Surgery for cochlear implants

You may also want to take a look at our page about what to consider when making a decision about cochlear implants.

Preparing for surgery

Once you and the implant team have decided to go ahead with surgery, they will arrange a pre-operative appointment with an ENT (ear, nose and throat) consultant. This appointment may take place in hospital or remotely. In this appointment, the ENT consultant will explain the surgery, discuss any risks, and ask you to complete a consent form. It’s important to read the consent form carefully to make sure you fully understand the procedure. 

Closer to your surgery date, the medical team will check your child and make sure they’re fit for both the anaesthesia and operation. If you have any questions or concerns, ask the surgeon or anaesthetist.

If your child hasn’t yet received a meningitis vaccination, it will be recommended before surgery.

You can learn more about the surgery experience by connecting with other families or reviewing helpful resources provided by implant manufacturers and hospitals.

Support from other parents

Many parents who have been through the cochlear implant process can offer valuable advice on practical matters involved with surgery. Your implant team can help connect you with support groups and services.

“I was petrified [before the operation]. And there was guilt at putting our baby through major surgery of up to 8 hours. But we also felt excited as it was what we’d been waiting for. We’d Googled every question and knew exactly what would happen. We didn’t want to be shocked by anything.” 

Lucie, mum to Harry, who is profoundly deaf and got cochlear implants when he was 1. 

Support from your hospital

Ask your hospital if they have resources to help prepare your child for surgery and their hospital stay. Many hospitals have play specialists or liaison nurses who will help guide your child through the experience.

Resources from implant manufacturers

Implant manufacturers often produce online videos, children’s stories and colouring books to help explain the surgery to young children.

• Hearing Success (Advanced Bionics website): Online communities where parents of deaf children can ask questions and share experiences.
• Your Cochlear stories (Cochlear website): Stories from people who have gotten cochlear implants.
• HearPeers forum (MED-EL website): An online forum where cochlear implant users from around the world share advice and experiences.

What happens during surgery

Surgery for cochlear implants is done under general anaesthesia, which means your child will be given medicines to send them to sleep during the procedure.

The surgery involves making a small cut behind the ear. The surgery team may need to shave a small amount of hair around the ear. 

The internal receiver is then placed securely beneath the skin, and the electrode is inserted into the cochlea.

Before closing the wound, the surgical team will carry out tests to check the cochlear implants are working.

The wound will then be closed with dissolvable stitches, which means no stitches will need to be removed later.

The operation usually lasts between 1 and 2 hours per ear, and most children can go home the same day. However, some children may need to stay in hospital for 1 or 2 nights.

“That first night was horrendous, but by morning he was eating and smiling, so it was worth it. Harry came home the following evening and the bandages came off that day.” 

Lucie

Risks of surgery

While any surgery carries risks, the specific risks related to cochlear implant surgery will be thoroughly discussed with you by your ENT doctor. If you have any concerns, speak with your surgeon or any member of the implant team.

Meningitis

Although the risk of meningitis with cochlear implants is very small, it is slightly higher than in the general population. Therefore, it is recommended that your child receives a meningitis vaccination before surgery. This is usually given by your GP.

Facial nerve damage

The facial nerve is close to the surgery area. However, the risk of nerve damage is very small, and the surgical team uses monitors to prevent any issues.

Infection

Infection around the implant site is rare but can happen. If it does become infected, the implant may need to be removed. If your child develops a fever or experiences worsening pain or dizziness after leaving the hospital, contact the implant centre, ENT department or GP as soon as possible for advice.

Device failure

The internal receiver and electrode are sensitive electronic devices. While rare, they may stop working and need to be replaced during a second operation (known as re-implantation).

Most deaf people will need at least one re-implant in their lifetime. The NHS has a duty of care to provide a working device if surgically possible and in agreement with the child and parents. Re-implantation is usually successful.

All cochlear implant manufacturers publish their failure rate in line with medical device legislation.

Other side effects

Some temporary side effects, such as a metallic taste in the mouth or dizziness, may occur but typically resolve within 7 to 10 days.

Recovery

After surgery, you will be able to see your child in the recovery area. A dressing may be placed around their head, which will likely be removed the day after surgery.

The implant surgeon will usually meet with you on the same day of the surgery to explain how it went. They may have taken an X-ray after the surgery to show the implant's position. If they haven’t done this on the day, they will make a separate appointment to do so.

Before leaving the hospital, you’ll be given a follow-up care plan with instructions for keeping your child’s head dry and managing pain. Your child will also need to avoid blowing their nose for about 2 weeks. If there’s anything you’re not sure about, ask a member of the team or nursing staff. They should give you a phone number you can call if you have any worries after you get home.

You do not need to see your GP after leaving hospital, but it’s a good idea for your child to be seen by an ENT consultant a week after the surgery to check the wound is healing well.

Children typically recover quickly and are often up and about within 1 or 2 days. Your child might feel some side effects, such as dizziness, swelling and tinnitus. Young children might feel mild to moderate pain for a few days after the operation. Older children and young people are more likely to feel pain in their head or neck. The operation site might feel sore for about 7 to 10 days after the surgery. If the pain gets worse during this time, contact the cochlear implant team.

Switch-on

The implant will be activated around 3 to 4 weeks after surgery, which gives the incision enough time to heal properly.

During this time, your child will not have access to sound, so it's important to think about how you will communicate. Many families find it useful to learn some family sign language – check out our free family sign language courses.

More about the switch-on process.