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Implant cochléaire

Cochlear Implant : Recommendations and Contraindications

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activities, "cochlear implant", contraindications, precautions, recommendations, safety

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Adults and children with a cochlear implant can participate in a great number of sporting and recreational activities. However, a few basic precautions should be taken.

In some situations, it is recommended to remove the external equipment of the implant system (sound processor). In other situations, it is important to use safety equipment to reduce the risks associated with blows to the head. 

Here are few safety tips in this regard :

 

Activities

 

Aquatic activities

Swimming at the beach or pool

Remove the processor when swimming or use proper bathing accessory.
It is allowed to swim by putting the head under the water and jump from the edge of the pool (head or feet in front) 3 months after the surgery.

Warning : 

  • If the child has trans-tympanic ventilation tubes, he/she should wear earplugs. 

  • Wait for hair to be completely dry before putting back the external equipment of the implant after swimming.

  • If the sound processor falls in the water, do not put it back; use the dehumidifier box that came with your processor. Contact the Technical Support Service of the CHU de Québec – L’Hôtel-Dieu de Québec, Raymond-Dewar or the MAB-Mackay Rehabilitation Centre if the device does not function properly after using the dehumidification box (e.g.: Zephyr).

  • Avoid that the external equipment of the implant comes in direct contact with water or sand. When a child is playing in the sand, he/she should avoid touching his/her processor. 

  • Some companies have created waterproof accessories for swimming with the processor (for some models only).  It is possible to buy these accessories through the manufacturer’s website.  Check with your audiologist for details.

 

Water sports (windsurfing, jetskiing …)

Wait 3 months after surgery. Always remove the external equipment of the implant.


High diving

  • A dive can be performed 6 months after surgery with a maximum height of 3 meters (risk of displacement of the internal part beyond this height).  

  • If the adult or child experienced numerous ear infections (otitis), it is recommended to consult a physician to find out which precautions to take. 


Scuba diving

Wait one year after surgery; ask your surgeon to examine your eardrums and indicate that it is safe for you to go diving. 
 

Sports

Wait 1 month after the surgery before resuming sports activities.


Wear a helmet

For all activities involving a risk of falls or blows to the head.
Wearing a helmet reduces the risk of damaging the cochlear implant (internal part). However, if a blow is received to the head, the risk of internal damage remains present despite the protection. Some helmets favor pressure points on the front and back rather than on the sides of the head, which may help reduce the pressure on the coil.


Baseball

Wear a batter’s helmet at all times. 


Soccer

Avoid bouncing the ball off of your head. The use of a protective shell headband is recommended. The custom headband can be done by an orthotist specialist.


Cycling

A bicycle helmet will protect the implant provided it covers the coil, and thereby the internal part. If the microphone is integrated to the coil (depending on the sound processor model), the helmet could hinder your hearing. Thus, one can install mirrors on the helmet or on the handlebars of the bicycle. 

The use of a FM system may also be interesting. This system transmits the voices directly to the sound processor. For more information, speak to your audiologist. 

 

Skateboarding, Using a scooter or Rollerblading

Wearing a helmet is recommended.


Winter sports 

The wearing of a protective helmet is recommended when skating, snowboarding and skiing. Choose a fabric toque which will keep your head warm while avoiding excessive sweating. Many styles are available in sports specialty shops. 
 
Furthermore, the sound processor must be protected from the cold. Wear the body-worn processor under your clothes and protect the behind-the-ear processor with a toque when exposed to cold over long periods of time. 
 

Contact sports : Boxing, Wrestling, Football, Karate

The practice of these sports is not recommended, unless you wear a highly resistant helmet. Please consult your surgeon before taking up again any of these activities. 


Extreme sports : Parachuting, Bungee jumping

These sports are not recommended.  However, if a cochlear implant user decides to partake in them, the use of a helmet is essential and the processor must be removed. The helmet should leave enough space so as not to apply direct pressure on the area of the internal part. These helmets will reduce the force of an impact but will obviously not protect the implant from a major blow. In any case, a person who was recently implanted (within the past year) shouldn’t participate in these activities without the prior authorization from their surgeon.


Jogging, Tennis, Badminton

Wear a headband to absorb sweat. 


Walking outside

Wear a hat, hooded jacket or carry an umbrella when it's raining or snowing. 


Theme Park Rides

  • Avoid rides with sudden movements where your head could hit the side or any other obstacle. 

  • Be careful and remove your processor before the ride starts if you think that it could fall off.

  • Extreme rides like the Goliath at La Ronde, and rides with sharp drops, such as the Orbit at La Ronde and the Hip Hop at the Galeries de la Capitale are prohibited. These rides use a system that propels them very quickly towards the sky and then back down towards the ground. There is a small risk that the forces at play could move the electrodes in the implant, damaging the cochlear implant. This type of ride is found in most amusement parks, under different names. 

 

Precautions
 

Static Electricity

Avoid static electricity

Static electricity is produced when two non-conductive materials are rubbed together causing friction.  Plastic, rubber, dry air, computer monitors, television screens and synthetic fabrics such as polyester are good examples. 

The sound processor possesses features which minimize damage caused by static electricity. Certain risks remain, however. Static electricity may result in the deprogramming of the sound processor and, in some very rare instances, cause the internal device to cease functioning. Cochlear implant manufacturers recommend the removing of the external equipment when doing activities that could generate static electricity. 

 

Here are just a few of the objects and activities which could generate static electricity (remove external equipment) : 

  • Plastic toys (cars, balls, tunnel, slide, waterslide, …).

  • Dragging one’s feet on a carpet.

  • Rubbing balloons on one’s head.

  • Making pirouettes or rolling on the synthetic lawn carpet.

  • Playing under parachute fabric, on a trampoline.

  • Running on a treadmill.

  • Getting dressed (e.g. putting on a wool sweater).

 

Here are a few other tips :

  • Before touching and connecting the sound processor, touch any object which is conductive (e.g. metal or another person). This will ground the electrical charge.  

  • Moist air may help prevent the buildup of static electricity. A humidifier and adjusting the heating/air conditioning may also help prevent static electricity.

  • Use an anti-static fabric softener when washing clothes and sheets.


Moisture

Avoid source of moisture

  • To prevent the deterioration of the device, it is better to keep water, sweat and other sources of moisture away from the implant’s external equipment.

  • To avoid moisture-related problems, use the dehumidifier box that was provided with your sound processor (e.g.: Zephyr, Cedis, Drystar etc.). A daily (every night) use of the dehumidifier is recommended. It is not necessary to remove the disposable batteries.  Rechargeable batteries can also be placed in these dehumidifiers (except for the DryStar). 

  • You can also purchase a moisture protection pouch such as the “Ear Gear”. For more information, contact your audiologist.


Extreme temperature

Avoid extreme temperatures

  • The sound processor can be damaged by exposure to sunlight. The processor is not made to withstand temperatures under -20 oC or over 45 oC (113 oF).

  • Avoid leaving the sound processor in the glove compartment or on the dashboard of your car.

  • Also, avoid placing the sound processor next to an oven or fireplace.


Sound processor

Protect your sound processor

  • If you are wearing a body-worn processor, wear the sound processor and wiring under clothing. This will help to prevent the equipment from coming into contact with other objects or water during your activities. Moreover, position the processor in order to protect it in case you fall. 

  • If you are wearing a behind-the-ear or on-head processor (ex: Kanso or Rondo), use as needed retention means for keeping the processor in place to prevent it from falling and to avoid losing it (eg: earmolds, retention accessories, headbands…).  Ask your audiologist for more information.

  • Pets and children can be attracted to all external parts of a cochlear implant.  Keep the equipment out of the reach of pets and children (ex: keep the processor in a box such as your dehumidifier box at night).


Connecting accessories

(Does not affect recent processor models)
  • It is prohibited to plug your sound processor into an electrical device (plugged into the wall, eg.: television, computer…) with a direct audio cable.  These cables, sometimes provided by cochlear implants companies, are designed to be plugged into battery powered devices such as MP3, IPod, infrared system, etc.  

  • Other alternatives exist for connecting electrical devices : headphones (on-ear), neck loop, silhouette, Bluetooth wireless accessories.  Also, Cochlear company (Nucleus) provides a special cable for direct connection, the "Mains isolation cable", which can only be used with Nucleus products. 


Interferences

Cell phones 

Cochlear implants users may hear distorted sounds when they are near certain types of cell phones. These pose no danger to the implant.


Next-generation smart meters (Hydro-Quebec)

There may be audible interferences with the sound processor when the cochlear implant user is near the meter.  There is no risk to the internal part.


Induction cook-tops

Induction cook-tops produces a magnetic field which could cause for the cochlear implant user.  It is therefore recommended to keep the implant at a safe distance of at least 0.5 meters from the induction cook-top.  However, there is no known risk to the internal part.


Metal detectors and anti-theft devices  

The anti-theft devices located at the entrance of many stores pose no danger to the cochlear implant. However, some people may hear distorted sounds. The implant can also activate the alarm (rarely). Have your cochlear implant identification card ready in case of need.


Airplanes and airports

  • Flying is allowed 1 month after surgery.
  • Please advise airport security that you or your child is wearing a cochlear implant. Present the cochlear implant identification card that was handed to you during the programming process. The alarm of the security systems could be set off by the implant.
  • People wearing a cochlear implant can pass through the security system (namely a “gate” that detects the presence of metallic objects) without any harm.  However, we recommend that you turn down the volume or shut it off completely to avoid any unpleasant noise. To avoid any electrostatic discharge or damage to the microphone, the processor must be worn, and not placed on the conveyor belt or through X-ray machine.

  • ​Some airports are equipped with scanners that conduct “virtual strip searches” with the goal of increasing passenger safety. These scanners operate with a technology using millimetric waves or low dosage of X-rays. Implant manufacturers state that these scanners present no danger to the internal and external equipment of the implant. We recommend, however, that you remove your implant and hold it in your hand when going through a scanner. This will avoid you from hearing any type of interference.
  • If the airline company asks you to close all your electronic devices at the time of take-off and landing (computers, telephones…), you must turn off your remote control and your Bluetooth accessory (ex: ComPilot, Phoneclip, Roger Pen etc.).

Beauty care

Hair styling

  • For cutting hair very short (with a hair clipper), wait 3 months after surgery.

  • If you want to dye your hair or curl it with a permanent wave, wait 1 month after surgery. 

 

Esthetics

  • When visiting a tanning salon, remove the processor.

  • Laser hair removal or skin treatment is allowed.  It is important, however, to avoid the area near the implant and to remove the sound processor. 

  • When undergoing electrolysis, avoid the neck, face and head.


Skin integrity at the implant site

Be careful of your skin

  • Avoid constant pressure on the coil (magnet too strong, helmet too tight, sleeping directly on the coil, etc.).

  • It is strongly discouraged to wear the processor at night.

  • If the magnet of your antenna is too strong, the long-term risks are :

    • Irritation, discomfort, twinges, aches.

    • Thinning of the skin. Malfunction of the processor with your cochlear implant.

    • In more advanced cases : skin ulcer with possibility of tissue death and exposure of the implant, infection and risk of having to explant the implant.

  • Note that if you lose or gain weight, the strength of your magnet may need to be readjusted.

  • If you feel pain or soreness at the implant site, see your audiologist and/or ENT immediately.


Medical examinations and other therapies

 

Medical exams

Magnetic Resonance Imagery (MRI)

  • Never enter a room equipped with a magnetic resonance device without precaution.

  • Should you have to undergo an MRI, always consult your surgeon before the examination. The feasibility and the necessary precautions to be taken during the examination will be evaluated.

 

 X-rays

They pose no danger for the internal part (you must however remove your sound processor).

 

Tympanometry (used in audiology)

It is necessary to wait 2 months after the surgery before performing a tympanogram on the ear that has received a cochlear implant. This test may only be done if you or your physicians have serious doubts about the condition of the ear.

 

Medical examinations and therapies prohibited

  • Electrosurgery.

  • Diathermy or neurostimulation.

  • Ionizing ray therapy.

  • Electroconvulsive treatment.

  • Monopolar electrical cauterization.

 

Laser eye surgery

Laser eye surgery is possible, but the laser beam must never be directed toward or near the implant site.
 

Radiation therapy

It may be contraindicated. It is very important to consult your surgeon before beginning treatment.


Dentist

The use of ultrasonic scaler is prohibited.


Physiotherapy, Osteopathy or Chiropractic and Acupuncture therapy

  • Avoid the following treatments to the head or neck: ultrasound diathermy, TENS therapy, interference current therapy, ultrasound therapy or lithotripsy (shock waves). There is no contraindication for these therapies to areas below the shoulders.

  • Magnetic treatments are forbidden: a person wearing a cochlear implant must avoid any exposure to strong electromagnetic fields or high levels of electrical current, as they could cause a breakdown of the implant’s internal part.

  • Therapy using short-wave or micro-wave diathermy is forbidden for any areas of the body, as it may also result in a breakdown of the internal equipment.

  • Manual therapy including cervical tractions, massages as well as the application of hot or cold compresses is allowed. It is important, however, to avoid the application of mechanical force directly to the implant area.

Warning! In all cases, the implant’s external equipment must be removed during therapy.


Pacemaker

  • A person wearing a cochlear implant should not approach his head at a distance of less than 15 centimeters from the chest of someone with a pacemaker.

  • For individuals wearing a Pacemaker :

    • There will be no interference when the cochlear implant processor is worn on the ear as it should.

    • Keep the processor (especially the magnet on the antenna) at least 15 centimeters (6 inches) away from your chest (where your Pacemaker is located).

    • Remove the processor while the Pacemaker is being programmed.

    • Make sure that the implant’s programming cable does not fall across your chest where your Pacemaker is located.


If in doubt

Should you have any questions, please contact your programming center or the Centre québécois d'expertise en implant cochléaire.

  • CHU de Québec – UL, L’Hôtel-Dieu de Québec (HDQ) :

    • Secrétariat : (418) 691-5420.

    • Service ORL : (418) 691-5490.

    • Audiologie : (418) 525-4444.

 

  • CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Centre de réadaptation MAB-Mackay : (514) 488-5552.

 

  • CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Installation Raymond Dewar (IRD) : (514) 284-2581.

Dernière révision du contenu : le 28 novembre 2019

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