Cochlear Implants and Electrocautery: A Live Animal Model

Objectives The use of monopolar cautery is regarded as a contraindication in cochlear implant (CI) recipients, despite a large amount of contradicting data. The objectives are as follows: (1) Evaluate the effects of high‐powered electrocautery on CI devices. (2) Record any high‐powered electrocautery induced temperature changes. Methods After IACUC approval, 12 manufacturer‐donated CIs were implanted in two anesthetized pigs. All devices underwent pre‐study integrity checks; six had onsite impedance testing, while six received post‐cautery analysis. Fifty watts coagulation was applied for 20 min at sites 1–15 cm from the CI. Bluetooth thermometers monitored three sites of temperatures. Devices were explanted for analysis. Stata 17.0 was used for statistical analysis. A p ‐value < 0.05 was considered statistically significant. Outcome measurements were as follows: (1) Changes in the temperature. (2) Changes to the implanted CIs during electrocautery. (3) CI integrity analysis following electrocautery. Results The mean temperatures at the three sites (a*, b*, c*) was 32.9°C–38.8°C. Maximum absolute temperature changes averaged 4.1°C (95% CI: 1.4–6.8) for scalp measurements and 2.9°C (95% CI: 1.0–4.9) for round window measurements. Neither time ( p = 0.09) nor distance ( p = 0.64) generated significant scalp temperature changes. Devices were stratified by proximity. Mean maximum temperature changes showed a gradient by distance. Differences in device proximity were not statistically significant. Postimplantation device analysis was performed on six devices, and all passed the manufacturer in‐depth device analysis. Conclusions This controlled experimental evidence, demonstrating 100% device integrity across all tested conditions, challenges current manufacturer contraindications and supports evidence‐based guideline revision. Level of Evidence N/A.