Cochlear Implant Surgery for the Deaf & Hard of Hearing

A cochlear implant can enable deaf or hard of hearing people to hear sounds. It replaces the function of the cochlea, the three small bones of the middle ear that turn vibrations into electrical signals to the auditory nerve. Cochlear implants may be used for people who can't benefit from hearing aids.

Today's cochlear implant surgery is a relatively minor operation of just a few hours. Your procedure may be a day surgery and you will need to arrange for someone to drive you home (you should not drive or take public transportation the day you have anesthesia). Or, you may spend the night at the hospital. Here is what to expect.

You will have an examination of your ear and a general physical exam by an otolaryngologist, a doctor specializing in treating the ears, nose, and throat, or an ear specialist called an otologist. You'll have a hearing evaluation, and often other imaging procedures, such as a CT scan of the temporal bone. There may also be psychological tests to see if you are likely to cope with the implant.

You'll have a patch of hair shaved behind the ear where the surgery will be done. You'll have an intravenous line inserted and be administered anesthesia. 

An incision is made and the skin and tissue flap is lifted so that the surgeon can drill into the skull bone behind the ear. A receiver is placed into the drilled-out area and an electrode array is inserted into the cochlea. The surgical area is closed up with stitches (a small permanent scar may result) and the head is bandaged.

Depending on the length of the surgery and other factors, you may either be sent home shortly after surgery or have to stay in the hospital for a short while. You'll feel the effects of coming out of anesthesia, and have some discomfort in your implanted ear. You'll have to keep the bandages on for a while and take care of the stitches. In about a week, you will return to have the stitches removed and the site examined

During the ​recuperation from the surgery, there may be minimal side effects such as temporary swelling. Side effects are minor if they do occur and are generally temporary: pain, changes in taste, dizziness, inflammation, bleeding, etc.

Children should stay out of daycare and school for a week after surgery and limit physical activity for three weeks. Adults should be able to return to work in one to two weeks after surgery. You should walk and do other light activity each day, but avoid strenuous activity such as running or weightlifting for four to six weeks.

The implant doesn't work immediately after the operation. You will return in three to six weeks to have the external transmitter attached and the implant activated. The sound processor, microphone, and implant transmitter are fitted and programmed and the audiologist determines what sound you are hearing. You will learn more about how to care for and use the device. You will then work with therapists to learn to associate the signals from the implant with sounds.

The surgery has the same normal risks associated with any surgery, and serious complications are rare. Meningitis has been shown to be a risk, and patients should take steps to reduce that risk, such as being vaccinated. The Centers for Disease Control and Prevention offers suggestions for reducing the risk of meningitis.