Cochlear Implantation: Device for Deafness

1. A cochlear implant is a device that, after implanting, improves the hearing of the patient.
2. It is used to improve the hearing ability of adults, children, and babies.
3. It is beneficial, especially in inner ear problems that are not managed by other treatments. There are the inner and outer components of the cochlear implant. The internal parts include an intracochlear electrode and receiver or stimulator. The outer component includes a speech processor, microphone and transmitting coil. 

What will happen if surgery is delayed?

1. Studies have been performed to determine the impact of delayed cochlear implant surgery on quality of life and surgical outcomes.
2. It has been found that delayed cochlear implantation may result in poor speech outcomes in children.
3. There is reduced quality of life as the people cannot communicate with others with their limited or no ability of hearing.

1. You may be able to hear speech at a nearly normal level.
2. You may be able to understand speech without lip-reading.
3. It's easier to talk on the phone and hear the TV.
4. You may be able to hear the music better than before.

Why is this procedure done? 

1. Cochlear implant surgery is performed to improve the following medical conditions:-
2. The hearing ability is so severe that it interrupts everyday communication.
3. Hearing of different types of sounds, like the sound of footsteps
4.  To enable,  to hear in a noisy environment.
5. If hearing loss is severe in either one or both ears
6. To enable the patients to find, where the sounds are coming from
7. Deafness & mutism in children
8. Profound deafness
9. This implant process can only be done if the patient does not have any underlying medical condition that can cause complications after the implant surgery. The surgery has an excellent outcome in patients who wish to participate in hearing rehabilitation and want to get this implant done. The patient can make a normal conversation with other people.

The procedure of cochlear implant surgery

The procedure of Cochlear implant surgery involves the following steps.

1. The anesthesiologist will inject the patient with a precise dose of general anaesthesia. After getting anaesthesia injected, the patient will not feel any pain. 
2. Once you are asleep, the surgeon will make an incision behind your ear. 
3. After this, the surgeon will make a small hole in the skull bone (mastoid bone). It is the position where the internal component of the device is placed.
4. Then, the surgeon will make a small hole in the cochlea. The electrodes are inserted through the hole. Wires of electrodes are threaded in a spiral with the cochlea.
5. The surgeon will insert the receiver under the skin behind the ear. It is attached to the skull, and then the stitches are done.
6. After the surgery, the patient is moved to the resting room. There the patient is closely monitored to check for any side effects from the surgery.
7. The patient is discharged after a few hours or on the next day of cochlear implant surgery.
8. The patient is asked to go home without activation of the device. The device is activated after three to six weeks of the surgery. It is done after three to six weeks so that in this period, the device can fit under the skin. 

What to expect before surgery?

1. On visiting the hospital on the day of surgery, the doctor will first refer you to an ENT specialist (ear, nose, and throat doctor) or otolaryngologist. The doctor will check if the candidate is suitable for cochlear implant surgery. Some tests that are often done on the day of surgery are:-
2. Various tests of hearing are conducted, such as audiograms.
3. An examination of the middle, external, and internal ear is done to check the signs of any infection or abnormality.
4. As a trial, a hearing aid is also used to check the patency of the hearing aid and the requirement of surgery.
5. CT scan.
6. MRI scan.
7. A psychological examination is also conducted to see if the patient can live with the implant in the future.
8. A physical test is also performed to determine the overall fitness of the patient for the implant procedure.
9. The doctor may also advise you to stop certain medications that may cause complications during or after the surgery.
10. The doctor may also recommend you stop eating or drinking at least 12 hours before the surgery.

What to expect on the day of cochlear implant Surgery? 

1. You can expect the following on the day of surgery:
2. You should reach at the scheduled time as advised by your doctor.
3. The paramedical staff will advise you to change your clothes and wear the hospital gown. Further, you may also be instructed to remove the jewellery or dentures before the surgery.
4. In the meantime, you may also receive the report of a pre-anaesthesia check-up. 
5. The nurses will check your vitals and shift you to the operation room.
6. What to expect during surgery? 
7. The doctor or the staff will insert intravenous lines into the patient during the surgery. 
8. The scalp around the site of surgery is shaved for better convenience.
9. Monitors, cables, and patches are attached to the skin of the patient for monitoring the vital parameters.
10. A mask is put on the face to deliver oxygen regularly to the patient.
11. After completing the procedure, the patient is shifted to the recovery room.

What to expect after surgery? 

1. Immediately after waking after the surgery patient may experience the following:
2. The patient may feel a little pressure or discomfort around the implant. 
3. Some patients may also feel dizziness or nausea. 
4. Some of the patients may also experience a sore throat caused by the tube.
5. The patient may feel disoriented or might be confused for a while.
6. Fever

First follow-up appointment

1. After the cochlear surgery is done, the doctor may ask the patient for follow-up appointments, generally after one or two weeks. 
2. On the first appointment, the doctor will remove the stitches from the back of the ear. He may also examine any swelling, numbness, or bleeding at the incision site. 
3. The doctor will prescribe some pain-relieving medicines for reducing pain.
4. The next appointment with the doctor would be probably after 3-6 weeks.
5. The doctor will activate the device after three to six weeks of surgery. 

1. Bleeding, swelling or pus from incision
2. A problem in balancing and coordination
3. Nausea and dizziness
4. Disturbance in taste
5. If the noise in-ear is either new or worsened than before
6. Infection at the site of surgery