10 Questions You Shouldn’t Miss Asking Your Cochlear Implant Surgeon

Keri Reynolds is a bilateral cochlear implant recipient who also works with the MED-EL USA team. She regularly shares her advice and personal tips with other candidates and recipients to help them on their own cochlear implant journey.

You’ve gone through all the candidacy testing and you are a candidate for a cochlear implant. Now what? What else do you need to know? What are the questions you need answers to from your CI surgeon? Thinking back through my personal experience, what did I ask AND what do I WISH I had asked? Here are my top 10 questions to ask your cochlear implant surgeon leading up to the surgery.

“Do you implant all 3 manufacturer’s devices?”

If your surgeon says “No.”, then a follow up question should be “Why?” How this question is answered will tell you a lot about the skill and experience of your surgeon. Although the overall surgical process is similar, there are still differences that go along with each manufacturer. Is your surgeon able to master the technique needed for successfully implanting the devices from each company? This question will also tell you about the surgeon’s desire to continue learning in order to embrace changing technologies.

What are the differences between the devices from each company and do the differences matter to performance after the activation of the audio processor?

Your surgeon may tell you something like this: “You will do well no matter which device you select.” But I want to know more! I want to know how well my surgeon KNOWS the implant and what outcomes can be expected due to the electrode array design—length of the electrode array, number of electrode contacts and spacing, and electrode array construction as in straight vs. pre-curled, flexible vs. stiff, etc. It is important to know exactly what my CI choice means for my future listening outcomes.

“Will I lose all my hearing, even the little bit of low frequency that I have, as a result of the surgery?”

The answer used to be yes. But, technology has changed, and MED-EL’s Flex electrodes are designed with structure preservation in mind. They are made to be flexible to preserve those delicate hair cells which can give you your residual hearing. Does you surgeon know that? Better yet, does he/she BELIEVE that structure preservation is possible?

Do they use soft surgical techniques that maximize the potential for structural preservation?

Listen for responses like slow insertion, minimal insertion force with no insertion tool used, and round window insertion. Specific techniques like this, together with a flexible electrode, can give you the best possible structure preservation. These are the techniques that focus on positively impacting the preservation of your hair cells so that you are ready for whatever the future holds. Just because the structures in your cochlea aren’t working, doesn’t mean that they should be damaged.

“What do I need to think about as I choose a manufacturer to be my hearing implant provider? If it were you, what would you consider?”

This response can be related specifically to the implant. If your surgeon shares more, then you have some bonus information from their perspective. Here are some points that can offer some great insight and help with the decision making process.

• Information about the audio processor and ease of use
• Sound coding strategies
• MRI compatibility
• Reliability
• Post-operation rehabilitation and device support
• Responsiveness and expertise of customer service
• Supportive network or community of other cochlear implant recipients, such as HearPeers
• Information about the CI companies and their history.

“What happens in the event of an accident or a health issue where I need an MRI?”

We don’t really like to think or talk about the “what if’s”. But, this is an important question to ask. Take the time to explore this question with your surgeon to find out about MRI safety—if you can have MRIs without the need for surgery to remove your cochlear implant magnet.

“What happens when new implant technology becomes available? Will I be able to access the new technology such as an updated processor?”

Exploring this question will help you set realistic expectations for taking advantage of future generations of technology. The CI journey is a lifelong journey and it’s important to know what the road ahead looks like.

“What are the potential side effects of the surgery?”

Dizziness? Tinnitus? Changes in taste? Sometimes people can experience some minor side effects that are usually temporary. Find out from your surgeon what he has seen with his patients. This can open the door for your surgeon to share how his surgery techniques minimize side effects as much as possible.

General surgical questions depending on what you need or want to know: “Will you shave my hair? Where will the incision be made? Is the hospital stay one that is overnight? How soon before I can use my device?”

Responses will probably vary from surgeon to surgeon as techniques and procedures may differ a little. You may have additional surgical questions but these above are just some of the most commonly asked questions.

“What outcomes can I expect? How soon before I can understand in a noisy restaurant? What about music—will I be able to enjoy it again?”

These might be considered questions for the audiologist, but asking your surgeon tells you a little more about his/her care about your quality of life. Everyone is different and there are never guarantees but the best access to sound, like being able to appreciate music, can really enhance your quality of life!

Wherever you are on the cochlear implant journey, take it from me, a MED-EL recipient of 14 years—you are on a wonderful, remarkable, life-changing adventure! Feel confident to ask the questions that you want answers to! Partner and communicate well with your CI team including your surgeon, your audiologist, and your CI company. Know where they stand so that you know what you are getting now and in the future.

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