Cochlear Implant

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What is a cochlear implant?

A cochlear implant is an electronic device that returns hearing. It can be an option for children with severe to profound hearing loss for which traditional hearing aids are not helpful. Your surgeon and audiologist will determine if your child is a candidate.

Unlike hearing aids, which make sound louder, a cochlear implant bypasses the damaged portions of the ear to deliver sound signal directly to the hearing (cochlear) nerve. Cochlear implants use a sound processor that fits behind the ear. The processor captures sound signals and sends them to a receiver implanted under the skin behind the ear. The receiver sends the signals to the inner ear (cochlea) through an implanted electrode. The electrode stimulates the cochlear nerve, which sends these signals directly to the brain where they are interpreted as sounds.

Why does my child need a cochlear implant?

Cochlear implants can return hearing in children with severe hearing loss who are no longer helped by using hearing aids. Cochlear implants can improve communication, speech and language development, the ability to participate in school, and quality of life.

Specific criteria for cochlear implantation need to be met. These include:

• severe to profound hearing loss on specialized hearing tests
• limited benefits from hearing aids
• motivated patients and families who can participate in the hearing rehabilitation after surgery with realistic expectations
• no medical conditions that will deem surgery to be unsafe.

Your surgeon and audiologist will evaluate your child and determine if a cochlear implant is an option. Children can be receive an implant as early as 9 months of age.

How is a cochlear implant performed?

This procedure is performed by an ear, nose, and throat surgeon.

Your surgeon will make a cut (incision) behind your child’s ear and create a small hole in the portion of skull where the internal device rests. Your surgeon will then create a small opening in the cochlea in order to thread the electrode into the inner ear. The skin incision is stitched closed so that the internal device is buried under the skin. An x-ray is performed to ensure the device is inserted appropriately.

This procedure is performed in a hospital operating room and does require general anesthesia. This means your child will be fully asleep and carefully monitored during this procedure. You will have a chance to talk with the anesthesiologist on the day of surgery to discuss any questions you may have about the safety and risks of anesthesia.

Are there any instructions I need to follow before surgery?

Your child must have a physical examination by his or her pediatrician or family doctor within 30 days before surgery to make sure he or she is in good health. The doctor you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery. For your child's safety, it is very important that he or she have an empty stomach when anesthesia is given. Please follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be cancelled.

What can I expect after surgery?

The procedure itself lasts around 2 hours if one ear is receiving an implant. If both ears are being implanted the procedure will usually take 3-4 hours. Your child will wake up in the recovery room after surgery. When your child is awake, he or she will be taken to the discharge area to complete the recovery. You can be with your child once he or she has been transferred to the discharge area.

Your child might experience pressure or discomfort over the implanted ear(s). Dizziness or nausea is also possible after the procedure but most kids feel well enough to return home the day of surgery or the next day. Your surgeon will discuss with you when the dressings can be removed after surgery but this is typically 24 to 48 hours after surgery. Pain is typically treated with Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen). Please let us know if your child develops a fever after surgery or if any redness or drainage comes from the incision site. Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0F that do not come down with Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen). We will see you back in clinic about 4 weeks after surgery for activation.

When will my child start to hear?

An audiologist will turn on (activate) the cochlear implants about 4 weeks after surgery. This gives your child time to heal. At the activation appointment, your surgeon will examine your child and if everything looks healed and healthy your audiologist will perform the activation. To activate the device the audiologist will adjust the sound processor to fit your child, check the components of the implant to make sure they are working, determine what sounds your child can ear, and set the device at an appropriate level so your child can begin to hear. The audiologist will also give you information about the proper care and use of the device.

What is the rehabilitation process like after surgery?

In order to optimize your child’s ability to hear, hearing rehabilitation is important. Rehab involves training your child’s brain to understand the new sounds heard through the implant. These sounds will sound different and new. Your child will continue to see your audiologist for several appointments after surgery to ensure the cochlear implant levels are adjusted so your child can hear but sounds are not too loud. This requires close attention and fine tuning so the first few months of rehab are important.

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician. If you have any questions, please call your Ear, Nose, and Throat clinic.

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