Pediatric Cochlear Implant Surgery: What to Expect

Research shows that getting a cochlear implant earlier is better for childhood development. Hearing helps children learn how to speak and read. It also supports them as they discover the social world and their environment. That's why pediatric cochlear implant surgery is now recommended for children as young as 12 months and is often carried out between 12 and 18 months. 

However, the "best age" depends on your circumstances. Every child is unique, with individual family, medical, and hearing needs. Doctors don't decide whether a child is a candidate for a cochlear implant based on their age. Instead, they look at the type and severity of their hearing loss. 

As a general rule, children from 12 months to 17 years are candidates for pediatric cochlear implant surgery if they have severe to profound hearing loss due to damage to the inner ear, in one or both ears. They've tried hearing aids without enough benefit. If that fits your child, they may be a candidate.

Once your child has been identified as a potential candidate, your care team will guide you through several steps before surgery is scheduled. 

• The audiology team tests hearing and speech, with and without hearing aids, to confirm severe to profound hearing loss that is not helped by hearing aids. 

• They may also have a CT scan or MRI, so the surgeon can be sure the inner ear will accept the implant. 

• The clinic will submit an insurance pre-authorization request. Most insurance plans cover pediatric cochlear implants. 

• Once insurance is approved, the clinic schedules the surgery. 

Many clinics will also connect your family with a mentor family who has already been through pediatric cochlear implantation. Hearing what another family experienced can be reassuring as you prepare. 

Pediatric cochlear implant surgery is a routine procedure that hundreds of thousands of children have experienced. Any operation carries some risk, but serious complications are very rare. 

The surgery itself usually takes between two and four hours and is performed under general anesthesia. Your child will be asleep throughout. 

During the procedure: 

•  The surgeon makes a small incision behind the ear. 

• Then they create an opening through the bone to reach the inner ear. 

• The implant's electrodes are placed inside the inner ear.

• The receiver is anchored to the skull, under the skin behind the ear.

• The surgical team closes the incision. 

Once surgery is complete, your family will move to a recovery area where the team watches over the patient for a few hours as the anesthesia wears off.

Children usually spend one night in the hospital after surgery. After a week to recover, they can return to school or daycare. They should avoid sports and other intense physical activity for three to four weeks while they heal. 

Two to four weeks after surgery, you will go back to your hearing care professional for activation. The cochlear implant sound processor is switched on for the first time. It's an exciting and emotional moment for families, but activation is just the start. Your child's brain still needs time to learn how to understand the new sounds it can hear. 

In the weeks and months that follow: 

• The hearing professional will show you and your child how to use and care for the external sound processor. 

• Listening and language therapy, usually about an hour a week, begins shortly after activation.

• You return to your hearing professional for regular programming adjustments throughout the first year. 

• Long-term, there will be ongoing check-ups to track progress and keep the implant working well. 

Over time, your child's hearing will become clearer and more natural. They'll be better able to learn, play, and connect with the people they love.