Pain, magnet displacement in MRI in patients with cochlear implants

November 20, 2014

Pain, discomfort and magnet displacement were documented in a small medical records review study of patients with cochlear implants (CIs) who underwent magnetic resonance imaging (MRI), according to a report published online by JAMA Otolaryngology-Head & Neck Surgery.

A CI can help patients with severe to profound hearing loss and about 300,000 people worldwide have the device. However, undergoing MRI can pose concerns for patients with CI because of exposure of the internal magnet to a strong electromagnetic field. There have been previous reports of adverse events, according to background in the study.

Bo Gyung Kim, M.D., Ph.D., of the Soonchunhyang University College of Medicine, South Korea, and co-authors reviewed the medical records of 18 patients with CIs who had MRIs between 2003 and 2014 at a single center. Of the patients, 16 underwent MRI in a 1.5-T scanner and two patients had an MRI in a 3.0-T scanner. The MRIs included 12 brain scans and 18 scans of other areas of the body.

Of the 18 patients, 13 completed their MRI scan without complications (25 of 30 scans). Five patients fitted with protective head bandages could not complete their MRI because of pain: one of these patients experienced magnet displacement. Another patient tolerated the pain and discomfort of her third MRI scan, despite having gauze bandages, but experienced magnet polarity reversal. The two patients that underwent 3.0-T MRI scanning, did so without bandaging and experienced no adverse events or complications (one patient had an MRI of the knee and the other patient, who had an MRI of the shoulder, did report some discomfort). Hearing-related performance was unaffected in three CI patients who had major adverse events associated with MRI scanning.

"In the present study, however, we found that seven of the 13 patients who had not undergone general anesthesia (seven of 19 MRI scans) experienced discomfort or pain during the MRI scans. Indeed, one patient who had undergone general anesthesia was awakened by pain during the MRI scan and could not complete the MRI. Our data clearly demonstrate that a significant proportion of patients experienced discomfort or pain during the MRI process and were unable to complete the scans. Therefore, in addition to device safety and image quality, patient comfort should be considered when performing MRI procedures," the authors note.

(JAMA Otolaryngol Head Neck Surg. Published online November 20, 2014. doi:10.1001/.jamaoto.2014.2926. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: A number of funding sources were disclosed. Please see article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: MRI in Cochlear Implant Recipients, Pros and Cons

In a related commentary, Emanuel Kanal, M.D., of the University of Pittsburgh Medical Center, writes: "Kim et al have reinforced a strong lesson for us all, that what may be considered safe by some may well be unsafe or unacceptable to others. Their reminder to consider not just mere safety but also morbidity and acceptability to the patient, is refreshing indeed. This should be added to our list of considerations prior to determining any risk-benefit assessment and patient scan recommendations regarding exposure of patients with implants to MRI environments."

(JAMA Otolaryngol Head Neck Surg. Published online November 20, 2014. doi:10.1001/.jamaoto.2014.2932. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Please see article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
-end-
Media Advisory: To contact corresponding author Jae Young Choi, M.D., Ph.D., email jychoi@yuhs.ac. To reach commentary author Emanuel Kanal, M.D., call Anita Srikameswaran at 412-578-9193 or email srikamav@upmc.edu.

To place an electronic embedded link to this study in your story The link for this study will be live at the embargo time: http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jamaoto.2014.2926 and http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jamaoto.2014.2932.

The JAMA Network Journals

Related Pain Articles from Brightsurf:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.

It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.

Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.

Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).

Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.

Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.

Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

Read More: Pain News and Pain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.