A cochlear implant is a device that helps with some types of hearing loss.
A cochlear implant is a medical device to help with some types of hearing loss.
The device has 2 parts. One part is worn behind the ear on the outside of the head. The other part of the device is placed in the inner ear (cochlea) through surgery.
Cochlear implants are for people 12 months or older who:
Have severe to complete sensorineural hearing loss in both ears
Do not hear well with hearing aids
Can have surgery
Will to go to therapy for help with speech and hearing
Can take care of the device
Will commit to long-term follow-up care
After surgery, your child will have therapy to learn how to use the device. This helps improve hearing and speech. Your cochlear implant care team usually includes an audiologist, otolaryngologist (ENT doctor), and speech-language pathologist.
How a cochlear implant works
A cochlear implant has 2 main parts that work together: an external device worn behind the ear and an internal device placed during surgery. A magnet holds the 2 parts together.
External Device: The outside part of the cochlear implant device sits just behind the ear. It has a microphone that picks up sound. The sound signals are sent to a sound processor. The sound processor turns the sound into a digital signal.
Internal Device: The inside part of the cochlear implant is a receiver placed under the skin. It receives the digital signals and then sends them to tiny electrodes placed in the inner ear. The electrodes stimulate the auditory (hearing) nerve. It sends the message to the brain. The brain interprets the message as sound.
Cochlear implants improve hearing. But they work differently than normal hearing aids. Patients will need therapy to learn how to use the device to improve hearing and speech skills.
A cochlear implant works by turning sounds into digital signals and sending them to the hearing (auditory) nerve.
Before cochlear implant surgery
A team of specialists will help you before, during, and after cochlear implant surgery. Your cochlear implant care team usually includes an audiologist, otolaryngologist (ENT doctor), and speech-language pathologist. You may also meet with a psychologist, child life specialist, or social worker.
Vaccines to prevent infections
Children should be up to date on their vaccines before surgery. Cochlear impacts can raise the risk of a serious infection called meningitis, especially pneumococcal meningitis. Meningitis is swelling of the lining of the brain and spinal cord.
Certain vaccines can help people fight meningitis. These include the pneumococcal, Haemophilus influenzae type b (Hib), and meningococcal vaccines. If your child is not up to date on these vaccines, they should have them at least 2 weeks before surgery. This will give the vaccine time to build up your child’s immune system. Children who are already up to date on vaccines do not need to get more shots.
Pneumococcal vaccine
Children under 5 years old with cochlear implants should get the same pneumococcal vaccines as other children their age.
Children ages 2 to 18 with cochlear implants may need extra pneumococcal vaccines, depending on what they have already received. If your child has already had a dose of the PCV20 vaccine, they do not need more. If they have not had PCV20, your doctor may recommend 1 more shot—either PCV20 or PPSV23.
Children ages 6 to 18 with cochlear implants who have never had a pneumococcal vaccine should get vaccinated. They can get either PCV15 or PCV20. If your child gets PCV15, they may also need a PPSV23 shot later.
Ask your care team which vaccines your child needs.
All children younger than 5 years old should get the Hib vaccine, including children with cochlear implants. Research data does not suggest that older children with cochlear implants need the Hib vaccine.
Your care team will give instructions for when to stop eating and drinking before the procedure. These fasting guidelines are also known as NPO instructions. Your care team will also let you know if your child’s medicines need to be changed.
During cochlear implant surgery
Patients are under general anesthesia for cochlear implant surgery.
During the surgery:
The surgeon makes a small cut (incision) behind the ear. This creates an opening so the electrodes can be placed into the cochlea.
The surgeon places the electrodes inside the cochlea.
The surgeon tests the device.
The surgeon closes the skin with stitches (sutures).
Cochlear implant surgery usually takes up to 2 hours for 1 ear. Your child will spend some time in recovery after surgery. Your care team will keep track of your child’s blood pressure, heart rate, breathing rate, and oxygen levels. They will also watch your child for pain, dizziness, and nausea.
Your care team will let you know when you can go home after surgery. They will also give you instructions on how to care for your child at home, including how to care for the incision and change the dressing. Be sure to follow these instructions. Talk to the care team if you have any questions.
After cochlear implant surgery
If your child uses a car seat and you will be driving your child home within 24 hours of the procedure, plan to have another adult sit with your child in the back seat.
A few weeks after surgery, your audiologist will activate the cochlear implant and teach you to use and take care of the device.
Your child will see an audiologist and speech therapist often after surgery. It takes time to get used to the cochlear implant and to learn new hearing and speaking skills.
When the cochlear implant programming is finished, patients should have routine check-ups with an audiologist at least once a year.
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Cochlear implant surgery is usually safe. But, like all surgeries, cochlear implant surgery has some risks. Possible risks include:
Infection: The area around the implant could get infected. Doctors give medicine to help prevent this.
Bleeding: Some bleeding can happen during or after the surgery. This is usually mild.
Swelling or pain: The area where the implant is placed may feel sore or swollen for a few days.
Dizziness: Some people feel dizzy or off-balance after surgery. This usually goes away.
Change in taste: Sometimes, the nerve that helps with taste can be affected, causing food to taste different for a while.
Device problems: Rarely, the implant may not work right. If this happens, it might need to be fixed or replaced.
Cerebrospinal fluid (CSF) leak: There is a small chance that some clear fluid around the brain could leak. Doctors know how to treat this if it happens.
Facial nerve injury: Rarely, the nerve that moves the face could be affected. Surgeons are careful to protect this nerve.
Most side effects are mild and go away on their own. Your care team will watch your child closely and help with any problems. If you have questions or concerns, talk to your care team.
Care at home
After you leave the hospital, watch your child closely and follow these tips:
Keep the area clean and dry: Follow your care team’s instructions for washing and caring for the incision.
Watch for fever and signs of infection: Call your doctor if you see redness, swelling, warmth, or pus around the incision, or if your child has a fever.
Take medicines as directed: Give any pain medicine or antibiotics exactly as your care team tells you.
Rest and recover: Make sure your child gets plenty of rest after surgery. Avoid rough play, sports, or activities that could bump the head until your doctor says it is OK.
Avoid getting the incision wet: Do not let water get on the incision until your doctor says it is safe to do so.
Follow up: Go to all follow-up appointments. During these, your care team will make sure the cuts are healing and the implant is working.
When to call your care team
You should call your care team after cochlear implant surgery if you notice any of these signs:
If your child has a fever of 100.4°F (38°C) or higher
Redness, swelling, or warmth around the incision that gets worse
Pus or drainage coming from the incision
Severe pain that does not get better with medicine
Bleeding that does not stop
Headache, dizziness, or confusion that is new or getting worse
Weakness or trouble moving the face
Any other changes that worry you or seem unusual
If you have questions or concerns, call your care team.
Questions to ask your care team
Questions to ask your care team may include:
What happens during cochlear implant surgery?
When can my child return to normal activities?
What medicines should my child take, and for how long?
When will the implant be turned on and start working?
What follow-up appointments are needed?
Who should I call if I have questions or concerns?
What should I do if my child has pain or other side effects?
Are there any special instructions for sleeping or wearing hats after surgery?
Key points about cochlear implant surgery
Cochlear implants can help people with severe sensorineural hearing loss hear better.
The device has 2 parts: 1 worn behind the ear and 1 placed in the inner ear during surgery.
Cochlear implants work by sending sound signals directly to the hearing nerve, which the brain interprets as sound.
Vaccines before surgery help protect against infections for patients with cochlear implants.
Cochlear implant surgery is usually safe, but possible risks include infection, bleeding, dizziness, and rare problems with taste or nerves.
Follow your care team’s instructions for home care. Call if you notice fever, redness, swelling, or other symptoms that worry you.
Patients need therapy and regular check-ups after surgery. Therapy helps them learn how to use the device, improve hearing, and improve speech.
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