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 an infant, the operation will ideally be planned around the child’s first birthday due to general constitution and anatomical considerations.
Actions before the operation
Cochlear implantations are performed in many ENT-clinics across Austria. You get the best therapeutic and surgical care in all of these institutions so you can be confident to choose a clinic near you.
A cold could lead to the postponment of the surgery appointment. As these dates are most set far in advance, you should protect your child for one to two weeks before the appointment and avoid situations where a cold might be caught.
Please check the list of medicines that your child might take regularly together with your paediatrician. Some medicines might be a problem in connection with surgery due to their ingredients and must be discontinued or adjusted in good time beforehand.
A comprehensive internal medical examination is standard procedure before any surgery and ensures a complication-free operation and recovery procedure.
If your 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 your child can hear again in the recovery room immediately after the operation. Usually, the staff in CI clinics are coordinated 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 still free of charge, 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 consider taking out a so-called companion cost insurance policy.
Of course, as a parent you will be excited and worried. However, you can be reassured by the decades of experience of the clinicians and technicians. In constrast 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 with simultaneous treatment of both ears, which is common today.
During implantation, a reception coil is attached to the skull behind the ear and an electrode arrey is inserted into the cochlea through a small opening called the round 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 on the safe side, you should inform them that your child cannot hear at this point, and that makes it easier for the staff and the little patient to interact.
Due to the very small incinsion, the pain from the wound will not be too great or last for too long. The children also recover much faster 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, dizziness can occur, but this usually applies more to older patients. In itself, this is harmless but is possible because the intervention is performed 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, which must be followed in any case. This includes:
- Regularly taking any medicines required (antibiotics, painkillers etc.)
- No hair washing until the stitched are removed (stitches must remain dry)
- General protection in the first weeks up to the first fitting
As your child will need more intensive care around and immediately after the operation, you are usually entitled to 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 under twelve years of age.
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 the age of 12 without prior agreement with your employer, and this counts as part of your annual holiday. If there is insufficient holiday credit left, you can still take holiday, but this will be unpaid.
First hearing impressions with the implant system
At the earliest after the stitches are removed (around ten days after the operation) but at the latest four weeks after the operation, the fitting takes place. During fitting, the young patient gets the external part of the implant, the “audio processor” which is worn behind the earlobe or as a button processor (slightly above). Only through it can the system be activated. So until that day, the ear is still deaf after the surgery. The audio processor is switched on and programmed. Audio signals can immediately be transmitted to the implant and perceived. A great and unforgettable moment for parents and child!