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Cochlear Implants

by Cynthia M. Johnson, MA

Definition

A cochlear implant is an electronic device that is implanted during surgery. It helps provide hearing to people who have a certain type of hearing loss. This type of hearing loss is usually caused by damage or a defect in the inner ear. The implants can directly stimulate the auditory nerve to send information to the brain.

Cochlear implants have 3 parts:

  • Speech processor—The speech processor looks like a long, narrow calculator. It is worn behind the ear or on a belt. It increases sound, converts it into digital signals, and sends these signals to the transmitter.
  • Transmitter—The transmitter is a headphone that is worn behind the ear. It receives electrical signals from the speech processor and sends them through the skin to the receiver.
  • Receiver—The receiver is the part that is implanted. It is a magnetic disc about the size of a quarter. It is placed under the skin behind one ear. A wire runs from the receiver to an electrode array that is placed in the inner ear, where it stimulates the nerves of the cochlea.

The Cochlea

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Reasons for Procedure

Cochlear implants provide a sense of sound for adults and children with profound hearing loss. They are designed for people whose hearing does not improve with surgical correction or the use of a hearing aid. Cochlear implants will not restore or create normal hearing.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Damage to nearby nerves
  • Problems with balance
  • Poor quality of hearing following the surgery

Smoking may raise the risk of problems.

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery, such as:

There is a link between cochlear implants and bacterial meningitis. You should be up to date on pneumococcal, meningococcal, and haemophilus vaccines.

Anesthesia

General anesthesia will be used. You will be asleep.

Description of Procedure

There are 2 parts to the procedure:

  • Implantation of receiver—A cut will be made in the skin behind the ear. A hole will be drilled through the bone behind the ear to the cochlea. A wire with the electrode array will be placed through the hole and into the cochlea. The receiver will then be put against the bone behind the ear. The wire will be attached to the receiver. The incision will be closed with stitches.
  • External hook-up—In 4 to 6 weeks, the area should be healed. At this point, the transmitter headpiece and speech processor will be connected.

How Long Will It Take?

About 1 and one-half to 2 hours for adults and up to 5 hours for children

Will It Hurt?

Pain and swelling are common in the first few days. Medicine and home care can help.

Average Hospital Stay

Some people may be able to go home the same day. Other people may need to stay longer.

Post-procedure Care

At the Care Center

The staff may give you pain medicine.

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

It will take 4 to 6 weeks to fully heal. Physical activity may need to be limited during recovery. You may need to ask for help with daily activities and delay return to work or school for a few weeks.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever or chills
  • Severe headache
  • Pain that cannot be controlled with medicine
  • Light-headedness or vomiting
  • Facial twitching or loss of muscle movement
  • Redness, swelling, excessive bleeding, or discharge at the incision site

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Academy of Audiology
http://www.audiology.org
National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca
Cochlear Implant Awareness Foundation
http://www.ciafonline.org

References

Cochlear implants. American Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/hearing/cochlear-implant. Accessed December 2, 2020.
Cochlear implants. National Institute on Deafness and Other Communication Disorders website. Available at:
...(Click grey area to select URL)
Accessed December 2, 2020.
Cochlear implants. US Food and Drug Administration website. Available at: https://www.fda.gov/medical-devices/implants-and-prosthetics/cochlear-implants. Accessed December 2, 2020.
Cochlear implants. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/meniere-disease. Accessed December 2, 2020.
Lopez-Escamez JA, Carey J, et al; Classification Committee of the Barany Society, Japan Society for Equilibrium Research, European Academy of Otology and Neurotology (EAONO), Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), Korean Balance Society. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 4/20/2021