Monopolar cautery should not immediately be associated with cochlear implant dysfunction after surgery in pediatric patients, according to findings published in Otolaryngology –Head and Neck Surgery. J. Cody Page, MD, and colleagues examined the use of monopolar cautery in subsequent surgical procedures among 190 pediatric patients with cochlear implants from a single pediatric hospital system. The researchers identified 15 patients (7.9%) and 17 different surgical procedures in which monopolar cautery was used. Of the 17 procedures, seven (41.2%) involved the head and neck, and 10 were done below the clavicle. There were no reports of device failure or a decrease in cochlear implant performance after surgery. A systematic review identified four more patients who had surgery with monopolar cautery after cochlear implantation with no change in cochlear implant function. While the most risk-adverse strategy for surgery in patients with cochlear implants is to avoid the use of monopolar cautery, its use “does not necessarily injure [cochlear implant] functionality,” Dr. Page and colleagues wrote.
