It’s natural to feel some apprehension before surgery so it can help to find out as much as possible beforehand about what to expect. Reassuringly, hearing implant surgery is now routine and has been performed thousands of times over the past 30 years with very few complications.
Here, we answer some of the most common questions. For personal advice, talk to the implant team at your clinic. Each hospital has its own procedure and will provide its own information.
What do I need to do before the surgery?
You should be given information by the clinic before the operation, detailing anything you need to do in advance. Key points include:
Check how long you/your child need to go without eating or drinking before the operation. This is important from a safety point of view.
You may want to wash hair before the operation as the incision area must be kept dry for at least a week afterwards. Dry shampoo is an alternative.
Remove body piercings, make-up and nail polish, which are not allowed in the operating theatre due to infection risk. Also, check the hospital’s policy on deodorant and lotions.
Tell the medical team if you/your child develop a cold, flu or are unwell before surgery.
If your child is old enough to be aware that they will be going into hospital, talk to them in advance about what to expect. The audiology team will have advice on this.
Make a medication list for the medical team. Besides prescription drugs, this should include over-the-counter medication and herbal remedies. The medical team may advise you/your child to stop taking them before the operation.
How long will I/my child be in hospital?
In general, patients in the UK leave hospital within two nights, and sometimes on the same day. How long you/your child will need to stay will depend on several factors, including your general health and whether there are complications, which can occur after any surgery.
What should I bring to the hospital?
A list of your/your child’s usual medications
Any medication you/your child will need to take that day
Pen and paper for communication with staff (it won’t be possible to hear until the audio processor is turned on after one to six weeks)
Slip-on shoes so you/your child don’t have to bend to tie laces or buckles (bending should be avoided for a few days after the surgery)
A shirt or blouse so you don’t need to pull anything over your/your child’s head (there will be a pressure bandage with ear protection)
Talk to your CI clinic for specific advice
When can the processor be switched on?
The first fitting usually takes place around two to six weeks after surgery, depending on the clinic and the type of implant you have had. This is when the audio processor is switched on and connected with your implant for the first time. The audiologist will play sounds, monitor your feedback and fine-tune your audio processor to suit your hearing – this is a process known as fitting, sometimes also referred to as mapping. Obviously babies and very young children can’t give vocal feedback but the audiologist can observe their reaction. This is just the start of the learning-to-hear process.
What are the most common complications after cochlear implant surgery?
Fortunately complications after implant surgery are very rare as it’s now a routine procedure with thousands of surgeries performed worldwide every year. A large national audit carried out in the UK in 2012 found that risk of major complications is just 1.6% .
Most complications, if they do occur, are temporary. Everyone has a slightly different risk so ask your surgeon how they relate to you. They include:
Bleeding and wound infection – This applies to all surgery
General anaesthesia risk – This applies to all surgery but is very small.
Dizziness – The vestibular system, which deals with balance, is connected to the cochlea.
Meningitis – The medical team should check that you’ve received appropriate vaccinations before carrying out the operation so risk is extremely small. This is important as it’s a potentially serious infection.
Facial nerve injury – Monitoring equipment is usually used during surgery nowadays, which means this risk is extremely small. In fact there were no instances of permanent paralysis in the 2012 UK audit.
Change in taste in the mouth – The nerve that controls taste travels through the ear, very close to the facial nerve. Usually this is a temporary side-effect that disappears after a few days or weeks.
Device failure – If this occurs, a new device can be implanted.
What will it feel like after the hearing implant operation?
Expect to hear cracking, popping and other noises in your ear and possibly a feeling of fullness or pressure. Chewing may also be uncomfortable at first. This is normal but ask your doctor if you have any concerns.
It’s a good idea to warn your family and friends that you won’t be able to hear right away after the operation, and that even after the audio processor is switched on, you will be starting a journey of rehabilitation.
Are there any restrictions on what I/my child can do after the operation?
Although most normal activities can be resumed soon after surgery, there are some general restrictions:
No vigorous exercise, contact sports, gym classes or heavy lifting in the first six weeks – your doctor will give more detailed advice.
Try to avoid bending over – to pick something up, bend your knees.
Don’t shampoo hair until the staples have been removed and keep the incision area dry for at least a week
Ask your doctor how quickly you/your child can return to work/school. This will depend on your job and whether or not it’s physically strenuous.
Don’t drive if you feel dizzy or are taking medication that may make you drowsy such as certain painkillers. Otherwise driving is fine.
Don’t blow your nose vigorously for 10 days after surgery. After 10 days, blow it gently, one side at a time with your mouth open.
Ask your doctor when it will be safe to fly.
What preparations should I make at home?
Buy in soft foods – Chewing may be uncomfortable after the operation, so prepare soft foods such as soups, yoghurt, jelly or protein shakes.
Have an extra pillow handy – Elevating the head when lying down may help alleviate swelling.
If you live alone, try to have someone at home with you immediately after the operation as you may feel dizzy afterwards or drowsy from the painkillers.
If you have any questions or concerns afterwards, talk to your CI team.
A HearPeers mentor can give you more advice on how to prepare for surgery.
This will depend on the type of implant. If it’s a bone conduction or middle ear implant, it may be an hour while a cochlear implant usually takes one to three hours.
After the first fitting, sounds may begin to seem quieter or different from when the audio processor was first switched on. As a result, you’ll need regular fittings to fine-tune your audio processor as your hearing perception continues to improve due to rehabilitation and practice. These are usually after one, three, six and 12 months, followed by annual appointments. If your processor features a data logging function, it will record how you use your device, helping your audiologist to make the right adjustments and tailor your rehabilitation programme accordingly.
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