Cochlear Implant Device Procedure

Cochlear implant surgery may take place in a hospital or an outpatient surgical center. You will be put to sleep under general anesthesia during the procedure so you will not feel anything nor remember the surgery. 

Your surgeon will:

  1. Make a small incision (cut) behind your ear.
  2. Drill a small hole through the bone to access the middle ear (a space inside your ear filled with air). 
  3. Look for the round window that leads to your cochlea, which is covered by bone for most people. The cochlea is a spiral-shaped bone that translates sound waves into electrical impulses to send to your brain. Your brain processes these impulses as different sounds.
  4. Drill a second hole to get to the cochlea; however, they may be able to access the cochlea by making another small incision (cut) in some people. 
  5. Thread a small electrode array into the cochlea (shaped like a snail shell) The auditory nerve moves electrical impulses from the cochlea to your brain, where they are processed as different sounds.
  6. Place a small receiver under the skin behind your ear and secure it to your skull. 
  7. Close the incision. 

After the surgery, you will go to a recovery area. Our care team will monitor you and keep you comfortable as you wake up. 

Why Choose University of Utah Health?

The Utah Cochlear Implant Program has implanted more than 1,000 patients, both adults and children. Our typical volume is 100 to 150 cochlear implants per year. We implant devices from the three available manufacturers, and perform surgeries at University of Utah Hospital, Primary Children's Hospital, and LDS Hospital, depending on insurance and the age of the patient.

Our team is a multidisciplinary group of professionals, who are dedicated to providing the finest care to severely hearing impaired patients. This team includes implant audiologists, surgeons, deaf educators, members of the parent/infant program, and speech pathologists. The team meets monthly to discuss potential cochlear implant candidates and make recommendations for the best possible treatment. Our surgeons are fellowship-trained and board-certified in neurotology.

Our Cochlear Implant Surgeons

How to Prepare for Cochlear Implant Surgery?

Before your procedure, our surgeons will discuss the steps necessary to prepare. Steps may include: 

  • getting your required vaccines, including meningitis and pneumonia; 
  • getting an evaluation to make sure you are healthy enough to go under anesthesia (be put to sleep); or
  • stopping or adjusting certain medications before the surgery date. 

Your surgeon’s office will also talk to you about when to stop eating and drinking the night before surgery. If you take daily medications (such as diabetes medications), your surgical team will provide instructions on when and how to take it the day of your procedure.

Cochlear Implant Surgery Side Effects

Cochlear implant surgery is safe. Most people recover quickly after surgery. However, as with any surgery, there are risks. The most common include: 

  • anesthesia risks; 
  • bleeding;
  • changes in your taste; 
  • dizziness that is usually temporary, but could last longer if there is damage to the balance center around your ear; 
  • dry mouth; 
  • infection around the implanted device; 
  • infection in the membrane around your brain (meningitis); 
  • injury to your facial nerve, causing facial paralysis; 
  • numbness around your ear; 
  • spinal fluid leaks; 
  • swelling, or 
  • tinnitus (ringing in your ears) that is new or gets worse. 

If you notice symptoms of an infection, such as redness or tenderness around the incision (cut), contact your surgeon right away. You should also call your surgeon if you have severe pain, fever, or fluid draining from the incision.

Cochlear Implant Recovery

When you leave the hospital you will get instructions on how to take care of the incision. You will need to change the bandages covering the stitches. Follow all instructions to make sure your wound heals properly. Avoid anything that causes pressure in your head, such as bearing down, lifting heavy objects, or blowing your nose.

We will schedule an appointment with your surgeon about one to two weeks after surgery to check the wound. At the same appointment, an audiologist will activate your device, and add the external speech processor. They will also program the speech processor to send signals to the internal device when it captures sounds. You will need several more follow-up appointments over the next few months for the audiologist to fine-tune the implant.

Rehabilitation after Surgery

A cochlear implant works differently than a hearing aid or normal hearing. It captures sounds and transmits a signal to your auditory nerve, then the signal is transmitted to your brain. It will be different from normal hearing signals. Learning how to interpret the different signals as sounds or speech takes time. 

Some patients will participate in rehabilitation with speech-language as part of their recovery. Other patients can do the rehabilitation at home with instructions from an audiologist. 

The rehabilitation process can take several months, and sometimes more than a year. It requires a significant commitment to make progress. Rehabilitation will help you gradually learn how to make sense of the sounds coming from a cochlear implant. Most people who go through the process have improved their quality of life and improved their ability to hear and communicate with others.

Cochlear Implant Success Rate

Cochlear implant surgery is generally safe. Our experienced surgeons can effectively place the receiver and sound processor to improve hearing in almost all patients. However, the results are not immediate. You will be able to hear sounds as soon as the device is activated, but it takes time for your brain to learn how to interpret and make sense of those sounds. 

Even in a best-case scenario, cochlear implants will not restore hearing entirely to what it was like before hearing loss. 

Cochlear implant recovery also takes time and effort. You will need to come in for multiple follow-up appointments for several months after surgery. During those appointments, our cochlear implant team will activate your device, then adjust the device over time to improve your hearing. You will also have to participate in rehabilitation for several months to see the most improvement in your hearing.

Cochlear Implant Removal

Some people need to have a cochlear implant removed or replaced after the surgery. The most common reason for cochlear implant removal is when part of the device fails. It is rare for a device to fail within the first few years after surgery. However, cochlear implants have only been around for about 40 years. There is not a lot of information on how long they last. 

You may need to have surgery to remove a device that fails several years, or even decades, after it is implanted. You may also decide to get a replacement device if a new device comes out in the future that offers better technology or other improvements. To remove and replace a device or remove the device entirely, the procedure and recovery process is the same.

Request a Consultation for Cochlear Implant Surgery

You will first need to have a hearing test and meet with an audiologist to determine if you are a candidate for cochlear implants. If you’re eligible, the audiologist will refer you for a consultation with one of our cochlear implant surgeons. Call 801-587-8368 to schedule a cochlear implant consultation, a hearing test, or an appointment with an audiologist.