Cochlear Implants

WHAT YOU SHOULD KNOW:

• A cochlear implant (CI) is a small device that helps improve your hearing. Normally, sounds are changed into electric signals by special hair cells in your cochlea. The signals are sent through your auditory (hearing) nerve to your brain, allowing you to hear sound. The cochlea is inside your inner ear and is the main body organ for hearing. Damage to the hair cells causes hearing loss. You may need a CI if you are very hard of hearing and hearing aids do not help. Your caregiver may also decide that you should have a CI if you are deaf.
  
  
• With a CI, you will wear a plastic ear piece with a tiny microphone. This is attached to a speech or sound box. The sound box may be worn on your belt or placed inside your pocket. During surgery, electrodes (wires) are put into your cochlea. A receiver is put under the skin behind your ear. The receiver is a listening tool and it works together with a transmitter. The transmitter is a round plastic coil that is worn outside your ear.
  
  
• Your caregiver may decide that you need a CI for one or both ears. A CI may help you communicate with other people. It may help you understand what people are saying. A CI may also help you feel better about yourself.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• After your surgery, you may not heal properly. You may start to feel dizzy. Around the cut, you may get an infection or some nearby skin may die. Your CI may not be in the right place or it could stop working. If this happens, you may need to have another surgery to fix it. During surgery, parts of the ear may be damaged. A nerve may be injured which may cause you to lose feeling in your face. You may also be unable to move parts of your face.
  
  
• After surgery, you may get meningitis. Meningitis is a serious infection around your brain and spinal cord. Without surgery, your hearing problems may get worse. You may also become deaf. Ask your caregiver if you are worried or have questions about your surgery, condition, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Pre-op care: You may be given medicine right before your surgery. This medicine may help make you feel relaxed and sleepy. You are taken on a stretcher to the room where your surgery will be done. You are then moved to a table or bed where you will lie on your back. A small amount of your hair may be shaved and your skin will be cleaned.
  
  
  • Epinephrine: This is medicine given as a shot into your skin. Epinephrine will help keep you from bleeding too much during surgery.
    
    
  • Antibiotics: Right before your surgery, your caregiver will put antibiotic medicine into your IV. Antibiotics help your body kill germs that may cause meningitis. Meningitis is a serious infection in the brain and spinal cord.
    
    
  • General anesthesia: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

• A small amount of your hair is shaved and your skin is cleaned. Your caregiver folds your outer ear inwards to cover your ear opening. He may draw lines on the back of your head to guide where he will do the surgery. Your caregiver cuts behind your ear along your hairline. He then lifts up a flap of skin and drills a hole through your skull (head bone). Your caregiver makes a hole in your cochlea and puts the electrodes inside of it.
  
  
• Your caregiver may need to remove bone to create space to put the receiver. The area created for the receiver is cleaned and kept from bleeding. The receiver is placed inside and then tied to the skull with stitches (thread). Your cut will also be closed with stitches. If you are having a CI placed in both ears, you may require a second surgery. This is called a two-stage surgery and is used to place the second CI. Your caregiver will decide whether a two-stage surgery is right for you.

After your surgery:

You are taken to a room where you can rest and stay until you are awake. Do not try to get out of bed until your caregiver says it is OK. You may then be able to go home or you may be taken to your hospital room. A bandage is placed behind your ear to keep the wound clean and dry. This will be removed the next day when your caregiver checks your wound.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Cochlear Implants (Inpatient Care)