Hello, my name is Harry Powell. I'm one of the cochlear implant surgeons here at
Guy's and Thomas' NHS Foundation Trust. I am one of a team of five
surgeons who may be looking after you or your child. In these short videos I'm
going to explain the cochlear implantation procedure and the risks.
This is part of the consent process so that you will understand what the
procedure involves prior to agreeing to it. By now you may have been through the
full assessment. This will have involved a number of appointments and also we
will have discussed you in our multidisciplinary team meeting.
If, as a a team, we think that cochlear implantation will be better for you than your
conventional hearing aids, then we may be able to offer cochlear implantation as
the next stage in your care. Before surgery it is important that you or your
child have a vaccination against meningitis. Because the cochlea is close
to the brain, there's a very slightly increased risk of meningitis after the operation.
To minimize this risk we therefore ask that you have the
vaccination prior to the surgery. We're going to give you two envelopes one for
the GP and one for yourselves so that you have all the information. We ask that
you make an appointment with your GP as soon as possible
so that you can have the vaccination at least a week before the surgery.
Before the operation a pre-assessment will take place. This is an appointment for us to
check your general health prior to the surgery. We may ask you to go for an
appointment in the pre-assessment clinic here at St Thomas' after your consultation,
or you'll have a separate appointment before the surgery.
All our adult surgery takes place at Guy's and almost all of our children's surgery
takes place at the Evelina London Children's Hospital on the St Thomas' site.
You will have a general anaesthetic for your operation. The anaesthetic
doctors will look after you and put you off to sleep so that you're completely
unaware and you don't feel any pain. It is important that you fast before the
surgery and we give you a letter with instructions as to when to stop eating
and drinking. The operation can take anything from one and a half to three
hours for each side every patient is slightly different and the anatomy
varies from case to case. This means that sometimes it is more complex than others.
The crucial thing to remember is that we will take the time it needs and carry
out the operation in the safest possible way. You are looked after during the
surgery by the anaesthetic team. This involves having a small tube placed
through your mouth and into your windpipe so we can breathe for you while
you're asleep. Sometimes after the operation people get a sore throat for a
few days. That's because of the breathing tube and it will settle and there's nothing to worry about.
There's a nerve that runs through your ear called the facial nerve.
It supplies all of the muscles of the face on that side,
the ones that enable you to close your eye, to smile and to raise your eyebrow.
We monitor this nerve during the operation. To do this we have to put some tiny
needles into the face one at the corner of the mouth and one just above the eye.
Afterwards when we take these out, this can lead to some bruising and that
usually settles over a week or so. We then prepare the area behind your ear by
shaving some of the hair. This is so that we can keep the area as sterile as possible.
If you or your child are having two implants, then we try to make sure
that they're as symmetrical as possible under the skin. We can't however guarantee
that they'll be exactly the same on either side. In small children and babies
the skin and soft tissues are very thin so the implant can look quite prominent
behind the ear after the surgery. This is nothing to worry about and it will just
entirely settle as your child grows.
That is the end of the first video. Now you can
watch the next video which explains more about the operation itself and
what the procedure involves.