(109) Electrocautery Safety in Cochlear Implant Patients: Examining Surgeon Awareness and Practice Patterns

Introduction: Electrocautery use in cochlear implant patients remains controversial as manufacturer recommendations and clinical evidence provide conflicting safety guidance. This survey-based study assesses surgeons’ knowledge, beliefs, and self-reported practices regarding electrocautery use and alignment with existing guidelines.

Methods: We conducted a cross-sectional, anonymous survey from September to December 2025. Practicing surgeons were contacted via email through a Northeast Ohio Medical University alumni directory and completed a one-time Qualtrics survey. Independent variables included practice characteristics and prior cochlear implant surgical experience. Primary outcomes included awareness of device-related risks, safety precautions, and prior formal education. Analyses included descriptive statistics and exploratory subgroup comparisons using Fisher’s exact test.

Results: Twenty surgeons completed the survey. Most practiced in urban or suburban settings (19/20, 95%), and 60% (12/20) reported more than 15 years in practice. Electrocautery was used in at least 75% of cases by 80% of respondents (16/20). Nine surgeons (45%) reported prior experience operating on cochlear implant patients, and 45% (9/20) reported awareness of monopolar electrocautery–related device risk. Surgeons with prior cochlear implant surgical experience were more likely to report awareness than those without such experience (7/9 [78%] vs 2/11 [18%]; p = 0.002). Surgeons with more than 15 years in practice were also more likely to report awareness (7/12 [58%] vs 2/8 [25%]; p = 0.041). Only 15% (3/20) reported prior formal education, and 58% (11/19) reported no modification of surgical technique.

Conclusions: Awareness of electrocautery-related risks in cochlear implant patients was variable and often lacking, with most respondents reporting no formal education and no modification of surgical technique. Greater awareness among surgeons with prior cochlear implant experience and longer practice duration highlights knowledge gaps and opportunities for targeted educational efforts.