It is very important to evaluate if you are a good candidate.
The first step is an initial consultation with a cochlear implant audiologist. You will have hearing tests to determine the type and degree of hearing loss. If the tests show you might be a candidate, you will have a return visit to discuss cochlear implants in detail. You will also have appointments with a cochlear implant surgeon and a health psychologist. Radiological evaluations are also a part of the evaluation.
The health psychologist will evaluate your emotional stability, motivation, coping skills, expectations, understanding of the process and its risks, and your support structure at home.
You will have CT scans to determine any cochlear abnormalities and to provide a "road map" for surgery. The surgeon may also recommend an MRI scan.
The cochlear implant surgeon will discuss the surgical procedure with you, review your medical history and discuss the risks of cochlear implant surgery.
Referrals to other professionals may be made as necessary. From the results of these evaluations, the cochlear implant team makes a final decision about candidacy.
Surgery and Risks
Cochlear implant surgery is a three-hour procedure and most patients go home the same day. The surgeon makes an incision behind the ear and makes an opening in the bone. Then, the surgeons inserts the electrode into the inner ear. The surgeon closes the incision and the patient goes to the recovery room.
- Risks associated with anesthesia
- Injury to the facial nerve causing paralysis of one side of the face. (Worldwide incidence of permanent facial paralysis following cochlear implantation is 2 percent. The function of the facial nerve is monitored during the surgery in every case. This monitoring helps the surgeon avoid injury to the nerve.)
- Infection at the surgical site
- Temporary loss of taste (This usually returns in about 2 months)
- Failure of the cochlear implant device to work after it is implanted
- Failure to provide benefit (A small number of patients report that they receive no benefit from the device. The rigorous candidacy evaluation process minimizes this possibility.)
- Nausea or dizziness after surgery (Usually this goes away after a day, but for some it lasts several days. In these cases, a hospital stay may be required.)
- Disappointment in the benefit obtained from the cochlear implant (We counsel all patients and their family members so that their expectations are realistic.)
Programming the implant
One month after surgery, patients return for implant "hook-up." On the first day of activation, a headpiece is placed on the patient’s head and the speech processor is connected to a computer. The computer programs the speech processor to provide effective stimulation for the patient. This is customized for patients so they hear important sounds (and not uncomfortable sounds).
Most people are disappointed on the first day. Voices do not sound normal. Some people say they sound mechanical or warbled (like voices under water), garbled, scratchy or raspy, or any combination of these. It can take up to six months to fully adjust to a cochlear implant.
Full programming or mapping of the implant takes six or seven appointments during the first three months following hook up, with follow-up appointments at three months, six months and annually thereafter.
While cochlear implants can help a person detect sounds better, the ability to make sense of those sounds has to be learned. Aural rehabilitation helps patients with hearing loss get the most benefit from a cochlear implant. University of Minnesota Medical Center is the Twin Cities’ leader in aural rehabilitation.
Aural rehabilitation focuses on:
- Detecting sounds, including vocalizations and environmental sounds
- Learning to discriminate between sounds (recognizing if sounds are the same or different)
- Identifying sounds (what is the sound or the word)
- Comprehension (using listening to better understand the environment)
- Providing support as you return to daily life and work activities