Frequently Asked Questions Regarding Cochlear Implants

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+ Which ear should I implant?
Based on your audiology evaluations and your hearing history, the surgeon will help to make the decision as to which ear to implant. Implanting the "poorer" ear (the ear with the least residual hearing and/or worst results in sentence tests) may allow individuals to use a hearing aid in the other ear. There are studies showing contradictory outcomes both for implanting the better and poorer ear, but the differences are not large. Familiarizing yourself with the research will help you to make this decision together with your surgeon.


+ Will I need to have preoperative tests?

Depending on your age, you will be asked to have preoperative tests done. These might include an EKG, a chest x-ray, and a blood workup. You will need to complete these within a month before the surgery date. These tests are necessary to determine whether you are physically capable of undergoing general anesthesia.

Specific to the cochlear implant surgery, you may be required to have a variety of tests including a CT scan or MRI, a psychological evaluation to ensure appropriate expectations, balance testing, and an audiology evaluation. A CT or MRI is necessary to determine if the cochlea (inner ear) is of sufficient size, and shape to allow adequate placement of the electrode wire of the cochlear implant into the cochlea.


+ What cochlear implant is the best device for me?

This is a question to ask both the surgeon and the audiologist. The audiologist will likely have more time to spend with you talking about the device. The Ear Institute of Chicago offers implants from three implant manufacturers: Cochlear Corporation, Advanced Bionics and MED-EL. The surgeons and audiologists of the Ear Institute of Chicago will not recommend a specific device for you, but will instead explain the features of each.

The audiologist will have "dummy" models for you to see and handle. Be sure to try them on your ear with the batteries in so that you can feel the actual weight and judge the comfort. The external processor will be with you day in and day out, so make sure you are comfortable with the technology's look, feel and function.

Overall hearing results in a testing situation are similar with each of the cochlear implant systems approved for sale in the United States. Some factors to consider include processing strategies, battery life, type of batteries used, customer service provided by the companies, and warranty.


+ Should I get a vaccine to help prevent meningitis before surgery?
The Self Help for the Hard of Hearing (SHHH) organization has a link to the Centers for Disease Control and Prevention's published age-appropriate pneumococcal vaccination recommendations to prevent meningitis. (Click here for the link) If your surgeon recommends that you get a vaccination, ask how many weeks before surgery you should get the vaccination. If your insurance company does not cover the vaccination, the cochlear implant manufacturer may offer to cover the cost.


+ Will I still be able to wear a hearing aid in the other ear?
If the opposite ear is adequately responsive, a hearing aid worn opposite a cochlear implant can provide important sound cues and enhance sound quality. The Ear Institute of Chicago recommends that you try using a hearing aid in the other ear only after a period of adapting to the cochlear implant. Your audiologist will recommend a timetable to maximize getting used to the new implant and when to start using the hearing aid and implant together.


+ Will insurance cover the cost of the cochlear implant and the surgery?
Cochlear implants are approved devices that have been shown to be safe and effective for individuals with advanced levels of sensorineural hearing loss. Most private insurance policies or health plans provide full or partial coverage for cochlear implants. Additionally, Medicare, the Veterans Administration, and Tri Care provide coverage. The Ear Institute of Chicago will assist you with insurance matters. If your efforts in gaining insurance coverage have been unsuccessful, your center will encourage you to seek help from the manufacturer of the cochlear implant you have chosen. Implant companies employ reimbursement specialists to help you determine the extent of coverage provided by your plan. Where necessary, they can help you gain pre authorization for the procedure.


+ How long will I be in the hospital?

Cochlear implantation is performed as an outpatient procedure. That is, you will go home the same day of surgery in most cases. Some factors that cause a patient to stay over night in the hospital include extreme nausea, dizziness or other medical factors. Nearly all patients will go home the same day of surgery.

Arrange to have someone drive you home and be with you overnight. Bring a pillow to rest your head on the journey, especially if it is more than a ten-minute drive. You also need to be prepared for possible nausea on the drive home, although you will likely be given medication to help with nausea.


+ How long will the surgery take?
The surgery lasts about 1 to 1.5 hours and is done under general anesthesia. A small portion of hair is shaved in the area behind the ear. The receiver is embedded under the skin behind the ear and the electrodes are placed in the cochlea through a channel created by your surgeon in the mastoid bone.


+ What are the possible risks of surgery?
As with all surgery, there are risks. Risks associated with cochlear implantation include infection, bleeding, imbalance, dizziness, taste disturbance on the side of the tongue undergoing surgery, and, rarely, facial nerve weakness. Fortunately, most risks/complications are unusual and when they do occur, these side effects are often short-lived.


+ How will I feel after surgery?
As with any surgery, individuals may react differently to the anesthesia. You may experience some nausea, dizziness and pain. This will go away.


+ What is the chance of failure of the internal device?
Since you are making a decision that will impact your life for a long time, the long term reliability of the internal device is an important consideration in choosing your cochlear implant. Overall, cochlear implants are very reliable. However, reliability does vary from manufacturer to manufacturer. It is important that you investigate this as part of the CI decision by discussion it with your surgeon or audiologist or by contacting the manufacturers.


+ How much work will I miss after surgery?
Individuals vary in their post-operative recovery but you can expect to miss from two to five days.


+ How soon can I resume exercise after surgery?
Patients are advised to refrain from heavy lifting for a few weeks. If you are active and exercise you should specifically ask when you can resume such activities as jogging, weightlifting, yoga, or tennis with your surgeon.


+ Will I need to keep water out of my ear canal after surgery?
Unless your physician tells you that you should keep water out of your ear canal, the answer is NO. The vast majority of cochlear implant surgery is performed behind the ear. So, the ear canal or ear drum are not damaged during surgery. In rare cases, the ear canal itself will be involved with the insertion of the cochlear implant. If the ear canal is involved, the physician will let you know to keep water out of the ear canal.


+ What result can I expect?
When evaluating your candidacy, the surgeon and audiologist will discuss possible results with you. Though there is a range of possible results, the average adult recipient using current cochlear implant technology may achieve sentence recognition scores in quiet rooms of 70 - 80% at six months after implantation.