Required preliminary examinations
After a consultation meeting and various audiological examinations in your implant clinic, assuming everything indicates a decision to have a cochlear implant, an X-ray or CT scan will follow along with a special check of the function of the auditory nerve, which is a prerequisite for a successful implant.
If your child is currently of infant age, the operation is ideally planned for around the child’s first birthday due to the general constitution and anatomical considerations.
Actions before the operation
Cochlear implants are carried out across Austria in many ENT-clinics . You get the best therapeutic and surgical care in all of these institutions so you can be confident in choosing a clinic near you.
A cold might lead to the operation date being postponed. As these dates are most set far in advance, you should protect your child for one to two weeks before, and if possible avoid situations where a cold might be caught.
Please check together with your paediatrician the list of medicines that your child might take regularly. Some medicines might be a problem in respect of an operation due to their ingredients and must be discontinued or adjusted in good time.
A comprehensive internal medical examination is standard before any operation and ensures a complication-free operation and recovery procedure.
In the event that you child has already been fitted on one side with a CI or hearing aid, it is helpful to hand the device to the responsible care staff shortly before the operation, so that you child can hear again immediately after the operation in the recovery room. Usually, the staff in CI clinics are tuned and trained to work together perfectly.
Support person in the hospital
For most parents, it is a given that they do not want to leave their child alone in the hospital in any circumstances. For this reason, one parent or grandparent often stays overnight in the hospital as well. Fortunately, that is usually no problem in Austria’s hospitals. Most public hospitals allow accompanying persons to stay overnight with a child below the age of 18.
But whilst accompanying an infant is free, there are fees for accommodation and board for the accompanying person after the infant age. The costs vary from hospital to hospital and from state to state. The daily rates are usually graduated according to the age of the child. Find out in advance from your hospital of choice about any costs or think about taking out a so-called companion cost insurance.
As a parent you will of course be excited and worried. However, you can be reassured by the decades of experience of the clinicians and technicians. Bu contrast to a tonsillectomy, the intervention is carried out in a relatively harmless area of the skull and has become a routine procedure in ENT surgery.
Generally, the operation is carried out with minimal invasion (small incision directly behind the ear), lasts between one and two hours and requires a hospital stay of only a few days, even if the operation is on both sides simultaneously, which is now usual.
In the implantation, a reception coil is attached to the skull behind the ear and an electrode is fed into the cochlea through a small opening called the oval window.
An intra-operative test by the technician in attendance identifies whether your child responds positively to the first stimulation of the implant.
After the operation
The medical staff in the recovery room look after your child immediately after the operation. To be safe, you should inform them that your child cannot hear at this point, and that will make interaction between the staff and the little patient.
The pain from the wound will not be too great or last for too long as it is now only a small incision. The children also recover much more quickly now as the duration of the anesthetic has been shortened over the decades of development of the operation procedure. Parents can usually stay with their child through the night and be at their side.
In rare cases, there can be a feeling of dizziness, but this usually applies more to older patients. In itself, this is harmless but is possible because the intervention is in the region of the balance organs.
In the course of discharge from the clinic, the medical and care staff will give you some information to take home that must be followed. This includes:
- Regularly taking any medicines required (antibiotics, painkillers etc.)
- The hair may not be washed until the stitched are removed (stitches must remain dry)
- General protection in the first weeks up to initial programming.
As your child will need more intensive care around and immediately after the operation than normally, you can normally claim carer’s leave. Basically, you can have one week of carer’s leave for each year of employment – to the extent of your weekly working time. You can take the carer’s leave weekly, daily, or hourly. Moreover, there is a second carer’s leave week within a working year (again to the extent of the weekly working time) if your child is not yet twelve years old.
After all continued remuneration payments from the entitlement within carer’s leave have been exhausted, you can take holiday to care for your sick child under 12 years old without prior agreement with your employer, and this counts as part of your annual holiday. If there is not sufficient holiday entitlement left, you can still take holiday, but this will be unpaid.
First hearing impressions with the implant system
The first fitting takes place at the earliest after the stitches are removed (around ten days after the surgery), but at the latest four weeks after the surgery. In this, the young patient gets the external part of the implant, the “audio processor” which is worn behind the earlobe or as a button processor (a little above). The system can only be activated by doing this. Until this day, the ear is still deaf after the operation. The audio processor is switched on and adjusted. Audio signals can immediately be transmitted to the implant and perceived. A great and unforgettable moment for parents and child!