When an MRI compatible cochlear implant magnet can hide important findings

Cochlear implants (CIs) are common treatments for people with severe to profound bilateral hearing loss and are used throughout the world in patients of all ages. While CIs provide management for people with severe hearing problems to hear and understand speech, issues arise when patients with CIs require MRI scans. Undergoing an MRI with CIs can lead to extreme pain for the patient and can produce shadowy artifacts in the MRI images, obscuring important pathological findings. This is especially important for at-risk patients with neurological diseases such as NF2. In the case of visual obstruction of essential findings, in order to obtain clear MRI images, surgical removal of the CI is done, which puts the patient at risk of infection and pain. We present a case where the shadow artifact from MRI imaging in a Neurofibromatosis type 2 (NF2) patient with a unilateral MRI compatible CI, hid important pathological findings, including a massive infratemporal meningioma.