Anyone treated a patient with cochlear implant, or anyone with the implant received treatment? If so,which type is safe? I’ve asked several electrologists and have gotten a lot of conflicting answers.
I’m going to attempt an answer but I have to say, I’ve never worked on anyone with such an implant.
I dont see a cause for concern. The currents used in electrology are usually localized to the area being worked on. I cant see that this would interfere with the implant. There is a slim possibility that the High Frequency componenet may cause some interference with the electronics in the ear implant, the same way a blender wouuld for a tv or radio or anything else that causes EMI such as a microwave, but such would not have any permanent effect I should think. I would have to ask, do you experience feedback when using a microwave? Electrolysis is very much like that, and if the answer is no, then you probably would not notice any difference with electrolysis either.
See now that’s what I was thinking. No reaction to microwave.I’m around short wave all the time…right? I don’t know much about these things but in my research I learned a little.
Medel, my company, claims it is not safe. And with further research I found the other two major companies, Cochlear and Advanced Bionics have also issued statements against it.
Medels statement as follows…The following medical procedures may damage the implant or surrounding tissue and must be avoided 1. Monopolar Electrosurgery, Diathermy, or Neurostimulation 2. Electrosurgery or Diathermy in the area of the head 3. Ionizing radiation therapy. Then it gives warnings about special precautions with MRIs.
I spoke with several electrologists…some claim no problem for short wave, one said only galvanic, some said no it’s not safe.
Thru my internet search…I found that maybe bipolar electrosurgery is ok as long as it is not right over the implant…but I’m not familiar with electrolysis methods and if bipolar is an option.
I mean, I have to listen to what my company says, along with my audiologist, but I just wonder if they are just being overly cautious.
Thanks so much for your response. My head is spinning from reading all this stuff that I don’t really understand…lol!
Okay well maybe I can help a little.
Diathermy is actually pretty much exactly what we do with thermolysis. We use radio frequency to heat up the tissues in a small localized area. In general the medical term diathermy relates to the same concept being used to heat up the tissues in joints. In electrolysis, we just do this on a much smaller scale. I dont know if the thermolysis output would be enough to damage your implant or issues. A question asked of the manufacturer might help though.
Galvanic is composed of DC electrical current. It passes from the anode ( what you hold) to the cathode ( the probe) . IT’s a small amount of current.I dont see anything in their warnings to say DC current is not okay. So your electrologist who suggested galvanic only may be on the right path, it’s a better answer than dont do electrolysis at all, even if it isnt ideal. To get a better answer particular to your case, you would probably need to consult with the manufacturer of your implant.
Thanks again for your response. So…the current wouldn’t be tempted to pass to the implant since there is metal there?
I would avoid galvanic precisely because there’s a good chance the current is going to pass through it. Not only could it be a problem for the circuitry, but it could also pose a risk to the tissue surrounding the implant (electrophoresis can cause a change in the ph balance of the tissue and it’s not going to occur just on the skin, but potentially surfaces inside that are in the path of least resistance (and most metals are going to be less resistant)).
If someone with a cochlear implant came into my office looking to have electrolysis done anywhere on the head, I’m definitely requesting a medical waiver from a doctor (and I would expect a doctor to decline it).
Oh, and just to add as far as thermolysis goes, while we aren’t using a lot of energy, we are emitting a radio frequency that can induce a current in a device and that current could, in turn, cause a voltage overload in the circuitry, damaging it permanently, not just creating some temporary line noise. The closer to the device that you are emitting the RF, the more power it will create.
And “so it flows” …
Electricity only flows from negative to positive.
Electricity is the flow of electrons, so the flow of electricity and flow of electrons are the same thing. The confusion stems from Benjamin Franklinâ€™s experiments. He had no way to determine which of the charged rods was the source of electrons and guessed wrong when he assigned the terms “Negative” and “Positive.” He intended to use positive for the source (electrons) and negative for the absence of electrons. In the early 1900s scientists were able to weigh the charged rods from Franklinâ€™s experiments with enough precision to determine that the “negative” rod was actually the source because it weighed more after being charged than before. The “positive” rod weighed less after charging than before.
It is a common misconception that the terminals on a DC power source were designed so that electricity would flow from positive to negative. It seems intuitive, since positive, marked +, seems to indicate a surplus, and we think of negative (-) as subtracting and taking away. In reality, the cathode/negative terminal of a battery is labeled thusly because it contains an excess of electrons, which are negatively charged. The electrons flow toward the positively charged anode/positive terminal. You know this, of course; my point is only that the terminals are not accidentally labeled backwards. It was never intended that electricity would flow from positive to negative. Electrons flow from the needle to the hand held device.
I will answer the writer’s question after I speak with a couple physician friends today …
Thank you EE for the input. I know cochlear devices have built in safety mechanisms to deter damage from things causing EMI. Guess the possibility always remains tho and better safe than sorry.
Wonder what the difference power levels are of like microwave, and other such devices compared to thermolysis? I know I have my face right next to the microwave looking in the window at my food…lol!
With cochlear implants becoming more common in the general public maybe they will do more testing to determine what is safe. I found an interesting article about it. Will post a link
Thank you Michael. This whole electrical charges, radio frequency discussion is really over my head…lol. I appreciate you guys taking time to respond.
Just saw this
alright, so it seems thermolysis is not recommended from everything I am reading here.
What about galvanic? Is there anything that indicates this is not safe? I know there are metals in the device, but is there a insulating housing that would prevent the transmission of Dc currents across the device?
Edit: after looking at the manufacturers video explaining the device, it appears there is a large metallic coil ( probably to recieve signal from the audio processor) so given that, I would say no the implant is not electrically isolated.
So my guess would have been wrong.It appears it is not possible to do electrolysis if you have such an implant.I have to say that answer really bothers me though, because I’ve never heard of a case where it simply wasnt possible to do electrolysis. This appears to be an exception to that rule
This site I found has several interesting links
Really bothers me too…lol
This article seems to be discussing monopolar signal, and galvanic electrolysis is bipolar
This article seems to be discussing monopolar signal, and galvanic electrolysis is bipolar [/quote]
Well see I didn’t know. From what I read bipolar is ok so long it is not within like 1 cm of the implant. I couldn’t find specifics online. So confusing
And see…this says electrolysis ok 2cm away from implant…but it’s from Britain
There are plenty of exceptions, some of which can be waived by a doctor and others where the electrologist should be a hard no even with a waiver.
Schools will give you safe default contraindications, which is fine considering that most electrologists don’t study electrical engineering in detail. Those of us willing to study more in depth (I personally went to college for computer engineering, which is half electrical engineering, though I didn’t finish due to family medical issues that also had me seriously considering medical school, both then and recently) can make more nuanced decisions about these things. Even then, I’m going to trust the manufacturer of a device even more than I am my own general knowledge or desire to help someone. Optionally, for a purely medical, non-electrical contraindication, see accutane.
FWIW, my Apilus manual also specifically contraindicates cochlear devices.
Uses forceps with both tines connected to power generator: one is active and other is indifferent electrode.
Current runs through tissue grasped by forceps.
Used in patients with implanted cardiac devices such as a pacemaker or defibrillator, to prevent electrical current passing through the device, which might short-circuit or fire inappropriately.
Waveforms in electrosurgery
Different waveforms may be generated by the electrosurgery machine for different procedures.
Continuous single, high frequency (>400 V) sine wave used at high heat for cutting / vaporisation leaves a zone of thermal damage. A high pitched sound is heard.
Pulsed or modulated waveforms allow tissue to cool between bursts so that the zone of thermal damage is minimal.
A sine wave turned on and off in a rapid succession (rectified) produces the slower heating process that results in coagulation. A rougher, lower tone is heard due to lower power.
Variable waveforms can be produced to blend cut and coagulation, as power is adjusted in real time depending on tissue impedance.
Cardiac pacemaker and defibrillators
Electric currents from electrosurgery electrodes pass through the patient’s body to the indifferent electrode. This may sometimes cause malfunction of implanted cardiac devices.
This risk may be mitigated in the following ways.
Use thermocautery including Shaw scalpel (no current flow through patient)
Use bipolar forceps with electrosurgery device (minimises current through patient)
If possible, avoid operating near the implanted device
Change pacemaker to fixed-rate mode or magnetically deactivate implantable cardioverter-defibrillator during electrosurgery.
And then I found this…I know it doesn’t mention electrolysis but I thought it might apply …from New Zealand tho