What is a cochlear implant?

There are several steps people who wish to get implanted.
A pre-implantation phase which lasts about 2 months and during which the patient must undergo various examinations: MRI, brain scan, ENT examination and speech therapy assessment and standard preoperative examinations. All will allow a feasibility assessment to be carried out to assess whether the implantation and placement of a cochlear implant are feasible or not.
The surgery phase. The cochlear implant is placed during a surgical operation under general anaesthesia. This operation is carried out more and more on an outpatient basis. The surgeon introduces two elements:
a. The processor and the antenna under the skin and muscle of the temple.
b. The electrode holder in the cochlea comprising between 15 and 20 electrodes depending on the brand.
The post-implantation phase which consists in making the necessary adjustments for the implant and hearing rehabilitation. The doctor should set the minimum and maximum levels of electrical stimulation for each electrode to be effective and comfortable. The adjustments are staggered over time and are made in collaboration with the speech therapist who, during rehabilitation, assesses the patient’s progress by noting, for example, that the highs are too weakly perceived to understand consonants. Speech therapy is important to allow the patient to reappropriate a sound universe that was no longer perceived and to stimulate again the auditory cerebral areas responsible for understanding. The continuation or termination of rehabilitation is decided by the speech therapist, in consultation with the patient. To optimize the results of cochlear implantation, it is also fundamental to use regular and intensive hearing training exercises.

The main contraindications for cochlear implantation are:
1. Complete or partial, but significant, obliteration of the cochlea.
2. Retro cochlear pathology.
3. Negative promontories test results.
4. Concomitant severe somatic diseases.
5. Intellectual disability.
6. The presence of focal pathology in the cortical or subcortical structures of the brain.
7. Lack of desire for many years of work with a deaf teacher after implantation (in adults) or lack of support from family members and their readiness for long-term rehabilitation work.