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Cochlear Implant Surgery

Front view of the inner ear with a cochlear implant in place.

A cochlear implant is a device that helps reverse nerve-related hearing loss. It can treat hearing loss that will not respond to hearing aids. During cochlear implant surgery, the device is implanted into the inner ear (cochlea). A few weeks after surgery, the device is activated and hearing is restored. Typically, only 1 implant is placed. But, if needed, an implant can be placed in both ears. You and your healthcare provider will discuss what’s best for you.

Preparing for surgery

Prepare for the procedure as you have been instructed. In addition:

  • Be sure to tell your healthcare provider about all medicines you take. This includes over-the-counter medicines. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery as directed by your healthcare provider.

  • Follow any directions you are given for not eating or drinking before surgery.

The day of surgery

The surgery takes 2 to 3 hours. Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This line delivers fluids and medicines.

  • You will be given medicine (anesthesia) to keep you free of pain during the surgery. You will have general anesthesia. This puts you into a state like deep sleep during the surgery.

  • The area around the implant site will be shaved.

During the surgery

  • The surgeon makes an incision behind the ear. The mastoid bone is exposed. This is the bone you can feel behind the ear.

  • The mastoid bone is opened with a surgical drill. Great care is taken to avoid harming the facial nerve, which runs through the bone. This nerve controls your facial muscles. A facial nerve monitor (a machine with a small sensor that is put onto your cheek) may be used to map the nerve’s exact location. This helps avoid damage.

  • The cochlear implant is placed inside the hole in the mastoid bone.

  • A group of electrodes called the electrode array is attached. This is placed into the inner ear.

  • More bone is removed from behind the ear. The receiver/stimulator is then placed in this hole. This allows the unit to lie flat under the skin.

  • The skin incision behind the ear is closed with sutures.

  • If an implant is being placed in the other ear, this may be done at this time.

After the surgery

You will be taken to a recovery room to wake up from the anesthesia. You may be sleepy and nauseated at first. And you may feel dizzy. You will be given medicine to manage any pain. You may then be taken to a hospital room to stay overnight. Once you are ready to go home, you will be released to an adult family member or friend. Have someone stay with you for the next couple of days to help care for you as your healing begins.

Recovering at home

Recovery time varies for each person. Your healthcare provider will tell you when you can return to your normal routine. Once at home, follow the instructions you have been given. While you recover:

  • Take prescribed pain medicine exactly as directed. Take it on time. Do not wait for the pain to get bad before you take it.

  • For 3 to 5 days after surgery, sleep with your head raised above the level of your heart. This helps reduce swelling.

  • Do not drive until your healthcare provider says it’s OK.

  • Care for incisions as instructed by your healthcare provider.

When to call your healthcare provider

Be sure you have a contact number for your healthcare provider. After you get home, call if you have any of the following:

  • Chest pain or trouble breathing (call 911 or other emergency service)

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Pain that does not get better with medicine

  • Symptoms of infection at an incision site, like increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Signs of meningitis, like increasing neck stiffness, sensitivity to light, dizziness that gets worse, or facial weakness (note: meningitis could happen months after surgery)

Follow-up

During follow-up visits, your healthcare provider will check your healing. Stitches or staples will be removed 7 to 10 days after the surgery. When the incision has healed, the outer part of the implant is attached behind your ear. This will allow the device to work. Continue to follow up with your healthcare provider as directed. Speech and hearing specialists will help you adjust to your implant.

Risks and possible complications

Risks of cochlear implant surgery include:

  • Bleeding

  • Infection

  • Temporary dizziness

  • Severe vertigo (dizziness) that lasts up to 6 weeks

  • Tinnitus (ringing or buzzing in your ears)

  • Device eroding through the skin

  • Facial nerve paralysis

  • Damage to nerves and blood vessels at or near the incision site

  • Leakage of brain fluid

  • Device failure

  • Risks of anesthesia 

© 2000-2017 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.