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Surgery for cochlear implants

Last reviewed: 25 June 2024

Getting cochlear implants means your child will need to have surgery. Find out what happens before, during and after surgery.

Preparing for surgery

Once you and the implant team have made the decision to go ahead with surgery, they will arrange a pre-operative appointment with an ENT (ear, nose and throat) consultant. In this appointment, the ENT consultant will discuss the surgery and any risks with you.

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

One or two weeks before surgery, you and your child will need to go to the hospital for a pre-assessment appointment. During this appointment, the medical team will check your child and make sure they’re fit for the general anaesthetic and operation. At this appointment, you’ll need to fill in a consent form for your child. It’s important that you read this carefully to make sure you understand the procedure and what the surgery involves. Ask your surgeon and anaesthetist if there’s anything you’re not sure about.

If your child hasn’t already been vaccinated against meningitis, then it will be recommended before surgery.

You can also find out more about the surgery process and experience through the following.

Other parents

Parents who've already been through the process will often be able to pass on valuable information on practical issues involved with surgery. Your implant team will be able to give you information about voluntary services and support groups you can reach out to.

Lucie is mum to Harry who's profoundly deaf. Harry got cochlear implants when he was 1 year old.

“I was petrified [before the operation]. And there was guilt at putting our baby through major surgery of up to eight 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.”

Your hospital

Ask your hospital if they have information to help your child cope with surgery and a stay in hospital. Many hospitals have specialist play professionals or liaison nurses who will help prepare your child.

Implant manufacturers

Implant manufacturers produce online videos, children’s stories and colouring books with information about cochlear implant surgery which helps to explain to young children what’s going to happen.

What happens during surgery

The surgery involves making a small cut on the side of your child’s head. The surgery team may need to shave a small amount of hair from behind your child’s ear to make this cut. The internal receiver is then put in and secured beneath the skin, and the electrode is inserted into the cochlea.

The wound is closed with dissolvable stitches underneath the skin, so no stitches need to be taken out later.

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

The surgery team or an audiologist will carry out tests to check the cochlear implants are working.

Lucie says,

“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.”

Recovery

After the operation, you’ll be able to see your child in the theatre recovery area. A dressing may be placed around your child’s head, which will probably be removed the day after surgery.

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

Before leaving the hospital, you’ll be given a follow-up care plan. This will include instructions about how to keep your child’s head dry and if they need to take any painkillers. Your child will also need to avoid blowing their nose for about two weeks. If there’s anything you’re not sure about, ask a member of the team or nursing staff. They should also give you a phone number to call if you have any worries when 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 your local ENT consultant a week after the operation to check the wound is healing well.

Children are usually up and about one to two days after surgery. After the operation, your child might feel some side effects such as dizziness or swelling. 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.

The implant is activated around three to four weeks after surgery, which gives the incision enough time to heal properly. Find out more about the switch-on process.

Risks of surgery

There are risks associated with any surgery that requires a general anaesthetic. With cochlear implant surgery there are some specific risks which your ENT doctor will discuss with you.

If you have any concerns about the surgery, speak to your surgeon or any member of the implant team.

Meningitis

Although the risk of contracting meningitis in those with cochlear implants is very small, it’s slightly higher than in the general population. Vaccination for meningitis is recommended before your child is given a cochlear implant, and this is usually given by your GP.

Facial nerve damage

The facial nerve is very close to the area that will be operated on. However, the risk of the nerve being damaged is very small, and monitors are used through the surgery to avoid this happening.

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 after leaving hospital, or if their pain or dizziness gets worse, you should contact the implant centre as soon as possible for advice. You can also contact your local ENT department and your GP.

Device failure

The internal receiver package and electrode are sensitive electronic devices. In rare cases, they might 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 have 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 other side effects of cochlear implant surgery include a metallic taste in the mouth and balance problems or dizziness. These are usually short-term and resolve within 7 to 10 days.

Useful resources

Chloe Gets Cochlear Implants

For a fun and child-friendly way to explain cochlear implants to your child, check out our free comic, Chloe Gets Cochlear Implants.