The decision to get a cochlear implant should be a well-informed one. It is a process, not an appointment. The following will give you a thorough idea of what is involved, from the initial evaluation appointment to your ongoing, post-implantation follow-ups.
Audiologic Cochlear Implant Evaluation
First, our audiologist will do extensive testing in the soundbooth with and without hearing aids. Using those results in combination with a detailed hearing loss history, the audiologist will determine audiologic candidacy for a cochlear implant. If the most appropriately-fit hearing aids are not able to benefit the patient to a certain extent, further cochlear implant candidacy is pursued.
An otologist will review the results of the hearing evaluation, perform a medical evaluation, and further determine cochlear implant candidacy. If both of these evaluations are in agreement, more detailed evaluations will be scheduled.
Possible Additional Evaluations
- A CT or MRI may be requested to evaluate the anatomy of your inner ear.
- Balance evaluation to determine the function of your vestibular system
- Speech and language evaluation
- You may be evaluated for cognitive and emotional factors that could affect successful adjustment and compliance in the long term.
If all evaluations return appropriate results, you can move forward with the procedure. You’ll receive a set of preoperative instructions that fit your specific health situation. Under general anesthesia, the internal components will be placed via an incision behind the outer ear and through the cochlea (inner ear). Once complete, a dressing is placed over the ear and the site will heal for approximately 3 to 4 weeks.
Most people are able to leave the hospital 3 or 4 hours after surgery and can manage any pain with over-the-counter pain medication. Your first follow-up visit with the otologist will be one week after surgery. They will check the incision and manage any symptoms arising post-operatively.
Initial Device Activation
The initial device activation happens after the healing period of 3 to 4 weeks post-operatively. Our audiologist will place the external components of the device on the ear and turn on the speech processor for the first time. This is called a cochlear implant programming, or mapping, appointment. They’ll measure things like how you’re distinguishing pitches, loudness judgements, and overall sound quality. They’ll also get your perspective on what you’re experiencing.
The input your brain receives will be different than normal hearing, so you will have to re-learn how the new type of input matches up with the sounds you are familiar with.
That first activation appointment is just the beginning. At subsequent follow-up appointments, the speech processor will be programmed, or mapped. We will continue to do speech testing to track progress with the cochlear implant. Feedback from the patient is very important as your brain re-learns to hear with new stimulation.
At each follow-up appointment, the audiologist will gather your feedback, test the technology, and make appropriate adjustments. The follow-up process requires patience and motivation to ensure successful integration of the implant into your life, and your audiologist will work with you for as long as it takes for you to optimize your hearing.
Speech therapy is often indicated following activation of the speech processor.