Cochlear implant magnet extrusion with subsequent surgical replacement and restoration of full implant use without the need for device explantation

Abstract

Objective and importance

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.

Clinical presentation

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.

Intervention and technique

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.

Conclusion

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.

Keywords:

• Cochlear implant
• Magnet
• Displacement
• Extrusion
• Replacement
• Nucleus

Acknowledgement

We would like to acknowledge Dr Ambrose Lee who took the original photograph when the magnet started to extrude.

Conflict of interest: None to declare.