What happens on the day of surgery?
Usually you will be admitted to the ward on the morning of the surgery. Before the operation a number of people will ask you questions to check and double check all the information is correct. The surgeon, a nurse and the anaesthetist will visit you. It may be that your bed is not ready until after the operation.
The length of surgery is one and a half to three hours for a unilateral implant. However a longer surgical time does not necessarily mean there is something wrong – it is just taking longer. If the length of time runs over it is usually for reasons unconnected to the surgery.
Some of your hair must be shaved before the operation after you are asleep. During the operation a flap of skin is lifted and a small well is made in the bone behind the ear for the internal device. A small hole is made into the cochlea (hearing organ) to allow the electrodes to pass through. The surgeon will choose the most appropriate way of closing the skin at the time. Before you leave the theatre, the implant will be tested electrically.
When you return from theatre, you will usually have an intravenous drip in your hand and a pressure bandage on your head. The drip will be removed when the time is right. The pressure bandage stays in place overnight. Initially you will be sleepy but most patients are up and about within a couple of hours. You will be given antibiotics to prevent any infection. You may feel sick or be sick after the operation, usually due to the anaesthetic.
When the pressure bandage is removed, the line of clips / stitches / steri-strips closing the wound are visible. They do not look pretty, but they do an excellent job of closing the skin to produce a neat scar in the long term.
Before discharge your implant will be x-rayed to check the position of the electrodes. Providing you are fit and well, you will usually be allowed home one or two days after surgery.
Steri-strips will usually come off after a few days. Stitches or clips can be removed in hospital or at your GP surgery and very occasionally you may need to return to theatre.
A date for initial stimulation of the implant will be arranged for about three weeks after the surgery.
Things to bring to hospital
Pyjamas and clothes with buttons down the front as it is difficult to pass clothes over the head after surgery
Money for your food and car parking.
What happens after I’m discharged from hospital?
Most people are in hospital for one or two nights before being discharged. After this you will have an appointment with the ENT surgeon in one to two weeks.
You will be sent three tuning and mapping appointments and three rehabilitation appointments in the post. These appointments will start approximately three weeks after the surgery. In the meantime, it is important you keep the wound and scar clean to avoid infection.
What do I do if I experience pain or infection after surgery?
Should you notice anything unusual about the implant site such as pain, burning sensation, soreness, discharge or it is hot to the touch, please contact the North East regional cochlear implant programme (NERCIP) for advice (available 9am to 4.30pm Monday to Friday).
It may be essential for you to be checked by one of our ENT surgeons to prevent or treat any infections which could cause further problems or delay the device switch-on. You may be asked to attend The James Cook University Hospital’s ENT casualty (10am to 4pm Monday to Friday) or ENT casualty at the freeman Hospital.
If the problem occurs out of office hours: James Cook Hospital patients please contact the ward where you stayed (usually ward 35) through the hospital switchboard to ask advice. Freeman Hospital patients please attend local A&E, GP or walk in centre who will contact the on-call registrar at Freeman Hospital.
After surgery when can I…?
Following cochlear implantation surgery people often have many questions regarding when they can carry out activities and what to do before they are seen again in the cochlear implant department. We cannot give an answer for every scenario or situation, therefore, if you have a query that is not covered here please contact us.
The timescales given below are an average and this can vary between patients. We would always advise that you discuss these timescales with your ENT cochlear implant surgeon.
- Wash my hair – One week
- Go swimming* (external must be removed unless you have a waterproof processor) – Six weeks
- Return to work – depends upon type of work, your keyworker will have advised you prior to surgery – On average one week
- Return to school – On average one week
- Fly – Six weeks
- Contact sport such as boxing, kick boxing, rugby, ice hockey – To be avoided
- Vigorous sports such as football, netball, hockey, squash – To be discussed with your surgeon depending upon progress – any other physical activity please ask your surgeon
- Artificial ski slope – Six weeks
- Skydiving or parachuting – Three months
- Activity park rides (excluding high speed or extreme force – see ‘what to avoid’ section under ‘living with your cochlear implant’) – Six months
* Some CI users have balance problems if this is the case they should not swim alone. It is possible to become disorientated under water and they must learn how to identify the direction of the surface. If goggles are worn ensure they are not too tight over the receiver.