Cochlear Implants Overview

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.

The Cochlea © 2009 Nucleus Medical Media, Inc.

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.

Anesthesia

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.

Post-procedure Care

At Home

After your procedure, be sure to follow your doctor's instructions .

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

RESOURCES:

American Academy of Audiology
http://www.audiology.org/

National Institute on Deafness and Other Communication Disorders
http://www.nidcd.nih.gov/

CANADIAN RESOURCES:

About Kids Health
http://www.aboutkidshealth.ca/

Cochlear Implant Awareness Foundation
http://www.ciafonline.org/index.html

References

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. US Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/default.htm . Updated April 2009. Accessed January 13, 2010.