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Definition
A cochlear implant is a surgically-implanted electronic device that helps provide sound to a person with severe sensorineural hearing loss. This is hearing loss usually caused by damage or a defect in the inner ear. Cochlear implants bypass damaged hair cells in the inner ear and directly stimulate the auditory nerve to send information to the brain.
Cochlear implants have three parts:
- Speech processorThe speech processor looks like a long, narrow calculator. It is worn behind the ear or on a belt. It amplifies sound, converts it into digital signals, and sends these signals to the transmitter.
- TransmitterThe transmitter is a headphone that is worn behind the ear. It receives electrical signals from the speech processor and transmits them through the skin to the receiver.
- ReceiverThe receiver is the part that is implanted. It is a magnetic disk about the size of a quarter. It is placed under the skin behind one ear. A wire that leads from the receiver to an electrode is placed in the inner ear where it stimulates the acoustic nerve.
Parts of the Body Involved
The cochlear implants is placed in the ear.
The Cochlea
2008 Nucleus Medical Art, Inc.
Reasons for ProcedureCochlear implants provide a heightened sense of sound for adults and children with profound hearing loss. They are designed for people whose hearing does not improve with surgical correction or the use of a hearing aid. Cochlear implants will not restore or create normal hearing. Risk Factors for Complications During the ProcedurePrevious surgeryPrevious chronic ear infectionsCongenital anomaliesOssification of the cochlea What to Expect Prior to Procedure Your doctor will likely do some or all of the following: Ear (otologic) evaluationThe external and middle ear are examined to check for infection or abnormalities.Hearing (audiologic) evaluation An extensive hearing test that measures how well you hear without a hearing aid. MRI or CT scan These tests are taken to evaluate the anatomy of your inner ear. Physical examThis includes a medical history and physical exam to ensure that general anesthesia is safe.Psychological evaluationThis may be recommended to determine how well you are likely to cope with a cochlear implant. During ProcedureAnesthesia will be administered. AnesthesiaGeneral anesthesia is used for this procedure.
Description of the Procedure There are two parts to the procedure: Implantation of receiverAn incision is made behind the ear to open the mastoid bone leading to the middle ear. The receiver is implanted and attached to several tiny electrode bands.External hook-upAfter 4 to 6 weeks, the area should be healed. At this point, the transmitter headpiece and speech processor are hooked up. After ProcedureHealing takes 4 to 6 weeks. You will not be able to hear through the device during this time. Once you have healed, you will have a "hook-up" session, in which the external parts of the device are fitted.Over the next few months, as hearing improves, your doctor will continue to make adjustments to the speech processor. This is called "mapping." How Long Will It Take?The implantation procedure usually takes about 1 to 2 hours for adults, and up to 5 hours for children. Will It Hurt?Anesthesia prevents pain during the procedure. Pain is moderate after the procedure. Possible ComplicationsPostsurgical infection at the site of implantationDamage to a facial nervePermanent damage to balance organs in the ear (rare)Emotional distress due to higher expectations than the technology can achievePoor quality of hearing following the surgery Average Hospital StayThis is determined on an individual basis.
Postoperative Care You will have frequent follow-up visits for the following: Headpiece fitting, done 4 to 6 weeks after surgeryAdjustments to the speech processor (mapping)Ongoing evaluation of hearing status In addition, you'll have cochlear implant training. This will help improve your ability to: Identify soundsRead lipsDevelop speech skills OutcomeA cochlear implant should improve the ability to sense sound. Most people with cochlear implants can hear medium to loud sounds and recognize speech at normal decibel levels. Results will vary, depending on the age of initial deafness, degree of hearing impairment, condition of the nerve fibers, and general health. Call Your Doctor If Any of the Following OccursPainDizziness or vomitingFacial paralysisSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge at the incision siteCough, shortness or breath, chest pain, or severe nausea or vomiting RESOURCES: American Academy of Audiologyhttp://www.audiology.org National Institute on Deafness and Other Communication Disorderswww.nidcd.nih.gov/health/hearing/coch CANADIAN RESOURCES: Cochlear Implant Awareness Foundationhttp://www.ciafonline.org/index.html
Hospital for Sick Childrenhttp://www.sickkids.ca/cochlearimplant/ References Cochlear Implant Association, Inc. website. Available at: http://www.cici.org/ . Last reviewed November 2007 by Elie Rebeiz, MD, FACSPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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