This is a consent form. We write on the inside about the risks and the benefits of the surgery and we ask that you sign on the opposite page, so that we can the have a formal agreement to proceed with the operation.
We will go through this in your consultation and you'll have an opportunity to ask any questions that you've thought of, and we'll go through everything again on the day of your surgery.
When everything is ready in theatre, we sterilise the area behind the ear. We make a cut through the skin and the soft tissues. You will have a scar behind the ear but this heals very well and usually after about a year it is barely visible. Once the bone behind the ear is exposed we go through that bone to access the middle ear in the cochlea, without disturbing the ear canal.
To get to the middle ear space we have to go between the facial and the taste nerves. There is a small risk of damage to both of these nerves during the operation.
The facial nerve supplies all the muscles of the face on that side and hence if there was damage this would cause weakness of those muscles. This risk is very small but it's important that we warn you about it and this is also why we monitor the nerve during the operation.
If the narrow gap between the facial nerves and the taste nerves is so small that we can't get through, then sometimes the taste nerve is damaged. That damage would result in an abnormal taste sensation on the tongue on the side of the operation towards the front of the tongue.
It causes a sort of metallic taste. That will resolve and settle down but it can take three to six months to do so. Sometimes the nerve is actually bruised and you still get those symptoms but they would settle more quickly.
Accessing the cochlea can be difficult, particularly if there has been recent infection or there's inflammation in the middle ear or scarring. We always try to insert the implant through one of the cochlear's natural openings called the round window, and we will aim to try and preserve any hearing that you still get benefit from. Despite our best efforts we can't guarantee to preserve the hearing, but we will always try.
Cochlear implants are currently guaranteed by their manufacturers for ten years. However just like any electrical device, your television, or your washing machine, there could be a fault or a problem with it before then. That said we've got plenty of patients who had their first implant more than 20 years ago and they're still getting benefit from it.
As you recover from the surgery, you may find that you feel your balance is affected for a short while. Immediately after the operation you might feel very dizzy and sometimes you can feel a little bit sick. This can either be because of disturbance of the inner ear from inserting the implant, which can affect the balance function, or sometimes it's also related to some of the anaesthetic drugs that we give you while you're asleep. Either way we can give you medicines that help reduce the nausea and the sickness feeling, and they'll generally make you feel a lot better. We can also give you medicines that you can take home if you need them, and usually over a few days this will all settle down and you'll feel back to normal.
Tinnitus is a noise in the ears that some people experience. It's a noise inside the head rather than a sound that comes from an external source. Some patients already have tinnitus and it may get worse after the surgery. If you've never had tinnitus before, you may experience it after the operation.
Usually it settles over a few days. Sometimes when the implant is switched on, it goes away completely. We can't predict or guarantee what will happen with the tinnitus, but generally it will subside, and we will be here to help you or advise you if it's bothersome.
Every operation carries a small risk of bleeding. When you wake up from the surgery you will have a head bandage on and this is there to protect that ear and to reduce the chance of bleeding.
You may get some bruising that runs down the neck from behind the ear. This is more common in older patients and it usually settles over about two weeks.
There is a small risk of infection due to this we give you antibiotics during the operation whilst you're asleep, through your drip. Sometimes we also give you a couple more doses after the surgery whilst you're still in hospital.
Occasionally we'll give you oral antibiotics to go home with but we'll explain this after the operation and the nurses would also go through it with you before you go home.
That is the end of the second video, now you can watch the third video which is about what to expect after your operation.