Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Pan, Tommy; Adeyemo, Adeshina; Armstrong, Douglas; Petfield, Joseph L.

doi:10.2106/jbjs.cc.21.00609

Cited by 2 publications

(4 citation statements)

References 27 publications

(28 reference statements)

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“…Review of the extant literature identified 9 human clinical studies, with a total of 84 devices and 199 discrete episodes of monopolar electrosurgery exposure 1,5,7‐10,15‐17 . Details of the involved studies are noted in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…After review by title and abstract, 15 articles underwent full-text review, resulting in 9 articles deemed appropriate (Figure 1). 1,5,[7][8][9][10][16][17][18] Articles were reviewed to ensure no overlapping populations. Disagreement was mediated by the senior author.…”

Section: Study Screening and Selectionmentioning

confidence: 99%

“…of monopolar electrosurgery exposure. 1,5,[7][8][9][10][15][16][17] Details of the involved studies are noted in Table 2. Of these, 6 reported on patient records and 3 involved cadaveric specimens.…”

Section: Literature Reviewmentioning

confidence: 99%

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Risk of Monopolar Electrosurgery in Cochlear Implant Recipients is Nominal: Evidence to Guide Clinical Practice

Dornhoffer,

Haller,

Lohse

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveComprehensively assess the prevalence of monopolar electrosurgery‐related device complications among cochlear implant (CI) recipients.Study DesignMultifaceted retrospective review and survey.SettingTertiary medical center.MethodsMultifaceted approach including: (i) review of the current literature; (ii) historical review of institutional data from an academic, tertiary CI center; (iii) review of industry data provided by 3 Food and Drug Administration‐approved CI manufacturers; and (iv) survey of high‐volume CI centers.ResultsLiterature review identified 9 human studies, detailing 84 devices with 199 episodes of device‐cautery exposure. From studies reporting on patients records, no implant showed evidence of damage after exposure. One cadaveric study using dental cautery reported 1 episode of device damage. Review of institutional records did not identify any CI damage in 84 instances of exposure. Data from the 3 major implant manufacturers showed a single report of damage that could be reasonably linked to monopolar electrosurgery, out of a possible 689,426 CIs. Last, a survey of 8 high‐volume CI centers did not identify any adverse events associated with monopolar cautery.ConclusionThese data estimate the risk of adverse device‐related events or tissue injury to be extraordinarily low. Short of operating in immediate proximity to the CI (ie, the ipsilateral temporoparietal scalp), these data indicate that monopolar electrosurgery can be used in the body and the head‐and‐neck of CI recipients with nominal risk. These findings may guide decision‐making in cases that are optimally or preferably performed with monopolar electrocautery and can be used to counsel CI patients following inadvertent exposures.

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Section: Resultsmentioning

confidence: 99%

Section: Study Screening and Selectionmentioning

confidence: 99%

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Risk of Monopolar Electrosurgery in Cochlear Implant Recipients is Nominal: Evidence to Guide Clinical Practice

Dornhoffer,

Haller,

Lohse

et al. 2023

Otolaryngol.--head neck surg.

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“…There are, however, several case reports of patients in whom the benefits of MEPs were judged to outweigh their potential risks, and MEP monitoring was successfully performed with appropriate precautions and without adverse effects. [56][57][58]…”

Section: Mepsmentioning

confidence: 99%

Intraoperative Monitoring of Scoliosis Surgery in Young Patients

Manning,

Emerson

2024

Journal of Clinical Neurophysiology

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Summary: Intraoperative neurophysiologic monitoring has added substantially to the safety of spinal deformity surgery correction since its introduction over four decades ago. Monitoring routinely includes both somatosensory evoked potentials and motor evoked potentials. Either modality alone will detect almost all instances of spinal cord injury during deformity correction. The combined use of the two modalities provides complementary information, can permit more rapidly identification of problems, and enhances safety though parallel redundancy should one modality fail. Both techniques are well established and continue to be refined. Although there is room for provider preference, proper monitoring requires attention to technical detail, understanding of the underlying physiology, and familiarity with effects of commonly used anesthetic agents.

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Neurophysiological Intraoperative Monitoring in Patients with Cochlear Implant Undergoing Posterior Spinal Fusion

Cited by 2 publications

References 27 publications

Risk of Monopolar Electrosurgery in Cochlear Implant Recipients is Nominal: Evidence to Guide Clinical Practice

Risk of Monopolar Electrosurgery in Cochlear Implant Recipients is Nominal: Evidence to Guide Clinical Practice

Intraoperative Monitoring of Scoliosis Surgery in Young Patients

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