Before, During, & After Implant Surgery

What happens before surgery?

Primary care doctors usually refer patients to ear, nose and throat doctors (ENT doctors or otolaryngologists) to test them to see if they are candidates for cochlear implants.

Tests often done are:

examination of external, middle, and inner ear for signs of infection or abnormality
various tests of hearing, such as an audiogram
a trial of hearing aid use to assess its potential benefit
exams to evaluate middle and inner ear structures
- CT (computerized tomography) scan. This type of x-ray helps the doctor see if the cochlea has a normal shape. This scan is especially important if the patient has a history of meningitis because it helps see if there is new bone growth in the cochlea that could interfere with the insertion of the implant. This scan also may indicate which ear should be implanted.
- MRI (magnetic resonance imaging) scan
psychological examination to see if the patient can cope with the implant
physical exam to prepare for general anesthesia

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What happens during surgery?

The doctor or other hospital staff may:

insert some intravenous (i.v.) lines
shave or clean the scalp around the site of the implant
attach cables, monitors and patches to the patient's skin to monitor vital signs
put a mask on the patient's face to provide oxygen and anesthetic gas
administer drugs through the i.v. and the face mask to cause sleep and general anesthesia
awaken the patient in the operating room and take him or her to a recovery room until all the anesthesia is gone

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What happens after surgery?

Immediately after waking, a patient may feel:

pressure or discomfort over his (or her) implanted ear
dizziness
sick to the stomach (have nausea)
disoriented or confused for a while
a sore throat for a while from the breathing tube used during general anesthesia

Then, a patient can expect to:

keep the bandages on for a while
have the bandages be stained with some blood or fluid
go home in about a day after surgery
have stitches for a while
get instructions about caring for the stitches, washing the head, showering, and general care and diet
have an appointment in about a week to the stitches removed and have the implant site examined
have the implant "turned on" (activated) about 3-6 weeks later

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Can a patient hear immediately after the operation?

No. Without the external transmitter part of the implant a patient cannot hear. The clinic will give the patient the external components about a month after the implant surgery in the first programming session.

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Why is it necessary to wait 3 to 6 weeks after the operation before receiving the external transmitter and sound processor?

The waiting period provides time for the operative incision to heal completely. This usually takes 3 to 6 weeks. After the swelling is gone, your clinician can do the first fitting and programming.

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What happens during the initial programming session?

An audiologist adjusts the sound processor to fit the implanted patient, tests the patient to ensure that the adjustments are correct, determines what sounds the patient hears, and gives information on the proper care and use of the device.

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Is it beneficial if a family member participates in the training program?

Yes! A family member should be included in the training program whenever possible to provide assistance. The family member should know how to manage the operations of the sound processor.

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Do patients have more than one implant?

Usually, patients have only one ear implanted, though a few patients have implants in both ears.

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How can I help my child receive the most benefit from their cochlear implant?

try to make hearing and listening as interesting and fun as possible
encourage your child to make noises
talk about things you do as you do them
Show your child that he or she can consciously use and evaluate the sounds he or she receives from his or her cochlear implant
realize that the more committed you, your child's teachers, and your health professionals are to helping your child, the more successful he or she will be

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What can I expect a cochlear implant to achieve in my child?

As a group, children are more adaptable and better able to learn than adults. Thus, they can benefit more from a cochlear implant. Significant hearing loss slows a child's ability to learn to talk and affects overall language development. The vocal quality and intelligibility of speech from children using cochlear implants seems to be better than from children who only have acoustic hearing aids.

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How important is the active cooperation of the patient?

Extremely important. The patient's willingness to experience new acoustic sounds and cooperate in an auditory training program are critical to the degree of success with the implant. The duration and complexity of the training varies from patient to patient.