Cochlear Implants
Definition
- Speech processor—The speech processor looks like a long, narrow calculator. It is worn behind the ear or on a belt. It increases 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 sends 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 |
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Reasons for Procedure
Possible Complications
- Infection
- Damage to nearby nerves
- Problems with balance
- Emotional stress caused by having higher expectations for the technology
- Poor quality of hearing following the surgery
- Smoking
- Previous surgery
- Previous ear infections
- Abnormal anatomy
What to Expect
Prior to Procedure
- Your doctor will examine you, paying particular attention to your ears. This can be done with:
- A medical history and physical exam
- Ear exam
- Hearing evaluation
- Psychological evaluation
- Your doctor may need pictures of your ear. This can be done with:
- You should be up-to-date on immunizations. Pneumococcal , meningococcal , and haemophilus vaccines are especially important. There has been a link between cochlear implants and bacterial meningitis .
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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 or warfarin
- 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
Description of Procedure
- Implantation of receiver—A cut will be made in the skin behind the ear. A hole will be drilled through the bone behind the ear to the cochlea. A wire will be placed 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—In 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?
How Much Will It Hurt?
Average Hospital Stay
Post-procedure Care
- Headpiece fitting, done 4-6 weeks after surgery
- Adjustments to the speech processor
- Ongoing evaluation of hearing status
- Identify sounds
- Read lips
- Develop speech skills
Call Your Doctor
- Pain
- 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
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
References
Cochlear implants. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/treatment/cochlear%5Fimplant.htm . Accessed February 7, 2013.
Cochlear implants. National Institute on Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/hearing/coch.asp . Updated March 2011. Accessed February 7, 2013.
Cochlear implants. United States Food and Drug Administration website. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/CochlearImplants/default.htm . Updated April 16, 2009. Accessed February 7, 2013.
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.
