of 55% at 55dB, 100% at 65dB and 80dB.

Discussion Is it medically justifiable to dispense with the easy MRI cochlear implant, which is common up to 3Tesla MRI, for patients with central pre-existing conditions? Can an easy MRT cochlear implant be dispensed with in young people who are expected to require an MRT in the course of their lives?

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Publication History

Article published online:
10 June 2020