Patient education: Cochlear implant in children – Discharge instructions (The Basics)

What are discharge instructions? — 

Discharge instructions are information about how to take care of your child after getting medical care for a health problem.

What is cochlear implant surgery? — 

This is a procedure to place, or "implant," a device into the cochlea to improve certain types of hearing loss (figure 1). It uses electricity to send sounds to the brain.

How do I care for my child at home? — 

Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for your child. Ask questions if there is anything you do not understand.

You should also:

●Give your child all their medicines as instructed:

•Their doctor might tell you to give your child non-prescription pain medicines, such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin). Never give aspirin to a child younger than 18 years old.

•If your child was prescribed other medications for pain (such as opioids), follow the instructions for taking them. Opioids can cause constipation. Some children might need to take a stool softener to help with this.

•The doctor might prescribe antibiotics to prevent infection. But this is not always needed.

●Take care of your child's incision – Your child might have stitches, skin staples, surgical glue, or a special skin tape on their incision.

•Keep the incision dry and covered for the first 1 to 2 days. Your child might need to wear a special cup that protects the area during this time. The doctor or nurse will tell you exactly how long to keep the incision dry.

•Once you no longer need to keep the incision dry, gently wash it with soap and water whenever your child bathes. Do not put the incision underwater, such as in a bath, pool, or lake. This can slow healing and raise the chance of getting an infection.

•After you wash the incision, pat it dry. The doctor or nurse will tell you if you need to put an antibiotic ointment on it. They will also tell you if you need to cover it with a bandage or gauze.

•Always wash your hands before and after you touch the incision, cup, and bandage.

●Keep your child home from school or day care until the doctor or nurse says they can go back. Most children should stay home for about 1 week after surgery. They can return once they feel ready. They should avoid sports and very active play for at least 2 weeks.

After your child heals, you should:

●Follow the doctor's instructions about any activities your child should continue to avoid – Your child might need to avoid certain activities for the rest of their life. These can include scuba diving and contact sports, such as football, kickboxing, and wrestling. The doctor or nurse can tell you exactly which activities to avoid.

●Remove the external processor for certain activities – These might include bathing or swimming. The doctor or nurse will tell you exactly when to take off the processor. Teach your child to be extra aware of their surroundings when the processor is off, since they will not be able to hear.

●Tell medical staff about your child's cochlear implant if they ever need to get an MRI – An MRI is a type of imaging test that uses a magnet to create pictures of the inside of the body. Sometimes, MRIs can move the receiver under your child's scalp. Some implants are "MRI safe," meaning the MRI will not move it. The medical staff will help you figure out if it is safe for your child to get an MRI with their implant.

What follow-up care does my child need? — 

The doctor will want to see your child again after surgery to check on their progress. Go to these appointments.

If your child had stitches or staples, they might need to have them taken out. The doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Make sure your child does not pick at it or try to remove it.

Your child will also need to see specialists to help them learn to use their cochlear implant. These can include:

●Hearing specialists – These are also called "audiologists" or "auditory rehabilitation specialists." At the first appointment, they will turn on, or "activate," your child's implant. They will also:

•Help put on the external processor

•Test the device and your child's hearing

•Adjust the device settings

•Teach you how to use and care for the device

●Speech specialists – These are also called "speech therapists" or "speech-language pathologists." They can help your child:

•Understand the new sounds they hear

•Develop their speech and communication skills

Your child will need several appointments with these specialists. Most children take a couple months to adjust to hearing with the cochlear implant.

Some children take longer to adjust and might need to see their specialists more often. For example, babies and young children need to ease into hearing new sounds. They usually see their audiologists every 2 to 3 months for a year after the procedure. Try to be patient. Your child's brain needs time to learn how to hear in this new way.

When should I call the doctor? — 

Call for advice if your child has:

●A fever of 100.4°F (38°C) or higher, or chills

●Redness or swelling around their incision

●A lot of bleeding from their incision

●Discharge or drainage coming from their ear

●A headache and a stiff neck

●Changes in behavior or trouble thinking clearly

●Trouble moving or controlling muscles, especially in their face

●Nausea or vomiting for more than 2 days after going home

●A lot of pain, even after taking pain medicines

●Changes in sense of taste

●Dizziness

More on this topic

Patient education: Cochlear implant in children (The Basics)
Patient education: Hearing loss in children (The Basics)
Patient education: Audiometry (The Basics)
Patient education: Anesthesia in children (The Basics)