Cochlear Implant Surgery

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What is a Cochlear Implant?

A cochlear [KOK-lee-uhr] implant is an electronic device that can help people hear. It is most often used for people who have profound (complete, total) hearing loss, and works by sending electrical signals to the nerves in the ear that send sound to your brain. A cochlear implant has two parts:

  1. Microphone. If you have a cochlear implant, you will wear a microphone outside of your body that takes sounds from around you and sends them to the implant.
  2. Receiver and electrode. This is the part of the implant that is installed in the cochlea in your ear. It takes signals from the microphone and changes them into nerve signals that let your brain hear the sound.
  3. Cochlear implant surgery is the surgery that is used to install cochlear implants into your ear. This surgery can be recommended by an audiologist [aw-dee-OL-uh-just] (a doctor who specializes in hearing problems) and is done by a surgeon who is experienced with installing these implants.

What are the Risks and/or Side Effects?

Cochlear implant surgery has these risks:

  • Anesthesia problems. An anesthetic [ann-ess-THEH-tik] is a medicine that puts you to sleep and makes you numb so that you aren’t awake and don’t feel any pain during the surgery. Sometimes people have bad reactions to anesthesia.
  • Bleeding and infection. Sometimes, the incision (cut) the surgeon makes to install the cochlear implant can get infected after surgery. Infection is rare but serious.
  • Facial nerve injury. The nerve that controls the muscles in your face goes through your ear. During surgery, this nerve can be injured, which can make your facial muscles weak or paralyzed.
  • Meningitis [men-in-JAHY-tis]. This is an infection of the lining around your brain that is rare but very serious.
  • Cerebrospinal [suh-ree-broh-SPY-nuhl] fluid leakage. The fluid surrounding the brain can leak out of the hole your surgeon makes to install the cochlear implant.
  • Reparative granuloma [rih-PAIR-uh-tiv gran-yoo-LOH-muh]. If your body rejects the implant, the area around it can get inflamed and cause other symptoms or problems.

If the surgery is successful, there can also be risks from using the cochlear implant itself. These risks include:

  • Hearing sounds differently. The sound from a cochlear implant is different from normal sounds and might seem mechanical or synthetic.
  • Losing more hearing. The implant might destroy any hearing that you had left in your ear before the surgery.
  • Inability to have certain medical tests. Some tests and procedures — such as MRI, neurostimulation [NOO-row-STIM-yoo-LAY-shun], electrical surgery, or ionic radiation therapy — can damage the cochlear implant.
  • Lifestyle changes. Cochlear implants react to electronics like theft detection systems, security systems, cell phones, and airplanes, so you might have to turn them off or not be able to go places that use these systems.

Discuss these risks with your doctor and surgeon and decide what is best for you.

What are the Benefits?

The main benefit of cochlear implant surgery is that it can make your hearing better if you are severely deaf. This surgery can help with:

  • Hearing different sounds. A cochlear implant can let you tell sounds apart at different volumes, as well as different kinds of sounds.
  • Talking. This implant can make it easier to understand what people are saying when they talk without needing to use lip-reading.
  • Other benefits. A cochlear implant might make it easier to use the phone, watch TV, or listen to music.

There are many things that can affect how successful this surgery is, such as:

  • How healthy your ears are. If your cochlea doesn’t have very many nerve cells, the cochlear implant might not be as effective, because it can’t send as many sound signals to the brain.
  • How long you have been deaf. If you have been deaf a long time, the cochlear implants might not work as well for you.
  • How old you were when you went deaf. If you became deaf as a child, and before you could speak, cochlear implants might be less effective.
  • How old you are when you get the implant. Younger people have better results with this surgery than older people.
  • How long you have used the implant. When you get used to the cochlear implant, it can work better than it did before.

Your audiologist can discuss the benefits of cochlear implant surgery with you and whether it’s the best procedure for your situation.

How Do I Prepare?

You can prepare for cochlear implant surgery by discussing it with your doctor and getting a referral to a clinic that specializes in installing these implants.

At the clinic, an audiologist and otolaryngologist [oh-toh-lar-ing-GOL-uh-jist] (a doctor who specializes in ear, nose, and throat problems) will do exams and tests to see if you are a good candidate for cochlear implant surgery. Some of these tests include:

  • Ear evaluation. The otolaryngologist will examine your ear canal and middle ear to look for infections or other issues that could make surgery difficult.
  • Physical exam. The otolaryngologist will do a physical exam and ask you questions about any medical complications or concerns about surgery.
  • Hearing evaluation. The audiologist will do tests to see how much you can hear with or without a hearing aid. These tests can see whether you can hear sounds at different volumes and tones.
  • Imaging tests. X-rays, CT scans, and MRIs can take pictures of your inner ear to help your doctor prepare for surgery.

How is it Done or Administered?

Cochlear implant surgery is an outpatient procedure, meaning that you come into the clinic, have the surgery, and go home on the same day. It is done by:

  1. Giving you a general anesthetic. This medicine will make you sleep and stops you from feeling pain or remembering the surgery.
  2. Getting to the cochlea. Your surgeon may perform a mastoidectomy [mas-toi-DEK-tuh-mee] with facial recess approach, or MFRA. During this procedure, the surgeon makes a cut behind your ear to open the mastoid [MASS-toyd] bone, which covers the space in your middle ear.
  3. Opening the cochlea. Your surgeon will open the part of your ear that contains the nerves that change sound into electric signals for your brain.
  4. Installing electrodes on your cochlea. The surgeon installs electrodes which are connected to a receiver that is installed under your skin behind your ear.
  5. Closing the incision. Your surgeon will close the incision made to install the cochlear implant.

After the surgery, you will wake up and be able to go home once you are alert enough to walk and stand. However, you might be tired for a while after the surgery and should plan to have someone drive you home.

When Will I Know the Results?

Your surgeon will be able to tell you if the implant was installed successfully right after your surgery, or if there were any problems.

Cochlear implants take time to get used to, and you will need to adjust them and learn how to use them over time. It might take weeks or months before you know how well your cochlear implants are working for you.

What are Follow-up Requirements and Options?

In the weeks after the surgery, your doctors will place the signal processor, microphone, and implant transmitter outside of your ear. These are the parts of the cochlear implant that pick up sound and send it to the receiver and electrodes in your ear. During the follow-up, your doctors will:

  • Adjust these parts of the implant so that they sound better.
  • Train you to listen to sound with your cochlear implant.
  • Talk to you about how to take care of your implant.

You will also need to return for regular check-ups and adjustments to the implant and receiver.

Cochlear [KOK-lee-uhr] implant surgery is a procedure that is used to install a cochlear implant, a device that can help you hear if you are severely deaf. The nerves in your ear turn sounds into electrical signals that your brain can process. Cochlear implants work by collecting sound with a microphone and stimulating these nerves directly, which can let your brain hear the sound.