Cochlear implant surgery is generally performed as an outpatient surgery under general anesthesia. The surgery typically takes three to four hours. Because the size of the cochlea remains unchanged during development, children receive the same internal electrode as adults. Surgical access to the inner ear is accomplished with minimally invasive techniques and vigilant monitoring of neighboring nerves, thus allowing for a safe and effective operation and a short recovery time.
Initial Stimulation and Programming
Two weeks following surgery, your child will return to The Center for Hearing and Speech for the initial stimulation and orientation of all external equipment. The initial stimulation appointment, also called initial “hook-up” or “activation” involves fitting the child with the external equipment (speech processor, transmitting cable, and coil) and “mapping” of the device. The delay between surgery and the initial stimulation is necessary to allow the incision to heal and any swelling to subside. The initial stimulation is the first time the child will hear with their new cochlear implant.
While most children do not understand speech through the implant at first, the initial simulation marks the beginning of an exciting time for the child and opens a door to a whole new world of sounds. This is an exciting day and we encourage family members to attend the appointment.
Sounds that are heard are adjusted in a process called mapping. The audiologist uses a computer to set levels for each of the implant’s stimulating contacts.
The objective of cochlear implant mapping is to optimize the perception of sound. As new cochlear implant recipients learn and gain experience hearing with their device, the audiologist will then reprogram and fine tune the implant. After initial adjustment to the cochlear implant, the hearing pathways gradually become more sensitive and effective. As the ability to use the implant improves over time, finer adjustments are made to enhance the quality of the perceived sound.
Follow-up CI Mapping
After cochlear implantation surgery, you and your child will return to The Center for two, consecutive, half-day initial stimulation appointments. Follow-up mapping appointments will then be scheduled for two-weeks and one month after the initial activation. Depending on how your child is adjusting to his or her new equipment at this point, mapping and testing will typically be reassessed at 3 months, 6 months, 9 months, 12 months, 18 months, and 2 years post-initial stimulation. However, it is not uncommon to need interim mapping sessions between these appointments for young children, for troubleshooting, or for more detailed assessment. After two years of successful cochlear implant use, children will often be able to transition into annual cochlear implant checks.