Cochlear ImplantsEn Español (Spanish Version)
A cochlear implant is a surgically-implanted electronic device. 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 three parts:
- Speech processor—The speech processor looks like a long, narrow calculator. It is worn behind the ear or on a belt. It amplifies 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 transmits them through the skin to the receiver.
- Receiver—The receiver is the part that is implanted. It is a magnetic disk 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 is placed in the inner ear, where it stimulates the acoustic nerve.
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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.
Complications are rare, but no procedure is completely free of risk. If you are planning to have an implant, your doctor will review a list of possible complications, which may include:
- Damage to nearby nerves
- Problems with balance
- Emotional distress due to higher expectations than the technology can achieve
- Poor quality of hearing following the surgery
Some factors that may increase the risk of complications include:
- Previous surgery
- Previous ear infections
- Abnormal anatomy
What to Expect
Prior to Procedure
Your doctor will likely do some or all of the following:
- Ear (otologic) evaluation—The external and middle ear are examined to check for infection or abnormalities.
- Hearing (audiologic) evaluation—This is an extensive hearing test that measures how well you hear without a hearing aid.
- MRI or CT scan—These tests are taken to check the anatomy of your inner ear.
- A medical history and physical exam are needed to ensure that general anesthesia is safe.
- Psychological evaluation—This may be recommended to determine how well you will cope with a cochlear implant.
Leading up to your procedure:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
- Arrange for a ride to and from the procedure.
- The night before, eat a light meal. Do not eat or drink anything after midnight.
General anesthesia is used for this procedure. You will be asleep.
Description of Procedure
There are two parts to the procedure:
- Implantation of receiver—A cut in the skin will be made behind the ear. A hole will be drilled through the bone behind the ear to the cochlea. A wire will be fed 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—After 4 to 6 weeks, the area should be healed. At this point, the transmitter headpiece and speech processor will be hooked up.
How Long Will It Take?
About 1½-2 hours for adults, and up to five hours for children
How Much Will It Hurt?
Anesthesia prevents pain during the procedure. You will have some pain after. Your doctor can give you medicine to help manage any pain.
Average Hospital Stay
The length of stay is based on individual circumstances. Speak to your doctor about how long your stay may be.
After your procedure, be sure to follow your doctor's instructions. Ask your doctor about when it is safe to shower, bathe, or soak in water.
You will have frequent follow-up visits for the following:
- Headpiece fitting, done 4-6 weeks after surgery
- Adjustments to the speech processor (mapping)
- 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
After you leave the hospital, contact your doctor if any of the following occurs:
- Dizziness 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
- Cough, shortness or breath, chest pain, or severe nausea or vomiting
In case of an emergency, CALL 911.
American Academy of Audiology
National Institute on Deafness and Other Communication Disorders
About Kids Health
Cochlear Implant Awareness Foundation
Cochlear implants. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/treatment/cochlear_implant.htm. Accessed January 13, 2010.
Cochlear implants. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/hearing/coch.asp. Updated August 2009. Accessed January 13, 2010.
Cochlear implants. United States Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/default.htm. Updated April 2009. Accessed January 13, 2010.
6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed December 2010 by Elie Edmond Rebeiz, MD, FACS
Last updated Updated: 6/2/2011
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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