Certainly! Here’s a step-by-step overview of the cochlear implant process in San Diego, covering evaluation, surgery, and follow-up, based on current clinical standards and local practices:
1. Evaluation and Candidacy
Multidisciplinary Assessment:
You’ll begin with a comprehensive evaluation by a team of specialists—otologists/ENT surgeons, audiologists, speech-language pathologists, and sometimes psychologists or educational consultants[1][10]. This ensures you’re a good candidate and that the implant will meet your needs.
Testing Includes:
- Diagnostic hearing tests (audiometry, speech perception)
- Auditory brainstem response or steady-state response (for some patients)
- Speech-language evaluation
- Medical imaging (CT/MRI) to assess inner ear anatomy
- Balance assessment (if needed)
- Review of hearing aid benefit and medical history
- Vaccination review (especially for children, to reduce risk of meningitis)[1][4][10]
Candidacy Criteria:
Generally, adults and children with moderate to profound sensorineural hearing loss in both ears, and who receive limited benefit from hearing aids, may qualify[2][10]. Motivation, realistic expectations, and commitment to rehabilitation are also considered.
2. Pre-Surgical Preparation
Pre-op Appointments:
You’ll meet with your surgeon and anesthesiologist to review the procedure, answer questions, and complete any last-minute tests[3][6]. You may be asked to get medical clearance from your primary care provider.
3. The Surgery
Procedure Details:
- Performed under general anesthesia, usually as an outpatient (same-day) procedure[5][6][11].
- The surgeon makes a small incision behind the ear, creates a pocket for the receiver/stimulator, and inserts the electrode array into the cochlea[4][5][6][11].
- The internal device is secured under the skin; the incision is closed with stitches or surgical glue[4][5][6].
- Surgery typically takes 2–4 hours per ear[5][6][11].
Risks:
Include infection, dizziness, ringing in the ears, numbness, rare facial nerve weakness, and very rarely, device malfunction or meningitis. Most complications are uncommon and manageable[4][6][11].
4. Recovery
- You’ll spend a few hours in recovery, then go home the same day or, rarely, after an overnight stay[5][6].
- Expect some soreness, swelling, or mild discomfort around the incision[5][6].
- Follow your surgeon’s instructions for wound care, showering, and activity restrictions. Most people resume normal activities within a few days[6].
- You’ll have a follow-up visit in about a week to check healing and remove any bandages or stitches[6][7].
5. Activation and Programming
- The implant is not activated immediately. You’ll return in about 3–4 weeks, after the incision has healed, for the initial “activation” appointment with your audiologist[5][6][7][9].
- At this visit, the external sound processor is fitted and programmed (“mapped”) to your hearing needs. You’ll begin to hear new sounds, which may initially seem unusual or mechanical[7][9][14].
- Several follow-up programming (mapping) sessions are scheduled over the first year to fine-tune the device and maximize your hearing benefit[7][10][13].
6. Rehabilitation and Long-Term Follow-Up
- Aural Rehabilitation:
You’ll work with audiologists and speech-language pathologists to adapt to the implant, improve speech understanding, and develop listening skills[7][13][14].
- Ongoing Care:
Annual or periodic checkups are recommended to maintain and optimize device function, update programming, and monitor your progress[7][13].
- Support:
Local resources, such as UC San Diego Health and Rady Children’s Hospital, offer comprehensive implant programs, and you can access community support groups for additional help and connection[8][12].
