The first consultation.
Every patient who would like to get an opinion regarding eligibility for an implantable hearing solution or who qualifies for the procedure will be seen by one of the CHi’s ENT surgeons.
During this consultation, the surgeon will ask about your medical history, particularly with regards to your hearing loss. You will also be asked about any other medical conditions you may have, medications you take, if you have any allergies, whether there are any medical conditions in your family that may be of concern, and your suitability for anesthesia.
You will then have a clinical examination. Depending on any medical conditions you may have, other specialists may also be asked to check you out.
The CHi surgeon will discuss the different types of suitable implants with you; as well as the surgery and the steps to be taken before and after this surgery. Don’t worry too much if you feel a little overwhelmed – you will be given an information leaflet regarding all aspects of the surgery to take home and read at your leisure.
The surgeon will arrange for you to have an appropriate radiological examination of your ear and brain. This will include magnetic resonance imaging (MRI) and/or a computed tomography (CT) scan. It is important that anyone undergoing this type of procedure is fully immunized, and the surgeon will discuss this with you as well.
CHi team meeting and motivation letter.
After this consultation and competition of your radiological examination, your surgeon will discuss all the medical and radiological aspects of your case with the multi-disciplinary CHi team. This is to ensure that everyone who is involved in your treatment, care and rehabilitation is on the same page.
Your surgeon will also prepare a surgical motivation letter for an implant for you to submit to your Medical Aid.
Interpretation of the radiological examinations.
The surgeon will interpret the findings of your radiological examinations (MRI and CT) and determine the suitability for an implant based on your anatomy. In cases of Active Transcutaneous Bone Conduction Implant, the surgeon will use the CT scan and Active Transcutaneous Bone Conduction Implant planning software to determine the best place for the fixation of the floating mass transducer (FMT). OTOPLAN is a software program that uses the patient’s CT scan to measure the dimensions of the . This is unique for every patient. Based on your anatomy, your surgeon will select the most appropriate electrode.
Pre-operative examination and informed consent.
You will have another consultation with your surgeon before your surgery. You will have a final, physical examination to ensure you have not picked up an infection or other condition that may make it necessary to postpone your procedure.
During this visit, you will be able to ask any additional questions you may have, and once you are satisfied that you understand everything, you will be asked to sign an informed consent form.
You will be admitted to the hospital early on the day of your surgery. It helps to speed the admissions process if you complete all the admission documents before arriving at the hospital. Surgery will take place under general anaesthesia in the operating theatre. You will usually stay in hospital for one night after the surgery. You surgeon will examine you once again before discharging you.
In the days and weeks following surgery, you will undergo several follow-up examinations at set times. You will have to contact your doctor’s rooms to make the necessary appointments. These examinations are very important. The aim is to evaluate and monitor the post-operative wound healing. In addition, your surgeon will also be available for any emergencies that may occur during this period.
Your surgeon will determine at which point you have healed sufficiently for the implant to be switched on. Switch-on usually occurs six weeks after surgery.
The involvement of the surgeon after switching on the implant.
Following switch-on, the surgeon will be available to you should any issues relating the device or wound arise.
However, it is usually best to contact your mapping audiologist first, as many of your concerns can usually be effectively managed without having to see the surgeon.
You will have to see your surgeon for a routine annual follow-up. During this visit, your surgeon will examine your ear, confirm the status of the implant and the integrity of the tympanic membrane (ear drum). Once your surgeon is satisfied that everything is as it should be, it may no longer be necessary to continue with the annual follow-up examinations. Thereafter you only need to see your surgeon if new issues arise. Remember, however, that your surgeon can be contacted at any stage.
IMPORTANT INFORMATION REGARDING MRI EXAMINATIONS
Should you need an MRI for whatever reason after your implant, please contact your surgeon first. This is because the MRI could affect the functioning of your implant. Your surgeon will guide the radiologist and assist should specific safety steps such as strapping be necessary.