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Electrosurgery Ensures Integrity Of Cochlear Implant Following Adenoids Removal

unding tissues, then the wound was closed with running locked silk suture.

Nasopharyngeal Electrosurgery: The palate and posterior wall of the nasopharynx were treated with either monopolar electrocoagulation or Coblation bipolar electrosurgery. Both were applied with continuous saline irrigation to ensure maximum electrical conduction. The monopolar cautery unit was set at 50, which is double the energy level typically used for adenoidectomy at our institution, and applied for 15 minutes; radiofrequency bipolar electrosurgery was performed using the Coblator II system. The duration of Coblation treatment was doubled to 30 minutes because of the inability to double the intensity of treatment beyond its maximum level of 9, as was done with the monopolar electrosurgical treatment. This yielded a total of 270 J with Coblation treatment.

Cochlear Implant Integrity Assessment: Implants underwent standard integrity checks by the manufacturer prior to shipping and after electrosurgery. These evaluations included open circuits, device electronics, ability of the device to function at normal levels, and stability of stimulation delivered by each channel. The manufacturers were blinded to the treatment group. Immediately prior to and after subjecting the animals to electrosurgery, ‘clinical’ telemetry was performed on each device by the respective manufacturer’s technical staff to ensure proper functioning of the device in situ.

Intraoperative telemetry revealed normal impedances and device integrity in all of the cochlear implants with the exception of the fifth Nucleus 24 CI, treated with electrocautery, which demonstrated an open electrode #15, both pre and post electrosurgery. Manufacturer testing revealed no additional abnormalities in any of the cochlear implants exposed to either monopolar or Coblation electrosurgery.

Conclusions: The study findings were intended to evaluate the cochlear implant device integrity, not support the
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