The following will give you a thorough idea of what is involved, from the initial evaluation appointment to your ongoing, post-implant follow-ups.

Audiologic Cochlear Implant Evaluation

First, our audiologist will do extensive sound tests with and without hearing aids. Using those results in combination with a detailed hearing loss history, the audiologist will determine your likelihood of success with a cochlear implant. If you decide to move forward, you’ll get further education so you fully understand the process.


Otologic Evaluation

An otologist at SUNY Downstate Medical Center will review the results of the hearing evaluation, perform a medical evaluation, and determine the likelihood of success of a cochlear implant. If both these evaluations are in agreement, further, more detailed evaluations will be scheduled.

Possible Additional Evaluations

  • An x-ray evaluation may be performed to evaluate the anatomy of your inner ear.
  • You may be tested to determine your current degree of balance and whether there’s a likelihood of balance issues after implantation.
  • You could be evaluated to determine how your hearing loss affects your current listening and speaking skills and whether you may need speech or hearing therapy after activation of the implant.
  • You might be evaluated for cognitive and emotional factors that could affect successful adjustment and compliance in the long term.

The Procedure

If all evaluations return positive results, you can move forward with the procedure. You’ll receive a set of preoperative instructions that fit your specific health situation.

Most patients go home the same day. Under general anesthesia, you receive an incision in the crease behind your ear. This location minimizes the visibility of the scar. Then the receiver, which is very slim so as to be almost unnoticeable, is placed in a pocket created under the skin.

In the next step, to avoid disturbing the ear canal or eardrum, an opening is made in your mastoid, a bone through which the cochlea can be reached. Through a tiny incision in the cochlea, a bundle of electrodes is implanted, and the incision is closed with absorbable stitches that do not need to be removed in a follow-up appointment. A dressing is placed over the ear.

Most people are able to leave within 3 or 4 hours after surgery and can manage any pain with over-the-counter pain medication. Your first follow-up visit will be one week after surgery. The purpose of this visit is to check the incision and generally check on things such as balance. At this time, you’ll most likely be able to go back to school or work.


Device Activation

The device activation happens after the healing period, which should be 3 to 4 weeks after surgery. Our audiologist will place the external parts of the device on you and use special software to test how you’re picking up sound. They’ll measure things like how you’re distinguishing pitches, your volume threshold, and sound quality. They’ll also get your perspective on what’s happening. You probably won’t hear and understand sounds well this first week. The input your brain receives will be different than normal hearing, so you will have to relearn how the new type of input matches up with the sounds you are familiar with.


That first session is just the first of several. One week later, your audiologist will do similar testing, but it will be informed by your reporting on how it went — perhaps the volume was too loud in this situation but not in that one; maybe you were able to distinguish different pitches better by day 3. The implant is technology, but you are not, so your audiologist needs to take into account the changes that are taking place in your cochlea and elsewhere as you go about your life and adjust to the new hearing situation.

Each follow-up will be similar, with the audiologist gathering your feedback, testing the technology, and making adjustments. The follow-up process requires patience and motivation to ensure successful integration of the implant into your life, but your audiologist will work with you for as long as it takes for you to optimize your hearing.

This is just an overview of a complex process that depends on your health, your hearing, your medical history, and your ability to stay motivated through the long follow-up and adjustment period. No two procedures are the same, but this should be enough to help you decide whether this might be an option worth pursuing.