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Electrosurgery Ensures Integrity Of Cochlear Implant Following Adenoids Removal

Electrosurgery employed in the removal of tonsils and adenoids does not result in a compromise of the integrity of the cochlear implant device//, a new study has found. The findings of the present study could eventually pave way for a safe, maximal pain-free and effective method to remove tonsils and adenoids in deaf children.

Cochlear implant (CI) recipients have been discouraged from having monopolar electrosurgery for ear, nose, and throat procedures due to concerns over possible damage to the implant and the auditory neurons. While monopolar electrosurgery is rarely, if ever, absolutely necessary, it greatly facilitates treatment in certain procedures such as adenoidectomy. With a growing population of patients receiving CIs at very young ages, more children with CIs may subsequently develop a need for an adenoidectomy, such as obstructive sleep apnea. Unfortunately, no published studies have evaluated the safety of electrosurgical adenoidectomy in CI reipients.

Over the past few years, radiofrequency bipolar electrosurgery (eg, Coblation?) has become popular for adenoidectomy and tonsillectomy because of reports of less post-tonsillectomy pain. The reduction in post-tonsillectomy pain has been attributed to the more limited spread of electrical current and reduced tissue temperatures with Coblation bipolar electrosurgery relative to monopolar electrosurgery. The more limited current spread with Coblation electrosurgery would theoretically impart less risk to a CI and the auditory neurons. As with other electrosurgical techniques, no studies have reported the safety of Coblation adenoidectomy in CI recipients.

Twelve frozen 40 – 50 pound pigs and 12 cochlear implants with superficial defects were used for the experiment. After thawing the pigs, the cochlear implants were placed unilaterally via a standard transmastoid approach. Saline was infiltrated into the cochlea and middle ear to ensure contact between the electrode and surro
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