Cochlear Implants

Procedures & Operations

What is a Cochlear Implant, and Why Might You Need It

A cochlear implant is an electronic device designed to restore a sensation of hearing to adults and children that are severe to profoundly deaf in both ears. It consists of an external speech processor and an electrode array, which is surgically placed under the skin and connects to the hearing nerves in the inner ear.

The Surgery Explained

Before the operation, you will be given a general anaesthetic. The hair behind the ear is shaved in an area about four inches from your hairline. The operation takes place in theatre and will take between two and three hours to complete (or about four hours if an implant is being fitted in both ears at the same time). In straightforward cases, it takes approximately two hours. You will wake up with a large bandage (like a turban) on your head. This will be in place for 24 – 48 hours and is then changed for a small dressing. Sometimes the surgeon will put some antiseptic gauze in your ear canal, which if present should be left for a week or two to protect the wound. This will be removed at your out-patient appointment.

What to Expect Following Your Surgery

You will be given post-operative instructions along the following guidelines:

  1. Adults: No heavy lifting or strenuous activity for 1 week and no contact sports for 4 weeks following the surgery.
    Children and Infants: No heavy lifting, strenuous activity, contact sports, or gym classes for 4 weeks following the surgery.
  2. Head should be elevated on 1-2 pillows when lying down for 1 week following surgery. For infants, place an extra blanket under the head to keep it elevated if possible.
  3. Remove the entire ear bandage 48 hours after the surgery. The incision and sutures should be visible and some oozing is normal. Young infants may try and remove the dressing themselves earlier. If this happens, attempt to re-apply the dressing but do not force the issue – if it has been on at least 24 hours this is sufficient.
  4. Showering and bathing is allowed after the ear bandage has been removed (48 hours after the operation).
  5. AFTER the bandages are removed, clean the incision with half-strength hydrogen peroxide (1/2 water, 1/2 20 volume hydrogen peroxide) to remove any old blood clots or crusting on the wound with Q-tips. DO NOT replace the bandage – leave the incision open to air. If there is any oozing, you may use a small sterile adhesive bandage temporarily.
  6. Apply Vaseline to the incision after cleansing with hydrogen peroxide. Do not use ointment that contains neomycin or Bacitracin as a growing number of patients are developing allergies to these ointments. The sutures are usually dissolvable and will fall out on their own. In adults and older children metal clips may have been used. If this is the case leave the wound alone until the clips have been removed; then the wound may be cleaned. There may be oozing and drainage from the incision – this is normal after surgery.
  7. You will be given a course of antibiotics to take following surgery. This is usually for two days but occasionally a longer course may be required. Please ensure the medication is finished as prescribed; do not stop early even if you feel well. If you think that you may be developing an allergic reaction to the antibiotic, a yeast infection, excessive diarrhoea or loose stools, or have severe abdominal cramping, please call your doctor’s office. Contact us as soon as possible for any high fevers, severe headaches, or unusual neck stiffness.
  8. Adults: The first post-operative clinic visit is 4-6 weeks after the surgery. The implant will be turned on about 4 weeks after surgery.
    Children and Infants: The first post-operative clinic visit is 2 to 4 weeks after surgery and the implant will be turned on 4-6 weeks after surgery.

Following your operation, you may suffer from:

    Pain: Soreness and pain are not unusual and will gradually diminish with time. Adults will be given pain medication to be taken for the first few days following surgery. Infants should be given paediatric-dosed paracetamol (over the counter) every six hours or so for the first 2 days following surgery. Older children will be given a pain medication to be taken for the first several days after surgery. Mild, intermittent ear pain is not unusual during the first two weeks after surgery. Pain above or in front of the ear is common when chewing and is temporary.

    Swelling: Swelling is expected following surgery. The swelling can occur behind the ear, in front of the ear, around the eye, or around the mouth. Some bruising may also occur. The ear may appear to stick out or appear to be higher or lower than the other ear. This is normal and will gradually improve over the weeks following surgery. However, if a golf ball sized swelling develops over the implant, please contact us as soon as possible.

    Ear numbness: Your ear may feel numb – this is temporary and will improve over several weeks or months. Be careful when using a hair dryer on a hot setting to avoid injury to the skin until sensation returns.

    Popping, fullness or ringing of the ear: You may experience ringing, popping, crackling, or other sounds in the ear. This is caused by nerve stimulation or fluid in the ear from surgery and usually improves with time. You may feel as if the ear feels clogged or filled with fluid. This is entirely expected after surgery.

    Dizziness: Dizziness may occur following surgery. Avoid sudden movements; stand up slowly. Dizziness is usually temporary and will improve with time. Gradually increase your activity levels.

    Drainage or discharge: A bloody or watery discharge is expected during the healing process. Call your doctor’s office for a yellow or green discharge. Discharge with foul odour should also be reported. Some patients notice a nosebleed or spit up blood – this is common and results from the blood that accumulates in the middle ear during surgery, and drains into the back of the nose. This is not cause for concern.

    Taste disturbance and dry mouth: This is common after cochlear implant surgery and results from irritation of the taste nerve (chorda tympani nerve) during the surgical approach to safely protect the facial nerve and expose the cochlea. This is a temporary sensation for the majority of patients. In some patients, this can last a few months or more.

    Meningitis following surgery: This is a rare condition that can follow cochlear implant surgery. If you or your child is experiencing high fevers, light sensitivity (photophobia), neck stiffness, a severe headache, or appears confused go to your nearest A&E Department as soon as possible.

    Tinnitus: You may experience “ringing” or “buzzing” in the ear following surgery. This is common and will usually improve after activation. If tinnitus was present before surgery, it may become louder until activation.

    Discomfort with chewing: You may have some discomfort with chewing – this is common and is temporary.

    Bruising around the eye or corner of the mouth: You may have some slight bruising around the eye or corner of the mouth – this occasionally occurs because of the facial nerve monitor electrodes and is temporary.

    Sore throat or hoarse voice: You may have a sore throat or hoarse voice and this occasionally occurs because of the breathing tube (endotracheal tube) that is used if you received general anaesthesia. This will usually improve over time.

To view and/or download further information relating to this procedure, please go to the Patient Information Leaflets section of this website.