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A cochlear implant is a device that helps reverse nerve-related hearing loss. It can treat hearing loss that will not respond to hearing aids. During cochlear implant surgery, the device is implanted into the inner ear (cochlea). A few weeks after surgery, the device is activated and hearing is restored. Typically, only one implant is placed. But, if needed, an implant can be placed in both ears. You and your doctor will discuss what’s best for you.
Prepare for the procedure as you have been instructed. Be sure to tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery. Also, follow any directions you’re given for not eating or drinking before surgery.
The surgery takes 2-3 hours. Before the surgery begins:
An IV line is put into a vein in your arm or hand. This line delivers fluids and medications.
You will be given medication (anesthesia) to keep you free of pain during the surgery. You will have general anesthesia. This puts you into a state like deep sleep during the surgery.
The doctor makes an incision behind the ear. The mastoid bone is exposed. This is the bone you can feel behind the ear.
The mastoid bone is opened with a surgical drill. Great care is taken to avoid harming the facial nerve, which runs through the bone. This nerve controls your facial muscles. A facial nerve monitor (a machine with a small sensor that is put onto your cheek) may be used to map the nerve’s exact location. This helps avoid damage.
The cochlear implant is placed inside the hole in the mastoid bone.
A group of electrodes called the electrode array is attached. This is placed into the inner ear.
More bone is removed from behind the ear. The receiver/stimulator is then placed in this hole. This allows the unit to lie flat under the skin.
The skin incision behind the ear is closed with sutures.
If an implant is being placed in the other ear, this may be done at this time.
You will be taken to a recovery room to wake up from the anesthesia. You may be sleepy and nauseated at first. And you may feel dizzy. You will be given medication to manage any pain. You may then be taken to a hospital room to stay overnight. Once you are ready to go home, you will be released to an adult family member or friend. Have someone stay with you for the next couple of days to help care for you as your healing begins.
Recovery time varies for each person. Your doctor will tell you when you can return to your normal routine. Once at home, follow the instructions you have been given. While you recover:
Take prescribed pain medication exactly as directed. Take it on time. Do not wait for the pain to get bad before you take it.
For 3-5 days after surgery, sleep with your head raised above the level of your heart. This helps reduce swelling.
Do not drive until your doctor says it’s okay.
Care for incisions as instructed by your doctor.
Be sure you have a contact number for your doctor. After you get home, call if you have any of the following:
Chest pain or trouble breathing (call 911 or other emergency service)
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Pain that does not get better with medication
Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage
Signs of meningitis, such as increasing neck stiffness, sensitivity to light, dizziness that gets worse, or facial weakness (note: meningitis could occur months after surgery)
During follow-up visits, your doctor will check your healing. Stitches or staples will be removed 7-10 days after the surgery. When the incision has healed, the outer part of the implant is attached behind your ear. This will allow the device to work. Continue to follow up with your doctor as directed. Speech and hearing specialists will help you adjust to your implant.
Risks of cochlear implant surgery include:
Severe vertigo (dizziness) that lasts up to 6 weeks
Device eroding through the skin
Facial nerve paralysis
Damage to nerves and blood vessels at or near the incision site
Leakage of brain fluid
Risks of anesthesia (you will discuss these with the anesthesiologist)