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Cochlear implants
Everything you need to know about cochlear implants
What are cochlear implants?
Cochlear implants are small electronic devices that are used to treat moderate to profound hearing loss. They are made up of two parts; an external (outside) part and an internal (inside) part that is implanted under your skin.
Unlike hearing aids, which make sounds louder, cochlear implants work by directly stimulating your cochlear nerve (the nerve from your ear to your brain), which sends signals to your brain, allowing you to perceive and process sound.
Cochlear implants may be used for people with hearing loss caused by problems in the inner ear. Most people with this type of hearing loss have a functioning cochlear nerve, but the nerve endings (hair cells) in the part of the inner ear called the cochlea, are damaged.
A cochlear implant bypasses the damaged part of your ear and sends sounds (electrical impulses) directly to your hearing nerve (the cochlear nerve).
You may have cochlear implants in one (unilateral cochlear implant) or both ears (bilateral cochlear implants). Cochlear implants may be used to treat hearing loss in adults and children.
A cochlear implant is made up of two main parts:
- External part: This part of the implant is worn outside your body and consists of a microphone to detect sound, a sound processor and a transmitter coil. Sounds picked up by the microphone are turned into electrical signals which are then sent by the transmitter via radio waves through the skin to the internal part of the cochlear implant.
- Internal part: This part of the device is implanted under the skin behind your ear and is made up of a receiver and an electrode array (a wire that carries electrical signals). The receiver picks up radio waves sent through the transmitter and passes them down the electrode array to your cochlear (a fluid-filled, spiral cavity in your inner ear), stimulating your auditory nerve and creating the sensation of hearing.
Types of cochlear implants
There are several types of cochlear implants that vary depending on where the external part of the device (external sound processor) is located. This may be:
- Attached to your clothes
- Behind your ear
- On your scalp
Why might I need cochlear implants?
Your consultant may recommend cochlear implants if you have severe to profound sensorineural hearing loss (hearing loss due to damage in your inner ear) and hearing aids are no longer effective.
What are the benefits of cochlear implants?
Cochlear implants offer many benefits including:
- Being able to hear your own voice and subsequently improve your speech, tone and pronunciation
- The ability to understand spoken language without lip reading
- The ability to hear sounds around you and subsequent improved safety
- The ability to communicate over the phone
- Being able to hear music and watch TV without subtitles
- May improve symptoms of tinnitus
- Babies and young children with hearing loss may be able to meet developmental milestones if cochlear implants are used from a young age
How much do cochlear implants cost?
The cost of cochlear implants depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.
Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.
Our flexible payment options help you spread the cost of your payment across a time period that suits you.
What to expect at your initial consultation
At your first consultation, you will be seen by a consultant ear, nose and throat (ENT) surgeon, a doctor specialising in conditions affecting the ears, nose or throat.
Your consultant will ask you about your symptoms, general health, medical history, and any medications you take regularly. They will ask you about your experience of hearing loss, how your hearing loss impacts your day-to-day life and what you hope to achieve from the treatment. They may perform a physical examination.
To determine whether cochlear implants are suitable for you, your consultant may order tests such as:
- Hearing (audiometry) tests: There are various hearing tests to check the severity of your hearing loss, identify any issues with your cochlea or eardrum and assess your ability to hear sound and understand speech. Hearing tests may be performed with and without hearing aids
- Auditory brain stem response: This test checks the connections between your inner ear and brain. It may be performed on people who can’t have pure-tone tests such as babies, small children and people with a brain injury that affects their hearing
- Vestibular test battery (vestibular function testing): Involves a series of tests that evaluate your vestibular system (inner ear balance system)
- Imaging tests: May include magnetic resonance imaging (MRI) or computed tomography (CT) scans that provide detailed images of your inner ear
Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. Your consultant will take time to get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.
How to prepare for cochlear implants
Your consultant will tell you everything you need to do to prepare for your cochlear implant surgery. Instructions on how to prepare will also be in your appointment letter.
If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice.
Around a week or two before your cochlear implant surgery, you or your child will need to attend the hospital for a pre-operative assessment to make sure you are fit for surgery. Take any medication you take regularly with you to your appointment. At your preoperative assessment, we will check your weight and blood pressure and order tests such as a blood test, chest X-ray and electrocardiogram (ECG) to evaluate your general health. Your child will need to be vaccinated against meningitis at least a week before cochlear implant surgery. This is because the cochlea is close to the brain and there is a slightly increased risk of meningitis after surgery.
Your consultant may tell you to stop taking certain medications, such as blood thinners for a few days before your surgery. This is to minimise the risk of bleeding during and after your procedure.
You will not be able to eat or drink anything from midnight on the day of your surgery.
What happens during cochlear implant surgery?
Before your surgery, you’ll need to sign a consent form to say that you agree to have the procedure and are aware of what it entails and the possible risks and complications of the surgery. The area behind your ears will be shaved to ensure it is as sterile as possible before the surgery.
Cochlear implant surgery is performed under general anaesthesia which means you’ll be asleep for the procedure and won’t feel any pain.
Once the anaesthetic has taken effect and the surgical area is sterilised, your consultant will make a small incision (cut) behind your ear and place the internal processor in a space between your muscle and bone.
Your consultant then drills a small hole through one of your skull bones (the mastoid bone) to access your middle ear and make a small opening in your cochlea to implant the internal part of your device.
Once the procedure is complete, your consultant will close the incision with stitches and place a sterile dressing over your surgical wound. If you are having bilateral cochlear implants, the procedure will be repeated on the other side.
Cochlear implant surgery normally takes from one and a half to three hours on each side.
Recovering from cochlear implant surgery
After your cochlear implant surgery, you will be taken to the recovery room where you will be monitored carefully until the anaesthetic has worn off.
When you wake up from your surgery, you may feel slight discomfort, pain or pressure around your ear. The nursing staff will give you pain medication to manage this if needed. You may also feel sick or dizzy, and your balance may be affected. These are temporary effects that normally improve over the next few days. Some patients experience tinnitus (ringing or other sounds in your ear) after cochlear implant surgery. This is usually temporary and improves as your ear heals.
Your consultant will give you instructions on how to care for your surgical wound at home. Keep your wound clean and dry and don’t wash your hair or get your surgical wound wet for seven days after your surgery. You will probably have dissolvable stitches that won’t need to be removed.
Avoid strenuous activity or heavy lifting for two weeks after your surgery. If you need to blow your nose, do so very gently.
Before you leave the hospital, your healthcare team will give you a series of follow-up appointments to check your recovery. You’ll also have an appointment with an audiologist (a health professional specialising in hearing disorders) to turn on your cochlear implant, make any necessary adjustments and work with you to recognise and understand sounds using your cochlear implant.
Using your cochlear implant
Cochlear implant surgery is only the first step in having a cochlear implant and the aftercare and rehabilitation following surgery are important to get the most from your cochlear implant.
Around one to four weeks after your cochlear implant surgery, you will return to the hospital to see an audiologist.
Your audiologist will check your implant and make any necessary adjustments to ensure it is working as effectively as possible. They will also teach you how to use and care for your cochlear implant.
Over several follow-up appointments, your audiologist will work with you to train your brain to understand and interpret the sounds you hear through your cochlear implant. Most people see a significant improvement in recognising sounds and understanding speech within three to six months of cochlear implant surgery.
You may need to have regular follow-up appointments for the rest of your life to check your hearing, make any necessary adjustments to your cochlear implant and carry out other tests.
It's important to note that the results of cochlear implant surgery vary from person to person and not everyone experiences the same level of success following the procedure.
How many nights will I need to stay in hospital?
Cochlear implant surgery is normally performed as an outpatient procedure meaning you can usually go home later the same day.
Will I be able to drive home?
You will not be able to drive yourself home from the hospital after your cochlear implant surgery or for 24 hours following a general anaesthetic. Please make arrangements for someone to collect you, or we can organise a taxi if you prefer.
How soon can I go back to work?
You should rest at home for the first few days after your cochlear implant surgery and can expect to take one to two weeks off work or school.
When can I drive?
You can drive when you can safely control your vehicle and perform an emergency stop. Don’t drive while you are taking strong pain medication or any other medicines that may affect your concentration and impair your reaction times, or while you feel dizzy or have problems with your balance.
When will I be back to normal?
Recovering from any type of surgery is a gradual process that is different for everyone. Recovering from cochlear implant surgery depends on several factors including your age, general health, the type of procedure you had and your individual recovery process. You can help your recovery to go more smoothly by making sure you are as well informed as possible about your surgery and recovery, taking things at your own pace and following your consultant’s post-operative instructions carefully. Call the hospital if you have any questions or concerns.
Most people are fully recovered from cochlear implant surgery after around one to two weeks.
Potential risks and complications of cochlear implant surgery
Cochlear implant surgery is a generally safe procedure, but as with any type of surgery, there is a small risk of complications.
Your consultant will explain all the possible risks and complications of cochlear implant surgery before your procedure and answer any questions you may have. It’s important that you are fully informed about any possible risks and complications before your procedure and can make an informed decision. You can help minimise the risk of complications by following the instructions you are given on how to prepare for your procedure and what to do afterwards.
Possible complications of any type of surgery may include:
- Adverse reactions to the anaesthetic
- Bleeding
- Blood clots in the legs or lungs
- Wound infection
- Damage to nearby structures
- Chest infection
In addition to the above, possible complications of cochlear implant surgery may include:
- Bacterial meningitis: Vaccination before surgery reduces this risk
- Facial paralysis: Damage to your facial nerve can result in temporary or permanent weakness or paralysis in your face. Your facial nerves will be monitored during your surgery.
- Cerebrospinal fluid (CSF) leak
- Device infection
- Device failure: Your cochlear implant may not work properly or stop working and need to be replaced
- Movement of the device
- Dizziness
- Balance problems
- Taste changes: A metallic taste in your mouth can occur after surgery. This normally resolves within around three months.
- Tinnitus: Is usually temporary
- Long-term headache, pain, or numbness at the surgical site
- Loss of residual hearing: It’s common to lose any remaining hearing in the ear with the cochlear implant. This has a minimal effect on how well you can hear after your surgery.
- Your hearing may not improve after cochlear implant surgery
Why choose Circle Health Group for cochlear implant surgery?
At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:
- Flexible appointment times and locations that are convenient for you
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to your individual needs
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard
- A range of delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
If you would like to see a consultant or learn more about cochlear implant surgery, book your appointment online today or call a member of our team directly on 0808 189 5499.
Clinical review and sources
- Cochlear implants National Institute on Deafness and Other Communication Disorders
- Cochlear implants RNID
- Cochlear Implants Johns Hopkins
- Patient Information about the Cochlear Implant Operation Manchester University NHS Foundation Trust
