Overview

A cochlear implant is a small electronic device that can give a sense of sound to some people with a hearing impairment. Part of the implant sits behind the ear on the outside of the body. The other part is placed under the skin in the same place.

Read the NHS information about cochlear implants.

Cochlear implant surgery

This surgery is done with a general anaesthetic. This means that you will be unconscious, which is a bit like being asleep, and you will not be able to feel any pain.

General anaesthesia involves having a tube placed through your mouth into your windpipe so a machine can breathe for you while you are asleep. Sometimes people have a sore throat from the breathing tube. This will settle over a few days.

We'll place tiny needles under the skin near your eyebrow, at the corner of your mouth and the top of your chest. These are connected to a machine, which lets us monitor your facial nerve. They are removed at the end of the operation, but sometimes people get some bruising in these areas. This can take a week or more to disappear.

After cochlear implant surgery

You might leave hospital on the same day, or stay 1 night in hospital, depending on when your surgery is (morning or afternoon) and how you are feeling.

Pain

When you wake up from the anaesthetic you might have a bandage on your head to protect your ear. It is usually taken off after a few hours or the next morning, either in hospital or at home.

You might have some pain around your ear for 1 to 2 weeks after surgery. You can take regular painkillers, that you can buy from a pharmacy or shop, if required. Always follow the instructions on the packet. 

You might get some bruising that runs down your neck from behind your ear. This is more common in older patients, and will settle over 2 to 3 weeks.

The wound site

The wound site might have some white sticky dressings over it. Do not worry if they come off in the first few days after surgery. Do not wash your hair or get the wound wet for at least 7 days.

We often use dissolvable stitches. Some surgeons also use glue on the outside. Any residue from the glue will wash away when you start washing your hair after 7 days.

If there are more specific instructions from your surgeon, they will be in your letter when you leave hospital. You should read it before you leave the unit, so that you can ask us questions if anything is unclear.

Possible side effects

After the surgery you might find that your balance is affected for a short while. Sometimes people get very dizzy immediately after surgery and feel sick. This can be a reaction to the anaesthetic but also due to disturbance of the inner ear. It usually settles within the first few days.

We encourage you to rest a lot for the first few days, and have 1 to 2 weeks off work. You will start to feel better and be able to do a little more each day as you recover.

You might get tinnitus (ringing or roaring sounds in the ear), or if you already have it, it might get worse immediately after surgery. This is due to disturbance of the inner ear or a blockage of the middle or outer ear. This should settle as your ear heals.

You might notice some popping or crackling sounds in your ear as it heals, or you might get a pulsing sensation. This should settle without treatment, but if you still have symptoms at your follow-up appointment, we can discuss them.

Try to be gentle if you blow your nose, and avoid straining and heavy lifting for 2 weeks after the operation.

Do not drive if you feel dizzy or off-balance.

Follow-up appointments

A series of programming appointments will take place at the hearing implant centre at St Thomas’ Hospital, starting about 4 weeks after surgery. The appointment details will be sent to you by the hearing implant team when you have had your operation.

When to get help

We advise you to check, or ask a family member to check, the wound site behind your ear every day for the first 4 weeks after surgery.

It is also important to check regularly the skin where the processor is placed.

You should email us a picture of the area you are concerned about if:

• there is an increase in pain which has not settled with ar painkillers
• the wound, or skin above the processor, has any redness, swelling or discharge

Send your photos to our secure email [email protected]. This email address is monitored Monday to Friday, 8am to 4pm. If you have any concerns outside these hours, please contact your GP or phone NHS 111.

If you have any concerns about your ears or cochlear implants, please contact us. If you suddenly become unwell, or have serious medical concerns, go to your nearest emergency department (A&E).

Having a cochlear implant means there is a very small increase in the risk of getting meningitis, although you might have been vaccinated to reduce this risk.

Read more about meningitis on the NHS website

The rash can be harder to see on brown or black skin. Check paler areas, such as the palms of the hands, soles of the feet, roof of the mouth, and tummy.

If you think you need urgent medical attention you can come to our urgent care centre at Guy’s Hospital, 8am to 8pm, 7 days a week. Outside of these hours, go to your nearest emergency department. There are ENT (ear, nose and throat) doctors on-call 24 hours a day.

Support and more information

Royal National Institute for Deaf People