Deep Brain Stimulation in the Setting of Cochlear Implants: Case Report and Literature Review

Stereotact Funct Neurosurg. 2015;93(4):245-9. doi: 10.1159/000380824. Epub 2015 May 21.

Abstract

Background/aims: As technology continues to advance for our aging population, an increasing number of deep brain stimulation (DBS) candidates will have preexisting implanted electrical devices. In this article, we discuss safe and successful DBS in a patient with Parkinson's disease (PD) and bilateral cochlear implants.

Methods: A 70-year-old male with PD and bilateral cochlear implants underwent successful microelectrode-guided DBS implantation into bilateral subthalamic nuclei (STN). The patient's cochlear implant magnets were removed and replaced in the outpatient clinic for preoperative MRI and stereotactic targeting. The cochlear implants were turned off intraoperatively for STN microelectrode recordings.

Results: Precise, MRI-guided stereotactic DBS implantation was possible. Intraoperative high-fidelity microelectrode recordings confirmed STN neurons with the cochlear implants turned off. These recordings were not possible with active cochlear implant devices. Our literature review describes the other approaches/techniques that have been used to manage DBS surgery in the setting of cochlear implants.

Conclusions: Despite the risk of electrical interference between implanted medical devices, DBS and cochlear implants may be safe and compatible in the same patient if necessary precautions are taken.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Artifacts
  • Cochlear Implantation / instrumentation
  • Cochlear Implantation / methods*
  • Cochlear Implants*
  • Deep Brain Stimulation*
  • Device Removal
  • Electrodes, Implanted
  • Electromagnetic Phenomena
  • Equipment Design
  • Hearing Loss, Sensorineural / complications
  • Hearing Loss, Sensorineural / surgery*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Magnetics / instrumentation
  • Male
  • Microelectrodes
  • Parkinson Disease / complications
  • Parkinson Disease / therapy*
  • Stereotaxic Techniques
  • Subthalamic Nucleus / physiopathology
  • Thalamus / physiopathology