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Surgery for a cochlear implant

What happens when my child goes into hospital for the operation?

Fitting a cochlear implant is now a well-established surgical procedure in children. Surgery may be done as a day case but usually involves an overnight stay in hospital. Your child will be seen and examined by the medical team, including the anaesthetist. You will be asked to fill in a consent form for your child. You will need to read this carefully to make sure you understand what the surgery will involve.

During the operation, your child will be under a general anaesthetic. The operation usually lasts between two to three hours. If your child is having two implants then the surgery will take longer. A cut will be made on the side of your child’s head, usually with little or no hair needing to be removed. The implant will be put in position and some tests will be carried out to check it is working properly. Tests are also run to measure your child’s response to the cochlear implant. The surgical wound is closed with dissolvable stitches underneath the skin, so there will be no stitches to be removed. Girl with dressing around head

After the operation you can see your child in the theatre recovery area. A dressing may be placed around your child’s head, which will probably be removed the day after surgery. The implant surgeon will usually want to see you soon after the operation to explain how it went.

You should make sure that you understand the planned follow-up care before you leave the hospital. If an x-ray of your child’s ear to show the position of the implant has not been done, a separate appointment will be made for you. After leaving hospital it is usually not necessary for your child to see your GP. If you have any concerns when you return home, contact the implant centre immediately.

Risks of surgery

There is a risk with any surgery that requires a general anaesthetic. With cochlear implant surgery there are some specific risks. Your ENT surgeon will discuss the following risks with you.

Meningitis
Implanting the electrode in the cochlea might slightly increase your child’s risk of catching meningitis. This risk is very small.

It is now standard practice to have a meningitis vaccination before surgery, and your implant team will explain this. The vaccine is usually given by your GP.

Facial nerve
Many parents are worried about the risk of damage to the facial nerve (the nerve which affects the muscles of the face). However, the risk is very small and the facial nerve will be monitored by the surgical team during surgery. You should discuss this with your implant surgeon.

Infection
Another concern is infection around the implant site, although this is also rare. If your child develops an infection it could result in the implant needing to be removed. If, after your child’s surgery, you are concerned that they might have an infection, contact the implant centre as soon as possible for advice. You can also contact your local ENT department and your GP for advice.

Device failure
The implant can occasionally fail for a number of reasons. This would mean that surgery (known as reimplantation) is needed to replace the device. However, reimplantation is usually carried out quite successfully in the same ear.

If you have any concerns about the surgery, talk to the implant surgeon or any member of the implant team.


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Information supplied by the National Deaf Children's Society. Reproduced with permission.
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15-Nov-2015 1:10 PM (AEST)