Cochlear Implant Surgery and Rehabilitation

Surgery to place a cochlear implant inside the ear is an outpatient procedure performed in a hospital or clinic, using general anesthesia. The patient returns to the audiologist a few weeks later to have the cochlear implant activated and programmed (mapped).

What happens during cochlear implant surgery?
Cochlear implant surgery takes place in a hospital or clinic. The surgery lasts about two hours. Patients are given medication (general anesthesia) so that they are asleep during the procedure.

  • The surgeon makes a small incision behind the ear and then creates an opening in the mastoid bone to guide the electrode to the cochlea.
  • The implant electrodes are placed inside the cochlea.
  • The surgeon places an internal processor in a pocket between the muscle and bone behind the ear. The internal processor receives information from an external speech processor that will be worn outside the skin.
  • The incisions are then closed, and the patient is moved into the recovery area and watched closely as he or she recovers from the anesthesia.

The patient is discharged after several hours of observation and can go home to rest. Overall hearing will be different on the side of the implant right after surgery — the device will be programmed a few weeks later, allowing time to for the incisions to heal. During this time, you will not be able to use a hearing aid in the ear that had surgery.

Recovery After Cochlear Implant Surgery
Before leaving the hospital or surgery center, you are given instructions on how to care for the incisions, which may include:

  • How to change dressings and care for stitches
  • When to resume washing the area around the incision (usually a day or two after the surgery)

During a follow-up appointment, about one week after the surgery, the surgeon will inspect the incisions and remove stitches. Typically, it is recommended to wait three to four weeks for the area to heal before activating the cochlear implant.

Increased pain, swelling, drainage or fever should be reported to the doctor after the procedure.

Cochlear Implant Activation and Programming
When the inner ear has healed enough, you will return to the audiologist, who will program the cochlear implant and show you how to use the external processor on the ear. The goal is to get the nerves and brain used to hearing again.

A series of programming appointments takes place during a four-week to six-week period. During the early programming appointments, most people do not understand the sounds coming through the implant. You will work with your audiologist and auditory rehabilitation therapist to develop a plan to train the brain to interpret sounds in a way that fits with your lifestyle.

After that, programming appointments are needed every six to 12 months during the life of the implant. These visits help the care team assess the progress as the brain learns to process sounds and give them meaning. Adjustments are be made to the implant if necessary.

Source – hopkinsmedicine.org

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