Our cochlear implant surgery videos can be found by clicking here.
The cochlear implant is an electronic device that provides sound information to individuals that have a sensorineural hearing loss in both ears and do not adequately benefit from hearing aids. The cochlear implant stimulates the surviving auditory nerve fibers in the center column of the inner ear, an area called the modiolus which houses the cochlear spiral ganglion. Bypassing the sensory structures of the inner ear, a cochlear implant provides auditory information directly to the hearing nerve. Note that the vast majority of persons said to have nerve hearing loss in fact have loss of the sensory system hair cells.
The cochlear implant has external and internal components. The external system includes a microphone, a speech processor computer, and a broadcast antenna. Surgery inserts the internal components, an internal receiver antenna, an internal processor, and an electrode that inserts inside of the cochlea. The individual then wears an external receiver, a microphone and a speech processor. A magnet holds the receiver to the head. The receiver is connected to a speech processor with a thin wire. The processor picks up sounds and converts them to coded signals. These coded signals are converted to electrical stimuli, which are then sent to the internal receiver and ultimately to the electrode array. These electrodes then stimulate the auditory nerve, which then sends information to the brain.
Our pediatric and adult cochlear implant program offers the latest technology in implants that are currently on the market. We work with all three major cochlear implant companies: Advanced Bionics, Cochlear Corporation, and MedEL. Our program is composed of a multi-disciplinary team of hearing healthcare specialists. The Tampa Bay Hearing and Balance Center coordinates care with multiple other resources in the State including public and private schools, the Bolesta Center, speech and language pathologists, social services for hearing impaired persons, and researchers in the area of cochlear implants, and nurses.
The initial evaluation, audiological testing, medical consultaion, preoperative consultation, and postoperative device programming are done at the Tampa Bay Hearing and Balance Center.
For patients coming from a distance, we make every effort to schedule appointments all on the same day. We can also provide information on lodging that is available in the area.
To schedule an initial consultation, please contact us.
Cochlear Implant Surgery
Implanting a cochlear implant involves a two-hour surgery, but time away from family in preoperative and postoperative care may exceed three hours. Prior to surgery, the patient, in consultation with the audiologist and the physician decide which ear will receive the implant. Only a thin area of hair needs to be shaved along the incision line. The surgeon creates a pocket in the skull behind the ear to accept an internal receiver. Under a surgical microscope, meticulous drilling through the mastoid bone accesses the cochlea. A small hole in the round window membrane opens the cochlea and allows insertion of the electrode array. With a special piece of equipment, tests of all of the electrodes assure that the device is functioning properly. View photos from a cochlear surgery here.
Care after Surgery
Surgery is almost always done as an outpatient. Most patients go home within four to six hours after surgery.
A dressing placed at surgery should not be removed until two days after surgery. A family member may remove the head dressing. Keep water out of the ear - use a Vaseline - petroleum jelly - soaked cotton ball to plug the ear for bathing. Do not put the ear - head under water until the doctor says the ear is ready. Usually an incision behind the ear can be washed starting two days after surgery. Pat it dry and coat it with Polysporin, Bacitracin, Neosporin or similar antibiotic ointment after bathing (remember to keep water out of the ear with Vaseline soaked cotton, though.) If the incision becomes red, call the doctor.
For any questions or concerns regarding your post-operative course, contact us. An answering service should pick the line up after office hours.
No strenuous exercising, and no activities that require severe straining for the first six weeks after surgery. Do not lift anything heavier than a gallon of milk. Plan to see the doctor about two weeks after surgery. Plan to return to work after a week if work does not require any heavy lifting or straining. If heavy lifting is necessary at work, stay out of work for at least two weeks. At the two-week postoperative visit, ask the doctor when to return to work. In order to prevent placing any strain on the surgical site, avoid blowing the nose vigorously. Open your mouth and do not pinch the nose for sneezing or coughing.
What to Expect After Surgery
Some tenderness, pulsation, popping, or clicking may occur in the ear. Ear fullness and occasional sharp pain may appear. All of this will go away gradually after surgery. For more annoying pain, use pain medication but only as needed. Use Tylenol or equivalent for less serious pain and stronger pain medicine as prescribed. If the pain medicine fails to relieve pain, notify the doctor. Sometimes, taste disturbance occurs, but usually clears within a few weeks to a few months. It can be permanent, especially if disease surrounds the taste nerve.
Patients sometimes experience dizziness and nausea after cochlear implant surgery. Some mild unsteadiness and brief dizziness with head turning is not uncommon. If dizziness is marked, do not get up without assistance. If dizziness is present, carefully increase walking every day. Notify the doctor if your dizziness is either marked or worsens. If dizzy, do not drive until quick head turns can be made without disturbing ability to focus. At the time of the post-op visit, ask the doctor when to resume driving. Some swelling above the ear and even a black eye may develop, but should be mild and resolve fairly quickly. Notify the doctor if body temperature is greater than 100.5° F. A short course of antibiotics should be taken per prescription instructions. Pain medication prescriptions should be used carefully. The most important time to have good pain relief is at time of sleep. Use the pain medication at bedtime the first few days. During the day, extra-strength Tylenol may be sufficient for many persons. Always double check for allergies to any medications. Also, notify the doctor promptly for any reaction to the medications that are prescribed.
To schedule an initial consultation, please contact us.