Required preliminary examinations
After a consultation meeting and various audiological tests in your Implant clinic, assuming everything indicates a decision to have a cochlear implant, an X-ray or computer tomography (CT) follow, along with a special test of the function of the auditory nerve, which is a fundamental precondition of a successful implant.
In the case of an implant exchange, a CT scan will also be required to determine the exact location of the old implant thus keeping the duration of the operation duration to a minimum.
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. Since these appointments are often set well in advance, you should take special care for one to two weeks in advance of the operation and avoid any situations where you could get a cold.
Please check the list of any medicines you might take regularly together with your general practitioner. 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 which ensures a complication-free operation and recovery procedure.
If you already have a CI or a hearing aid in the other ear, it is helpful to hand the device to the care staff responsible shortly before the operation so that you will have access to it immediately afterwards in the recovery room. If you can’t hear at all, it is definitely sensible to tell the staff early so that they can communicate with you in an appropriate alternative way. Usually, the staff in CI clinics are tuned and trained to work together perfectly.
You might be excited and anxious. However, you can be reassured by the decades of experience of the clinicians and technicians. By contrast to say, a tonsillectomy (removal of the tonsils), the intervention is in a comparatively harmless area and is now a routine intervention 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 will establish whether you respond positively to the first stimulation of the implant.
After the operation
The medical staff in the recovery room will look after you immediately after the operation and should be informed of your hearing impairment.
The pain from the wound will not be too great or last for too long as it is now only a small incision. Young patients in particular now also recover much faster as the duration of the anaesthetic has been significantly shortened with the decades of development of operation techniques.
The more advanced the age of the patient, the greater the chance of feelings of dizziness after the operation. In itself, this is harmless and arises because the operation is near your balance organs. If this happens, inform the hospital staff.
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 stitches are removed (stitches must remain dry)
- General protection in the first weeks up to initial programming.
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 and programming takes place. In this, you receive the outer part of the implant the “audio processor” which is worn behind the earlobe or as a Button processor (slightly above). The system can only be activated by this. Up until this day, the ear is still deaf after the operation. The audio processor is switched on and programmed. Audio signals can immediately be transmitted to the implant and perceived. This is a great and unforgettable moment for you and your relatives!
Tip: Take someone to accompany you to the first appointments! A partner, friend or relative can be a great support, especially in the initial phase and offers security in what might be a stressful situation for you.