COCHLEAR IMPLANT

General Information

DEFINITION--Installation of a microelectronic (tiny electrodes) system in the ear and a miniature receiver implanted under the skin with an implanted wire connecting the two.

BODY PARTS INVOLVED--Cochlea (an organ in the inner ear that transforms sound vibrations into nerve impulses for transmission to the brain); skin behind the ear or in the chest (sometimes).

REASONS FOR SURGERY--Treatment for severe deafness. The sensitive structures within the cochlea may have been damaged by trauma, toxic effect of drugs or infection. The auditory nerve carrying sound signals to the brain is intact, but it receives no stimulus. The implant provides signals which can be taken up by the auditory nerve. It improves, but cannot restore normal hearing,

SURGICAL RISK INCREASES WITH

• Recent or chronic illness.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Ear, nose and throat doctor (otolaryngologist).

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Medical and auditory testing to determine your suitability for implant.
• After surgery: Auditory testing.

ANESTHESIA--General anesthesia by injection and inhalation, with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made behind and slightly above the ear. A burr-type instrument is used to drill a circular hole in the bone for preparation for implanting the internal coil.
• The mastoid bone in the ear is opened to gain access for the electrodes that will be led from the internal coil into the inner ear.
• The internal coil is then positioned in the prepared site and secured with stitches.
• The electrodes are inserted deep in the inner ear.
• Once the surgical wound is healed, an external unit consisting of a stimulator with built-in microphone is provided for wearing behind the ear. It may be attached to eyeglasses or a headband or special magnets between the internal and external components.

POSSIBLE COMPLICATIONS

• Vertigo.
• Bleeding.
• Surgical-wound infection.
• Facial nerve damage during surgery.
• Technical failure of the implant.

AVERAGE HOSPITAL STAY--2 to 3 days.

PROBABLE OUTCOME

• Expect complete healing without complications. Stitches will be removed a few days after surgery.
• One or more follow up visits to your doctor will be needed to program the implant. The hearing capability with the implant will vary from person to person and cannot be reliably predicted.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap. Use an ear plug or shower cap to avoid getting water inside the ear.
• Use a warm compress to relieve incisional pain.

† You may use non--prescription drugs, such as acetaminophen, for minor pain. Avoid aspirin.

ACTIVITY

• Avoid sudden head movements as they can cause dizziness.
• Avoid bending over for the first few days following surgery.
• Try not to blow your nose or sneeze for the first two weeks.
• Resume work, normal activities and driving in 2 to 3 weeks.

DIET---While in the hospital, you may progress from a liquid diet to a soft diet to a regular diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.