Monopolar Cautery Use in Pediatric Cochlear Implant Users

Otolaryngol Head Neck Surg. 2023 Mar;168(3):478-483. doi: 10.1177/01945998221108051. Epub 2023 Jan 27.


Objectives: To determine the incidence and impact of monopolar cautery use in a cohort of pediatric cochlear implant (CI) users.

Study design: Case series from a retrospective chart review and a systematic review of the literature.

Setting: Tertiary academic referral center.

Methods: CI patient charts from 2012 to 2021 were reviewed from a single pediatric hospital system to determine if monopolar cautery was used during a subsequent surgical procedure. In addition, a systematic review of the literature was performed to identify additional, relevant patients. Postoperative CI function was the primary outcome measure.

Results: In total, 190 patients underwent a surgical procedure following cochlear implantation in a single pediatric hospital system. Fifteen patients (7.9%) and 17 distinct surgical procedures were identified in which monopolar cautery was used. Seven of these 17 cases (41.2%) involved the head and neck, and 10 were performed below the clavicles. No patients experienced a device failure or a decline in CI performance following surgery. A systematic review identified an additional 4 patients who underwent a surgery that used monopolar cautery following cochlear implantation, and no change in CI function was identified.

Conclusions: The present study adds additional support to the notion that monopolar cautery does not necessarily injure CI functionality. While the most risk adverse strategy when planning a surgical procedure for a CI patient is to avoid monopolar cautery use altogether, the use of cautery should not immediately be associated with implant dysfunction.

Keywords: cautery; cochlear implant; electrocautery; electrosurgery; monopolar.

Publication types

  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cautery
  • Child
  • Cochlear Implantation*
  • Cochlear Implants*
  • Electrocoagulation / adverse effects
  • Humans
  • Retrospective Studies