Part UT Health San Antonio

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 that 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 heightened 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 from the procedure are rare, but all procedures have some risk. Complications may include:

  • Infection
  • Damage to nearby nerves
  • Problems with balance
  • Emotional stress caused by having higher expectations for the technology
  • Poor quality of hearing following the surgery

Some factors that may increase the risk of complications include:

  • Smoking
  • Previous surgery
  • Previous ear infections
  • Abnormal inner ear anatomy

What to Expect

Prior to Procedure

Your doctor may do some or all of the following.

Your doctor will examine you, paying particular attention to your ears. This can be done with:

Evaluate internal structures with imaging tests, such as:

You should be up-to-date on immunizations. Pneumococcal, meningococcal, and haemophilus vaccines are especially important. There has been a link between cochlear implants and bacterial meningitis.

Leading up to your procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
  • Arrange for a ride to and from the procedure.
  • The night before, eat a light meal. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia is used for this procedure. 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 your ear. The wire will be attached to the receiver. The incision will be closed with stitches.
  • External hook-up—In 4-6 weeks, the area should be healed. At this point, the transmitter headpiece and speech processor will be connected.

How Long Will It Take?

About 1½-2 hours for adults and up to 5 hours for children

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

The length of stay depends on the reasons why you are having the implant. Speak to your doctor about how long your stay may be.

Post-procedure Care

At Home

After your procedure, be sure to follow your doctor's instructions.

You will have frequent follow-up visits for the following:

  • Headpiece fitting, done 4-6 weeks after surgery
  • Adjustments to the speech processor
  • Ongoing evaluation of hearing status

In addition, you will have cochlear implant training. This will help improve your ability to:

  • Identify sounds
  • Read lips
  • Develop speech skills

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • Severe headache
  • Pain
  • Lightheadedness or vomiting
  • Facial paralysis or twitching
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, 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: http://www.asha.org/public/hearing/treatment/cochlear_implant.htm. Accessed May 5, 2016.

Cochlear implants. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/hearing/pages/coch.aspx. Updated May 3, 2016. Accessed May 5, 2016.

Cochlear implants. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/default.htm. Updated October 28, 2015. Accessed May 5, 2016.

6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com: Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Last reviewed May 2018 by Michael Woods, MD  Last Updated: 5/23/2014