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Inside a Cochlear Implant Surgery

April 1st, 2008 by | Tags: | 5 Comments »

Last summer, I had the incredible opportunity to witness a cochlear implant surgery.  I can hardly find words to describe the absolute wonder and awe I felt as I stood, three feet from the operating table, using a high-powered microscope to peer into the cochlea of a little girl with whom, days earlier, I had compared nail polish colors on our “fancy toes” (another story for another day… everything, even a pedicure, is an opportunity for learning language!).

Rachel did a wonderful job illustrating the inherent risks of CI surgery, any surgery, or just living life in general.  I guess the question is — is the cochlear implant worth the risk?  For me, Rachel, and many others, the answer is a resounding YES!  Though the cochlear implant has been around for decades now, there are still so many myths out there about what the surgery actually entails.  Some myths may be due to lack of information, some perpetrated with a more malicious purpose.  Either way, I’d like to share with you my firsthand experience in the OR to clear up a few common misconceptions.

MYTH: “CI surgery is brain surgery” “Cochlear implants go into the brain” “CIs make a hole in the skull”

FACT: In a cochlear implant surgery, a small incision is made beind the ear (sometimes, a small amount of hair is shaved to make the incision site more sterile — for girls, French-braiding hair before surgery can minimize the amount of hair lost).  The surgeon lifts the skin away from the underlying bone, and uses surgical drills to create a “well” for the internal implant components to sit in between the skin and the skull.  At no time is the brain casing breeched or compromised in any way.  Then, the surgeon drills through the mastoid bone encasing the cochlea and inserts the electrode array.  Before the incision site is closed, an audiologist puts the external processor components into sterile casing and places them on the patient.  The processor, which is connected to a computer with CI programming software (as it is in a mapping appointment), allows the audiologist to perform tests that assess the integrity of the internal components and the proper insertion of the electrodes.  This is done so the surgeon can make any necessary adjustments before ending the surgery.  If all is well, the incision site is closed, the patient goes to the recovery room, and can return home later that day.

MYTH: “Cochlear implant surgery is a major, dangerous operation”

FACT:  If that was true, cochlear implant surgery would not be an outpatient procedure, as it usually is.  Though I went in to my surgery observation experience pro-CI, even I was amazed at how “dry” the surgery was!  The amount of blood was minimal, maybe like the worst cut I’ve ever had, and the drilling reminded me of orthodontist appointments where the dentist would grind down teeth to help position the braces.  This is not, however, intended to diminish the fact that yes, cochlear implant surgery is surgery, and, as with all surgeries, there are risks.  It is crucial that patients/parents understand this and make an informed decision.

MYTH: “The cochlear implant paralyzes facial nerves”

FACT: Facial nerve paralysis is a concern with cochlear implant surgery, as some of the facial nerves are located within the vicinity of the incision site.  To guard against this, however, the nerve is monitored throughout surgery so the surgeon is able to avoid such complications.

MYTH:  “Cochlear implants will give you meningitis”

FACT:  The population of people who receive cochlear implants is already at a higher risk of meningitis due to various factors that could have caused their deafness in the first place (malformations of the cochlea, genetic syndromes, previous history of meningitis, etc.).  Therefore, if a person with a CI develops meningitis, it is nearly impossible to establish a direct causal link between the implant and the subsequent illness.  In either case, the meningitis vaccine has done wonders in making this concern less and less of an issue for those considering cochlear implant surgery.

There are many more myths out there — I’ve heard some doozies! — but that’s all for now.  Want to see the surgery for yourself?  Click HERE for a captioned video of a CI surgery. (NOTE: When the surgeon discusses criteria for CI candidacy, he refers to the previous guidelines.  For the most up-to-date candidacy information, check with the FDA and your Cochlear Implant Center).

*I am NOT a physician.  If you, or someone you know, are considering a cochlear implant, the most important thing you can do is contact the nearest Cochlear Implant Center and speak with their team about how a CI may be a good choice for you!

Written by

Elizabeth Rosenzweig MS CCC-SLP LSLS Cert. AVT is a Listening and Spoken Language Specialist Certified Auditory Verbal Therapist. She provides auditory verbal therapy, aural rehabilitation, IEP advocacy, consultation, and LSLS mentoring for clients around the world via teletherapy. You can learn more about Elizabeth's services on her Website or Facebook.



April 1, 2008 at 5:07 am

Thank you for addressing the myths.

April 1, 2008 at 1:35 pm

I must be more squicked than I thought, couldn’t watch the video for more than 2 minutes into the operation. Nonetheless, thanks for addressing the myths. I hadn’t known some of it myself and I wear one.


April 2, 2008 at 11:54 am

Good job explaining the myths! A few weeks ago, I met a woman who recently had a surgery for her other ear, and her incision was only an inch and a half, and it was right behind her ear! AND…her hair was NOT shaved at all! HOLY COW! That’s a big difference to what I had in 1989! I have one of those typical C shaped incision on the sides of my head.

January 15, 2010 at 6:31 pm

My husband is getting real close in having his first cohlear implant. He has anemia, not bad enough to have a tranfusion. My question is can he still have the cohlear implants?

Thank you Lea


January 16, 2010 at 8:54 pm

Lea —

This is a question you should discuss with your husband’s surgeon in pre-operative appointments. Best wishes for a successful surgery!