Complications from cochlear implant surgery

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cimay2012

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I have a question about cochlear implant recipients experiencing some level of pain months after the implant surgery. Nine months after the implant surgery, my father is till experiencing some level of irritation near the implant area. There is a difference in his case of cochlear implant surgery than typical case, however.

My father at age 70 had a cochlear implant surgery in May 2012. If all goes well, cochlear implant patients go back for an post-surgery evaluation one month later. If the surgery area is healed, the device is activated and there are several visits with the audiologists subsequently to tune the device. In my father's case, there was an infection near the incision, so he had to go through another surgery to correct the problem in early June 2012. The infection was not deep enough to reach the implant, so the ENT surgeon with the help of plastic surgery tried to save the implant. The ENT surgeon opened up the incision, and cleaned out the infected area. Then the plastic surgeon did a skin graft from another section of the scalp on the incision area to allow for that area to heal. The reason for the skin graft is because the area behind the ear does not have much tissue to promote healing. Anyway, so here we are 8 months after the follow up surgery, he still experiences fairly significant irritations near the implant area. The symptoms include

+ Burning sensation just below the surface
+ Feels like there is swelling
+ Often feels dizziness and nausea.

When one of these pain episode strikes, he is unable to do anything but rest. These episodes are quite frequent and lengthy. They typically start soon after he wakes up in the morning and last hours, and this happens almost 3 to 4 days per week. Often the pain episodes occur for server consecutive days, then go away for a copule of days.

He visited the plastic surgeon and ENT surgeon three times in the last 6 months, and they simply just say that everything looks fine. They don't acknowledge that his experience is possible in certain patients. Of course, if they can't diagnose the problem, they can't really say how long he may experience these symptoms. On the first visit about 2 months after the surgery, the plastic surgeon said that these symptoms should go away in about 6 months.

Sorry for the long explanation, but I felt it is necessary to fully describe his situation. It is unlikely that anyone else would have gone through the same sequence of events, but I wonder if anyone else with cochlear implant may have similar pain symptoms long after cochlear implant surgery.
 
Elderly patients always present additional complications.
Your father is pretty awesome for getting a CI at 70 but despite how young he may be at heart (I'm thinking of my 87 year old grandfather who still rides his bike every day and refuses to wear a helmet because "only old people wear those") people older than 65 have unique needs.

First, they generally have much less subcutaneously fat than children and adults.
Infection is also more likely and the fact that your father had an infection is troublesome.
It is a good thing that the doctors were able to resect the damaged tissue and it is a blessing that the implant was not affected.
Since your father had a skin graft it is pretty normal to have pain at the site of the graft (my own father had an extensive graft after a burn in a motorcycle accident and had significant pain for over a year and that was his arm).
Also, cochlear implant recipients often expierence dizziness, some nausea or even pain especially if they have been deaf for a long time.
There are so many things for the brain to try to sort out.
Maybe your father might have some benefit by "easing into" the world of sounds each day.
As in, he wakes up, has his coffee, if he wants he tries the CI for a few minutes in QUIET, if it is not feeling OK then maybe he tries again later (also at a quiet time).
The thing is that the brain needs time to get used to so much new information. I have progressive hearing loss and everytime I get my superpower hearing aids replaced or reprogrammed it takes me about a week to adjust. And I'm only 26. So I ease into noise. I have just now realized that music sounds better (or is audible at all) when I wear my hearing aids. But loud high pitched sounds do hurt.
Brains of any age can adapt but they need to ease into things.
 
From reading the above- I am really lucky! I had just turned 70 when I had the Cochlea Implant operation.

I was advised prior to the operation-my daily swimming exercise was a factor in deciding I "fit the criteria-implantation". Aside I could resume swimming 2 weeks after the operation. I was activated 2 weeks later. Fortunately could hear with the implant- almost right away.
 
Hmm. Have they checked to make sure that he isn't allergic to the enclosure for the implant?
 
My audiologist has a 94 year old women who recently received a CI.

I had a severe allergic reaction after my CI surgery. It took nearly 3 months to clear. Everything is good now. I wish your father the best.
 
I am not sure how one can be "allergic" to the internal processor "parts" as it is "sealed"?
Something new?
 
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Allergies do happen, but very rare. There was a case where one person got a implant (can;'t remember if it was Cochlear or AB), had allergy reactions to it, so he was reimplanted with a Med-El, if I remember that right.
 
It is difficult to determine whether the pain is the result of skin graft or the implant surgery itself. As I mentioned in my earlier post, both ENT and plastic surgeon simply say that "everything looks fine" from their perspective.

The ENT surgeon did suggest another theory of cervical spine arthritis. He says that it is possible for this condition to send erroneous nerve impulses that might induce certain pain characteristics that my father is experiencing. Though he admitted that this condition is not very common in males at age 70. My counter argument is how it suddenly appeared after the surgery, to which he replied that several hours of position his neck one side during operation could have exacerbated whatever minor condition he already had started developing. To rule this out he recommended seeing an Orthopaedics doctor, who will examine the neck area. The problem now is that he can have an MRI with the implant, so the best option is to do a CT scan. I am doubtful of this theory.
 
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