Cochlear Implant Surgery

This page provides information regarding what to expect on the day of your child’s surgery and following their discharge from hospital.

Please use the links below (shown in blue) to navigate to the desired section of the page.

Surgery takes place at The James Cook University Hospital, Middlesbrough or The Great North Children’s Hospital, Newcastle. One person is allowed to stay overnight on the ward with your child.

What happens on the day of surgery?

Usually your child will be admitted to the ward on the morning of the surgery. It may be that their bed is not ready until after the operation. There is a family room to accommodate you if this is the case. Before the operation a number of people will ask you questions to check and double check all the information is correct.

The surgeon, the nurse and the anaesthetist will visit you. One parent may accompany the child to the operating theatre and stay whilst they are anaesthetised. The length of surgery is approximately between one and a half to three hours for an implant on one side and three to six hours for implants on both sides.

However a longer surgery 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. Part of your child’s head must be shaved before the operation. 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 to allow the electrodes to pass through. The surgeon will choose the most appropriate way of closing the skin at the time for your child. Before your child leaves theatre, the implant will be tested electrically.

What happens after the surgery?

When your child returns from theatre, they will usually have a drip in their hand or maybe their foot and a pressure bandage on their head. The drip will be removed when the time is right. The pressure bandage stays in place overnight. Initially your child will be sleepy but most children are up and about as usual within a couple of hours.

Your child will be given antibiotics to prevent any infection. Your child may be sick after the operation. During the operation some blood may pass from the ear to the mouth and the child may swallow it. This might appear later in the sick.

When the pressure bandage is removed, the skin glue / stitches / steri-strips closing the wound are visible. They do not look pretty but do an excellent job of closing the skin to produce a neat scar in the long term.

Before discharge your child’s head will be x-rayed to check the position of the electrodes. Providing they are fit and well, your child will usually be allowed home one to two days after surgery.

Steri-strips will usually come off after a few days and skin glue peels off after a few weeks. Stitches or clips may need to be removed in hospital and occasionally a child may need to be returned to theatre.

A date for initial stimulation of the implant will be arranged approximately 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.
  • Some of your child’s favourite toys.
  • Something for you to do during the long surgery.
  • Money for your food and car parking.

What happens after my child is discharged from hospital?

Most children are in hospital for one or two nights before being discharged. After this your child will have an appointment with the ENT surgeon in one to two weeks.

When the new processors arrive in our office, the implant keyworker who you have met during the assessment period will visit you to deliver them. This is so that you can become familiar with the parts and have an idea about the controls before the initial tuning. It is also so that your child can wear the processor(s) in the ‘off’ position for a few days before the initial tuning and get used to how it feels. This means there are not so many new experiences to cope with at the initial tuning.

Soon after the cochlear implant surgery, you will receive the first three tuning or mapping appointments with the audiologist.

In the meantime, it is important the wound and scar are kept clean to avoid infection. You will be given instructions about this when your child is discharged from the hospital after surgery.

What do I do if my child experiences pain/infection after surgery?

Should you notice anything unusual with the wound such as redness, swelling, hot to the touch or discharge, please contact the cochlear implant office immediately for advice during office hours. It may be essential for your child to be checked by one of our ENT surgeons to prevent or treat any infections which could cause further problems or delay your child’s device switch-on.

Out of office hours: James Cook Hospital patients please contact the ward where you stayed (usually ward 22) through the hospital switchboard to ask advice. Freeman / RVI patients please attend local A&E, GP or walk in centre who will contact the Freeman Hospital ENT Registrar through the switchboard.

After surgery when can my child……?

Following cochlear implantation surgery people often have many questions regarding when their child 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.

After surgery when can my child…? Timescale
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 e.g. boxing, kick boxing, rugby, ice hockey To be avoided
Vigorous sports e.g. football, netball, hockey, squash To be discussed with your surgeon depending upon progress – any other physical activity please ask your surgeon
Gymnastics
Artificial ski slope Six weeks
Skydiving/parachuting Three months
Activity park rides (excluding high speed/extreme force – see ‘what to avoid’ section under ‘living with your child’s 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.