The Process of Gettting a Cochlear Implant
The process of getting a cochlear implant involves activities before, during, and after the actual surgery. In most cases, people get an implant in only one ear, although there are situations in which people sometimes get implants in both ears.
- Seeing a doctor - You will see a special doctor, usually an ENT (ear, nose and throat doctor) or otolaryngologist who will perform a test to find out if you are a candidate for a cochlear implant.
- Tests often done are:
- exam of external, middle, and inner ear to assess structures and condition of parts of the ear
- various tests of hearing, such as an audiogram
- a trial of hearing aid use to assess its potential benefit
- exams to evaluate middle and inner ear structures
- CT (computerized tomography) scan – a specialized type of x-ray helps the doctor see if the cochlea has a normal shape.
- MRI (magnetic resonance imaging) scan – an special imaging technique used to see “soft tissue” such as parts of the middle and inner ear
- If you are a candidate based on the test results, you may then have:
- a psychological examination to see if you are motivated to complete the implant rehabilitation
- an exam or questionnaire for general anesthesia
During Surgery
The doctor or other hospital staff will:
- Prepare you for general anesthesia and surgery (start medication to relax you, add equipment to monitor heartbeat and breathing, position face mask for oxygen and other gases, give medication to make you feel like you are asleep)
- The area behind the ear is cleaned and the surgeon makes a cut in the skin, gently lifting it away from the mastoid bone.
- Using special tools, the surgeon shapes a shallow well in the mastoid bone to hold the implant, and a small hole to reach the cochlea.
- The surgeon puts the body of the implant in the shallow well and threads special connectors through the hole to the cochlea.
- The skin is placed back over the implant, the cut is closed, and bandage applied.
The operation usually takes a total of 2 to 3 hours.
- When you wake up from surgery, you may be in a special room until the anesthesia wears off. At first, you may feel dizzy, confused, or have an upset stomach or sore throat (from a breathing tube used during general anesthesia).
- Once the anesthesia wears off, some people go home the same day, while others stay one day in the hospital.
- Before you leave the hospital, you get instructions on how to care for your surgery area, bandages, how to shower, and wash hair. Most people feel well enough to resume normal activities within a few days. You do not have a new sense of “hearing” right away. Time is needed for healing before the implant is “turned on.”
- About 1 week after surgery, you see your doctor to have your stitches removed and the surgery area examined.
- The surgery area takes about 3 to 5 weeks to heal completely and for any swelling to go down.
- About 3 to 6 weeks after surgery, the implant is "turned on" (activated). People who get implants say waiting for this moment is an exciting time.
- After healing is complete, your doctor will do the first fitting and programming of the implant. This includes:
- adjusting the sound processor to fit the implanted patient
- testing to make sure the adjustments are correct
- learning what sounds the patient hears
- teaching proper care and use of the device
- Whenever possible, a family member is included in the training sessions, so they know how to work controls of the sound processor.
- Training sessions can vary in length and complexity. Learning to hear – and to speak – again, or for the first time, can be a long process. For someone who has been without sound for a long period, or a child who has never heard, it takes some time for the brain to get used to the stimulation from the implant. This involves a rehabilitation program (called habilitation for those who have never experienced sound).
Adults
- Your rehabilitation program will involve developing new listening skills through daily activities. Your speech clinician, or other members of your implant team, will help you come up with helpful techniques which may include:
- Using your implant system for as many hours a day as possible.
- Reading aloud to yourself, your family and friends.
- Listening to books on tape while you read along with a printed copy.
- Listening to the radio at home and in the car.
- If you have been without hearing for a long time, you may need an auditory development program. Designed by members of your implant team, your program will:
- Encourage you to practice recognizing speech and environmental sounds.
- Develop techniques to use hearing for communication.
- Help you and your family develop techniques that make communication easier.
Children
- A good training program increases a child’s ability to benefit from a cochlear implant. Several options may be available, including auditory-verbal and auditory-oral programs.
- Any program should include:
- Getting the child to wear the speech processor whenever they are awake.
- Providing plans to teachers, therapists, and the family that focus on improving the child’s listening skills using the implant for spoken communication and learning (and reducing forms of visual communication).
- Listening and speaking skills that are mixed into the child’s daily activities.
- Motivational support to help maintain the training program. Learning to use a cochlear implant takes time and effort, but the results can be amazing.
