Questions people ask about a Cochlear Implant

 

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Why have a Cochlear Implant?

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A Cochlear Implant has returned hearing for many people who have lost their hearing. If hearing aids are no longer giving you any or much benefit, you may be a candidate for a Cochlear Implant. “My favorite saying when people ask why they should have a Cochlear implant? My reply always is – Why NOT! “ Alan Keir bi-lateral implantee. If you are assessed as suitable then your quality of life could improve.
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Will a Cochlear Implant allow me to hear?

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This will depend on your type of hearing loss. As a general rule cochlear implant technology benefits people for whom hearing aids don’t allow them to hear speech sounds. This is called sensorineural hearing loss or nerve deafness. There may be factors to consider such as other medical conditions.
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Is the implant guaranteed to work?

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All internal external components of a Cochlear Implant are designed to create the perception of sound. Many factors affect a person’s auditory condition, such as length and cause of deafness and auditory nerve survival and these make it difficult to predict your outcome after having an implant. One very important aspect is developing realistic expectations of what can be expected.
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Can I talk to someone who has had an implant?

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Meeting a number of people who have already had this procedure is a good way to understand the likely outcomes. Contact anyone on this website and ask them questions. These people are listed under the Personal Stories section. Choose someone from your area and ask to meet them. Cochlear Implant centres are usually able to link you with other recipients who have a similar hearing loss history to you. Join the Cochlear Implant Chat Forum and members will be glad to answer any questions.
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How do I go about getting a Cochlear Implant?

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Ask your audiologist or GP for a referral to your local Cochlear Implant Clinic. Clinic details are available from the Clinics Menu on this web-site. Or contact Cochlear (Links Menu) and they will tell you your nearest centre.
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What happens at the Cochlear Implant Clinic?

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Clinic audologists are trained to assess a candidate for suitability for a Cochlear Implant.
Step 1: You will undergo a number of different tests to ensure you have the type of hearing loss and anatomy which will ensure a good outcome from the implant. Depending upon your hearing condition, this may take a number of visits over a period of a few months.
Step 2: They will put you in touch with other implantees.
Step 3: They will discuss the likely outcomes of your surgery including the risks.
Step 4: They will discuss how you go about scheduling the surgery and you will either be scheduled for surgery or wait listed (if a public patient).
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How long will I have to wait?

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Discuss this with the clinic staff, but as a guide if you have private health cover you probably won’t wait more than a few months. If you are a public patient you will be put on the waiting list. Patients are prioritised depending on their needs. In Australia the length of time varies between states because the government allocates a different number of implants per year to each of the states.
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What is the surgery like?

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You should talk this over with your surgeon. However, as a guide, usually surgery takes two to three hours under general anaesthesia. Most people are discharged same day or within 24 hours. The surgery is routine and there is usually only minimal discomfort. Most people return to normal activities within a few days to a week.
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What happens during surgery?

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A small area of your head will be shaved. The surgeon makes an incision behind your ear and carefully lifts the skin and tissue to uncover the mastoid bone. A small depression is made in the mastoid bone where the body of the implant will be placed. A hole is drilled through the bone to reach the cochlea. Through a small opening in the cochlea the surgeon inserts the electrode array. The incision is closed and your head is bandaged.
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Will I be able to hear immediately after surgery?

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No. However, your implant is tested during the surgery so the surgeons know it is working. You are also likely to have a short test before discharge to test if you can hear anything. It takes between two and five weeks for the swelling to go down and the site needs to heal before you are fitted with your external speech processor.
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Will I have a visible scar?

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Usually the incision is quite small (3-5 cm) and is situated behind your ear. Once the skin heals, the scar will hardly be noticeable. You will probably have a slight bump over the implant and, depending on your hairstyle, this will usually be covered by your hair.
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What are the risks of surgery?

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There is risk associated with all surgical procedures. It is important to discuss this with your surgeon. Some risks will be those applicable to surgery performed under general anaesthesia while others will be specific to the cochlear implant surgery and your individual medical history.
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Q

Which ear should I have implanted?

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The implant team will help you make this decision. This will be based on

  • Length of deafness in each ear
  • Speech discrimination scores
  • Superior benefit from a hearing aid in one ear
  • Comparison of the hearing loss in each ear
  • Balance system history
  • Issues such as ossification in the cochlea
  • Medicatal conditions that might impact one ear more than the other
  • Individual preference
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Should I have both ears implanted?

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Bi-lateral implantation is becoming a reasonably common practice as hearing professionals worldwide recognise the benefits of binaural hearing. Many people with one implant are choosing to have a second implant (see bi-lateral implantees under Stories). These people report improved quality of sound and improved hearing in noise. Click here to print Cochlear’s guidelines of the benefits of bilateral implantation.
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As technology advances will I have to have another implant?

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The internal implant has been developed so it will be compatible with technological advances contained in new speech processors. When there are new speech processors, those recipients with older implants can access the latest technology for improved hearing.
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What is the latest Technology?

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Technology is improving all the time. Go to the Cochlear web-site to find out about the latest release.
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What is hearing like after I have my Cochlear Implant?

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You will not hear immediately after surgery. (Refer question above). A few weeks after your implant you will attend your cochlear implant clinic and e fitted with your speech processor. This will be programmed to your personal hearing needs. Most recipients report that the moment when the speech processor is switched on is not a magical moment. Most likely your hearing nerve hasn’t been stimulated for some time (in some cases decades) and it needs time to ‘wake up’. Your brain needs time to adjust to and understand the new stimuli it is receiving. It’s like when you get up at night and switch on the bathroom light and your eyes need time to adjust to the brightness. So too, does your hearing nerve need time to adjust to the sound it is now receiving. For most implantees this happens within a few days or weeks, although many report continual sound improvement over longer periods.
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What improved hearing results can I expect?

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In open sentence testing (ie the participants were read sentences on any subject and had to repeat them back word for word without the benefit of lip reading) of 92 implantees the median score of understanding was 91%. The mean was 80% understanding. Of those who understood the least (the 1st quartile) 75% scored above 68%. (VIC CIC). When considered that these people heard probably 50% or more prior to implant, then almost everyone experiences improved hearing after the implant.
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Does it sound normal?

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Most recipients report the sound they now receive is very close to what they used to hear before they went deaf. One recipient tells a story: Some months after having my implant I received a phone call at work. The caller only told the receptionist that she was a friend. I took the call without knowing who it was or what the call was about. My caller asked, “Do you know who this is?” I said, “Well give me a little more.” She replied, “I haven’t talked to you by phone for a very long time.” (That was pretty much everyone in my life so that didn’t help much.) However, I replied, “It sounds like Joanne.” And it was. I had not seen Joanne for many years because she lives in another state; she is an Australian and doesn’t have any identifying characteristics in her voice such as an accent. If I could recognise her voice over the phone with no prompts, then this tells me that the sound I now hear is very, very close to what I used to hear.
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Will I be able to enjoy music again?

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Many Cochlear Implantees enjoy and appreciate music. However, music is complex; harmonies, chords, often played my many instruments at the same time. Most implantees report if they listen to familiar music (music they knew before they went deaf) over and over again, then they start to understand and hear it like it was before. Some factors do seem to influance progress. Things like prior experience of music before you went deaf, motivation and practise.

Read Personal Expriences of Music with a Cochlear Implant.

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Will I be able to use a telephone?

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The external speech processor includes an inbuilt telecoil and this allows sound from most telephones to travel directly to the processor. Many recipients report success in using land line and mobile phones both using telecoil or just voices naturally down the phone line. There are a number of adaptors available to plug directly into the processor to aid with telephone reception. However, each recipient is different and your experience may depend on factors such as how long you’ve been deaf etc.
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What will it cost?

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Each state government has a public list for those who do not have private health funds. Check with your Health Fund to make sure they will cover the cost. Depart of Veterans Affairs also funds implants for those eligible
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What happens after receiving the implant?

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After surgery and the switch on process is complete, you go on with your life using your new hearing. The clinic staff is available to discuss any questions or concerns. In the first year you may go to the clinic 3-4 times for changes in your maps. After that mapping should be done probably only once or perhaps twice a year. Your surgeon is likely to want to see you once a year to check everything is still ok.
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Q

Do implants ever stop working?

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Cochlear takes reliability very seriously. Any devices which stop working are analysed by a team of specialists to find out why. Four years post implant 99.7% of devices implanted in adults and 99% in children continued to function normally. 15 years post impant reliability was 96.8% in adults and 92.7% in children. Failure in child implants is largely due to increased risk of trauma in energetic children.
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Q

Can I have an MRI if I have a Cochlear Implant?

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Under certain conditions an MRI is safe if you have a Cochlear Implant. However, ALWAYS check with your ENT specialist and your imaging clinic to make sure how an MRI MUST be undertaken. Click here to print out Cochlear Ltds guidelines for having an MRI if you have a Cochlear Implant. Read about Faye’s experience of having an MRI with bi-lateral Cochlear Implants.