Wednesday, April 05, 2006

Scuba Diving With Cochlear Implants


We have had several inquiries about scuba diving with cochlear implants. We have found the report below by a group in Berne Switzerland - although anecdotal is helpful.



MARTIN KOMPIS, MD, PHD DOMINIQUE VIBERT, MD PASCAL SENN, MD MATTHEUS W. VISCHER, MD RUDOLF HÄUSLER, MD
BERNE, SWITZERLAND

We report on a patient with bilateral cochlear implants (a Med-El Combi40 and a Med-El Combi40+), as well as considerable experience in scuba diving with both of his implants. After having been exposed to 68 and 89 dives, respectively, in depths of up to 43 m, both cochlear implants are in working order and the patient continues to receive excellent speech recognition scores with both cochlear implant systems. The presented data show that scuba diving after cochlear implantation is possible over a considerable number of dives without any major negative impact on the implants. (Ann Otol Rhinol Laryngol 2003:425-427.)


KEY WORDS — bilateral cochlear implantation, cochlear implant, diving, hyperbaric exposure.

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Dr. Avi Shupak, President, Israel Otoneurology Society and Head, Otoneurology Department, Carmel and Lin Medical Centers sends us this citation about cochlear implants under pressure - which we somehow missed.

Effects of hyperbaric exposure on the integrity of the internal components of commercially available cochlear implant systems.

Backous DD, Dunford RG, Segel P, Muhlocker MC, Carter P, Hampson NB.

Otol Neurotol. 2002 Jul;23(4):463-7; discussion 467.

The Listen for Life Center at Virginia Mason, Virginia Mason Medical Center, 1100 Ninth Avenue, X10-0N, Seattle, WA 98111, U.S.A. otoddb@vmmc.org

HYPOTHESIS: This study investigated whether pressure changes common to scuba diving and to hyperbaric oxygen therapy would not cause crush damage or leakage from critical seals in commercially available cochlear implants. BACKGROUND: The implanted packages of cochlear implants are susceptible to electrical failure caused by leakage from critical seals and to crush injury when exposed to changing barometric pressures encountered in recreational diving and in hyperbaric oxygen therapy. METHODS: Six Clarion 1.2, eight MED-EL Combi-40+, six Nucleus CI22M, and six Nucleus CI24M cochlear implants underwent three exposures at 165 feet of seawater (FSW) (6 ata abs), 99 FSW (4 ata abs), and 60 FSW (2.8 ata abs), simulating rates in accordance with U.S. Navy dive tables for nondecompression dives. Dives to 45 FSW (2.4 ata abs) simulated wound therapy. Before each dive began, after each dive, and after completion of the dive protocol, each device underwent telemetry and electrical integrity checks. All implants were returned to their respective factories for final electrical and quality control testing. RESULTS: All 26 devices completed the dive protocol. One Nucleus CI24M implant had a fault recorded at electrode lead 18 on predive and final product testing, which was absent during interval dive measurements. All 26 devices passed final electrical and quality control testing. In addition, the six Clarion units passed repeat helium leak testing. CONCLUSION: The implanted components of the Clarion 1.2, MED-EL Combi-40+, and Nucleus CI22M and CI24M were safely subjected to repeated pressure changes up to 6 atm abs, equivalent to 165 feet of seawater, without electrical failure from leakage at critical seals or crush damage.

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