There are 3 main steps to receiving a cochlear implant:
- Cochlear implant evaluation and meeting Dr. Ruffin
- Learning to use the cochlear implant
Cochlear implant evaluation
Your cochlear implant surgeon will gather your hearing and medical history and examine the ear. The purpose is to ensure that the cochlea is the site of hearing loss and ensure that the cochlea is able to accommodate the electrode. This requires imaging, most often with CT scan or MRI of the ears. Imaging is usually obtained after an audiologist determines that you meet the hearing criteria for a cochlear implant. The purpose of this appointment is also to make sure you are healthy enough to undergo surgery.
An audiologist will ensure that the hearing aid is appropriately programmed. They will also administer a sophisticated series of hearing tests. If the patient meets criteria for a cochlear implant, they will teach the patient all about cochlear implants and what to expect.
If you meet criteria for a cochlear implant during the evaluation process, this means that a cochlear implant is expected to help you hear better than a hearing aid. [See this post] for an in-depth discussion about "benefit" and the experiences of other patients with cochlear implants. : Benefits of Cochlear Implants
Surgery is a 1.5 - 2.5 hour procedure that involves an incision hidden behind the ear. Bone is removed to gain access to the cochlea. The electrode of the cochlear implant is inserted into the cochlea. We use “soft surgery” techniques to prevent damage to and preserve the structure of the cochlea. Most patients go home after surgery. Those with obstructive sleep apnea may need to stay overnight in the hospital.
Learning to use the implant.
Two weeks after surgery, we inspect the incision and activate the cochlear implant. There are about 6 other visits spread over the course of the year to fine tune or "map" the CI:
- Postoperative check and cochlear implant activation
- Cochlear implant mapping at 2 weeks
- Cochlear implant mapping at 1 month
- Cochlear implant mapping at 3 months
- Cochlear implant mapping at 6 months
- Cochlear implant mapping at 12 months
Learning to hear with the implant takes about a year. Most patients make significant progress in the first 3 to 6 months. There are different components to hearing with a cochlear implant. People "peak" on these benefits at different times:
- Volume: People usually are able to hear how loud they're talking on the day of activation. They are usually able to monitor and control the loudness of their voice immediately.
- Hearing words without lipreading in quiet: Usually measurable by 3 months. Peak at 6-9 months.
- Hearing in noise: Often takes an entire year to peak. Some people continue to make improvements for a few years.
- Music: Highly variable, but likely 1 year.
- General sound quality: 1 year
- Localization in patients with bilateral implants: Usually sooner rather than later.
Benefits in noise can occur over a longer period of time.