What happens at a cochlear implant evaluation?


We will test your hearing and speech understanding both with and without your hearing aids to determine if you could benefit from an implant. Testing is performed by an audiologist who specializes in advanced hearing care.

You should bring your recent hearing tests and your hearing aids to your appointment.

If you do not have hearing aids – or – if your current aids are not appropriate for your hearing loss, a trial period with new devices will be offered. This step is required by the FDA to ensure that candidates for implantation are selected appropriately. If the audiologist feels that a hearing aid trial is needed, this process will be discussed with you.

The audiologist will also review how an implant works and show you the components.

If you are an implant candidate and would like to learn more, an appointment will be made with the surgeon (Dr. Bauer or Dr. Gregory). They will determine if you are medically eligible for surgery and to discuss risks and benefits of an implant.

I am a candidate.  What happens next?

You may need to see your primary care physician or other specialist to determine if you are healthy for surgery.

You will be scheduled to have an xray, called a CAT SCAN or temporal bone CT, to check the inner ear for scar tissue or other problems that might prevent successful implantation.

You will need to have immunizations (vaccinations) against the bacteria that can cause ear infections. Prevnar 13 and Pneumovax are required before you can have implant surgery. This is to minimize the risk of infection of the implant and around the brain (meningitis) that can occur with ear infections.

Does insurance cover cochlear implants?

Most insurances will approve and cover cochlear implantation. Prior to surgery, we will contact your insurance and obtain pre-certification of benefits.

What happens on the day of surgery?

The out-patient surgery uses general anesthesia and typically takes 3 hours to perform.

You should have someone bring you to the hospital for the surgery and remain with you the first day after surgery.

A small area of hair directly behind the ear is shaved. The incision is closed with absorbable stitches and covered with a small bandage.

Most people are discharged home after surgery. You will be given medications for pain and 5 days of antibiotics.

What happens after surgery?

You will wear an ear cup over the surgical site for 48 hours. After that you should wear the cup at night to protect the ear, but can leave it off during the day. You can stop using the ear cup 5 days after surgery.

You should keep the incision behind the ear dry for one week after surgery. When you wash or shower, cover the area with a dry washcloth. After one week you no longer need to avoid water exposure.

You will not be able to hear in the surgical ear after surgery until your cochlear implant is activated.

When do I return for follow-up?

You will be seen in clinic 7 to 10 days after surgery by Dr. Bauer or Dr. Gregory to check the ear for healing.

Your audiologist will turn the implant on 3 to 4 weeks after surgery. You should bring a family member or friend to this very important appointment. The audiologist will program the implant, and you will hear sounds for the first time with the implant. The quality will not sound normal but do not be disappointed or discouraged. Typically, patients describe the sound quality as robotic or “tinny.”  This will improve over time.


What can I do at home to get the most from my implant?

Daily listening exercises are the most important things that you can do to rapidly improve your hearing ability with your implant. We recommend 2 hours of listening exercises daily and only using the cochlear implant during this time.