Cochlear Implant Surgery

WARNING: THIS IS A LONG POST WITH LOTS OF PICTURES

Thank you to all of our family and friends who have shown such great love and support as we have proceeded with Kelsey's surgery. We have received several questions that have made us realize, we have probably not done a very good job explaining what a cochlear implant is, and what it can do for Kelsey. This post will first explain what a Cochlear Implant is and what it is capable of, and then will show some pictures of Kelsey's surgery.



What is a Cochlear Implant?

A cochlear implant is a medical device that is designed to provide a sense of hearing to individuals with profound hearing loss. A cochlear implant stimulates the auditory nerve with a tiny electrode array, resulting in a relatively crude approximation to normal hearing. The most advanced electrode arrays today use only 22 electrodes, whereas the healthy human cochlea has thousands of hair cell receptors for transmitting information about sounds. A cochlear implant is very different from a hearing aid. Hearing aids amplify sounds, a cochlear implant bypasses the damaged portions of the ear and directly stimulates the auditory nerve. The sense of hearing that the cochlear implant provides is fundamentally different from that of normal hearing. 



This diagram provides a basic overview of how the device works.



First, a surgery is performed to implant a receiver, magnet, and electrodes. For Kelsey, an incision was made above each ear, down behind each ear, and finally out towards the back of her head. The skin was folded back, and the muscle parted until the skull was visible. A portion of the skull had to be carved away to allow for a small pocket where the receiver, and magnet could be embedded. Then a small hole was drilled through the bone to allow a wire to bypass each of her external ear canals and eardrums. The wires, are then looped into the cochlea ending at the auditory nerve. The wires contain the electrodes that will help to stimulate the auditory nerve. The following picture shows the Freedom Device that Kelsey had implanted behind each ear. 

Freedom Device
The circle portion is silicon with a small circle magnet, while the large square is the receiver. The short wire is for ground, while the long wire with the loop is inserted into the cochlea and ends at the auditory nerve. The entire Freedom Device is implanted into the head, and then surgery is complete.

Kelsey is home now and resting comfortably. Her swelling is going down and she is returning to her normal "busy" self. The next step is to wait for her incisions to heal before proceeding to the external portions of the Cochlear Implant. We have an appointment on November 1st to have the external device activated. Because Kelsey has never heard any sound, we expect November 1st to be a bit of a scary day. The following picture shows the Nucleus 5 Device that Kelsey will wear.

The Nucleus 5
The main piece will fit behind her ear with the bottom portion containing the battery, and the upper portion containing her speech processor. Once activated the speech processor will collect sound and convert it into a digital signal. It will send that signal along the short wire up to the transmitter (Circle Piece). The center of the transmitter contains a magnet that will attach itself to the magnet previously implanted as part of the Freedom Device. The internal receiver will collect the digital sound, send it along the internal wire and ultimately end up stimulating the auditory nerve.

We plan to video our November 1st Appointment to document when Kelsey hears her first sounds. Although Kelsey has over 60 signs, when it comes to sound it will be as if she is a newborn again. We may not know for years the level of success this Implant may prove to her. It is because of this uncertainty that we plan to always sign first with her, and have American Sign Language always be her first language.  

Kelsey's Surgery

On Thursday we visited our Surgeon's office for Kelsey's Pre-Op appointment. Mostly they just checked her ears, answered a few of our questions, and marked her ears.

 She got a little bored, so I had to improvise a balloon.

She did not enjoy having her ears looked at.

We finished our Pre-Op appointment earlier than we had planned so we made a brief trip to Hogle Zoo to let Kelsey look at the animals. She loves animals.

You can see where her ear has been marked. "Y" for "Yes, you can implant this ear."

On Friday Morning we arrived at Primary Children's Hospital at 6:45 a.m. She was measured, weighed and had her vitals taken. We also changed her into her clothes.

After she had been changed we moved to meet our Anesthesiologist. He was very kind and had a great idea to ease the separation anxiety surely to come when we could no longer be with her in the operating room. He brought over a wagon and placed some toys inside. Alisa pulled the wagon until we reached the doors where we had to say goodbye.



This scene was the hardest part of the whole day.

Surgery took nearly 4 hours....it felt longer than this. After the surgery was completed Kelsey's surgeon Dr. Shelton came and found us in the waiting room to tell us that the surgery went according to plan with no complications. We were allowed to join her after she began to wake up.

We feel truly blessed and believe that so many of the prayers offered in Kelsey's behalf were answered as she was able to sleep for the far majority of the time we spent in the hospital. Thank you for all the prayers.



Maybe "Princess Leah" for Halloween?

Early Saturday morning they came in to remove the large bandages. Amazingly they did not have to use stitches, but instead use something called Steri-Strips to basically tape the wound together. This is supposed to minimize the scar.

While waiting for the "all clear" to go home, Kelsey began to act like her old self and was ready to get out of our small room. Thankfully we found the Wagons again and she took a ride around the halls.

Kelsey is doing great. The last few pictures were taken about 48 hours after surgery. The strips will stay on for about 7 days, and after that we can finally give her a bath.

We will continue to update this family blog with Kelsey's progress, beginning next with her November 1st activation appointment. Thank you for all the love and support.