Cochlear Implant Surgery

What is cochlear implant surgery?

A cochlear implant is a small electronic device implanted under the skin behind your ear. The device electrically stimulates the cochlear nerve (hearing nerve) to help restore hearing.

There are 2 parts to a cochlear implant:

• An external part or processor that sits behind the ear and captures sound signals.
• An internal part that is implanted under the skin behind the ear. It receives the sound signals sent and sends the signals as tiny electrical currents to the nerve endings in the cochlea (inner ear).

Compared to conventional hearing aids, a cochlear implant may be beneficial if you have:

• Severe to profound hearing loss in one or both ears
• Severe to profound hearing loss involving only the high frequencies of one or both ears
• Severe hearing loss that is associated with very disturbing and disabling tinnitus

Why do you need cochlear implant surgery?

Cochlear implant surgery bypasses the damaged structures of the inner ear to directly stimulate the auditory nerve. If you have severe to profound hearing loss, cochlear implant surgery may be a suitable treatment for you compared to a hearing aid.

A cochlear implant surgery offer many benefits. It can improve your quality of life by giving or returning your abilities to:

• Hear music and phone conversations
• Hear speech without relying on other visual cues such as facial expressions or lip reading
• Listen clearly in loud or noisy environments
• Locate where sounds are coming from
• Recognise sounds from your everyday environment

Cochlear implant for children or baby

A cochlear implant may be a good option for your child or baby due to the following benefits:

• Better opportunities in life and career with improved or restored hearing ability
• Improved safety with the ability to hear alerts and warning sounds
• Language development with regards to speech and hearing

Children generally experience the best results from a cochlear implant when it is done at a young age.

Extra care must be taken to maintain and protect the device during play.

What are the risks and complications of cochlear implant surgery?

Cochlear implant surgery is generally considered safe. Risks can include:

• Failure of internal device, requiring further surgery to repair or replace it
• Inflammation of the membranes surrounding the brain and spinal cord (meningitis) after surgery, which may be preventable through vaccination
• Loss of any remaining, unclear, natural residual hearing in the implanted ear for some people

While complications are not usually experienced, they include:

• Balancing problems
• Bleeding
• Device infection
• Dizziness
• Facial paralysis
• Infection at the surgery site
• Spinal fluid leak
• Tinnitus
• Unusual sense of taste

How do you prepare for cochlear implant surgery?

You might need to:

• Avoid eating or drinking before the surgery
• Temporarily stop taking certain medications or supplements

Your doctor will advise you further on how to prepare for your surgery.

What can you expect with cochlear implant surgery?

Cochlear implant surgery is done under general anaesthesia, which means you will be in a sleep-like state during the procedure.

Estimated duration

The procedure usually lasts about 2 – 4 hours.

Before the procedure

Your ENT (Ear, Nose, Throat) doctor will conduct a detailed medical evaluation that may include:

• Hearing, speech and sometimes balance tests
• A physical examination to assess your inner ear's health
• Magnetic resonance imaging (MRI) or computerised tomography (CT) scan of the skull to assess the condition of the cochlea and inner ear structure
• Mental health (psychological) testing to determine your ability to learn to use cochlear implants

During the procedure

Your ENT surgeon will:

• Make a cut or incision behind your ear.
• Form a small hole in the portion of skull bone (mastoid) where the internal device rests.
• Create a small opening in the cochlea to thread the electrode of the internal device.
• Stitch the skin incision close, leaving the internal device under your skin.

After the procedure

Most people feel well enough to return home the following day after surgery. It is normal to experience:

• Dizziness or nausea
• Pressure or discomfort over the implanted ear or ears

Your cochlear implants will not be turned on until 2 – 6 weeks after your surgery to allow time for the surgery site to heal.

Care and recovery after cochlear implant surgery

After your surgery, speech and everyday noises will sound different from what you remember. Your brain will need training and time to recognise what these sounds mean through the cochlear implant. This is an ongoing process that can be aided by wearing the sound processor continuously during waking hours.

You may require some additional therapy training with auditory verbal therapists who specialise in helping you develop natural sounding speech and language ability with the use of your cochlear implant.