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.

Getting Ready

Before your surgery:

• You may need to be given a pneumococcal vaccine at least two weeks before your surgery. A vaccine is a shot of medicine to help prevent illness. A pneumococcal vaccine helps prevent you from getting a brain infection. Ask you caregiver for more information about this vaccine.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• You may need to have blood tests, hearing tests, and imaging studies done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• Ask caregivers about directions for eating and drinking.

Day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• 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.
  
  
• 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.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will lie on your back during surgery. A small amount of your hair may be shaved and your skin will be cleaned. Your caregiver will fold your outer ear inwards to cover your ear opening. Medicine called anesthesia will be given to keep you asleep and free from pain during your surgery.
  
  
• Your caregiver will cut behind your ear along your hairline. Your caregiver will then lift up a flap of skin. A hole will be drilled through your skull (head bone). A hole will be made in your cochlea and the electrodes will be placed inside. Your caregiver may need to remove bone to create a space to put the receiver. The receiver is kept in place with stitches (thread) attached to your skull. Your cut will 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 will be taken to a room where you can rest 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. You will have a bandage behind your ear to keep the wound clean and dry. This will be removed the next day after your caregiver checks your wound.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your surgery on time.
  
  
• You get sick (a cold or the flu).

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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 (Precare)