Cochlear implantation is performed under general anaesthetic to create ideal conditions for surgery under the microscope. There are two parts to the implant: the implant body with the magnet and the electronic components, and the electrode which is inserted into the inner ear. The implant is placed in a bone bed behind the ear. The surgeon drills through the mastoid bone and pushes the electrode towards the middle ear and from there into the opened cochlea.

On the eve of surgery, the procedure will be discussed with the patient in great detail. It will have been decided by then which side is to be implanted and which type of implant is to be used. The patient shouldn’t eat or drink anything after 10 p.m.

In the morning, the patient is placed under general anaesthetic and an additional local anaesthetic is applied to the surgical area. The skin around the incision line is disinfected. After the patient’s head is covered, a cut is made behind the ear. A cavity is created in the mastoid process to make room for the electrode and access the middle ear. The inner ear bone (called the promontory) is then visible. The surgeon drills away the bone to expose the membranous inner ear, which is slit open carefully to preserve any residual hearing. The electrode is inserted through this opening into the inner ear. Using sutures, the implant itself is secured in place in a separate bone bed within the mastoid cavity. After intraoperative testing of the implant and intraoperative monitoring of the auditory nerve by measuring the stapedius reflexes, the cochlear opening is sealed with connective tissue and the wound is closed.

Some postoperative pain around the surgical site is possible, which may be aggravated by chewing. As a rule, the pain should have subsided within a few days. The stitches can be removed after six to ten days, and the patient can be discharged home after only five days. Mild wound healing complications may subsequently occur, which is why the wound area should not be cleaned vigorously or allowed to get wet. Any complications that occur with the healing of the wound are likely to be caused by a suture allergy. The surgical thread partially disintegrates and can then be removed. The wound will take another two to three weeks to heal completely. If necessary, the patient’s ENT doctor should be consulted on an outpatient basis. In an emergency, our emergency telephone number (+49-511-532-2481) can be called at any time.

After surgery, the implant and electrode function must be tested regularly. For this purpose, tests in our German Hearing Center (Deutsches HörZentrum, DHZ) must be scheduled. Those who wish can take part in our remote care programme and do the follow-up fine-tuning close to home.