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Flying allowed after first check at 1-2 weeks; processor fitted around week 4."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Wound inspection and dressing/suture check."}},{"purpose":"assessment","requirement":"routine","after":{"min":21,"max":35,"unit":"days","qualifier":"Device activation and first programming (switch-on) after healing."}},{"purpose":"rehabilitation","requirement":"routine","after":{"min":60,"max":120,"unit":"days","qualifier":"Repeat programming/mapping adjustments and auditory rehabilitation review; further visits continue over the first year."}}],"indications":["Severe-profound sensorineural hearing loss, limited hearing-aid benefit","Profound single-sided deafness with disabling tinnitus or listening difficulty"],"main_risks":["Wound infection or, rarely, meningitis","Facial nerve injury or taste disturbance (chorda tympani)","Dizziness or vertigo and balance problems","Tinnitus (new or worsened)","Loss of residual hearing","Cerebrospinal fluid leak","Device failure or electrode migration requiring revision","Skin flap problems or hematoma","Risks of general anesthesia"],"pain":"Mild to moderate pain, pressure or soreness behind the ear for a few days, usually controlled with simple analgesics; fullness or numbness around the ear is common.","preparation":["Audiological assessment and hearing aid trial","CT and/or MRI of the temporal bone and inner ear","Preoperative medical and anesthetic evaluation","Vaccination review (e.g., pneumococcal) per local guidelines","Counseling on expectations and rehabilitation","Fasting before general anesthesia as instructed","Hair shaved only at surgical site if requested"],"recovery_timeline":[{"phase":"First days","description":"Head bandage, mild pain, possible dizziness; discharge same day or next morning.","restrictions":["Keep dressing dry","Avoid straining and heavy lifting","No blowing nose forcefully"]},{"phase":"Weeks 1-2","description":"Swelling subsides and wound check; return to light activities or desk work.","restrictions":["Avoid pressure on the implant site","Keep the incision dry until cleared"]},{"phase":"Weeks 3-5","description":"Healing is largely complete; device activation and first programming of the sound processor.","restrictions":["Avoid contact sports and head impacts"]},{"phase":"Months 1-12","description":"Gradual auditory adaptation with repeated programming and rehabilitation.","restrictions":[]}],"rehabilitation_days":{"min":2,"max":7,"unit":"days","qualifier":"Time to ordinary daily activities. Most resume within 2-3 days; dressing lasts 24-48 h. Mild dizziness may last weeks."},"result_longevity":"The internal device is designed for long-term, often decades-long use, though outcomes vary and the external processor is upgraded or replaced periodically; device failure may require revision.","revision_rate_pct":{"min":3,"max":8,"unit":"percent","qualifier":"Primary implants needing revision or reimplantation long-term (up to 10-20 years); mainly device failure, infection, extrusion, trauma. Higher in children."},"scars":"A small curved or straight incision behind the ear, usually well hidden in the hairline and fading over months; a small area of hair may be shaved.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One surgical procedure for unilateral primary implantation; device activation is a separate post-healing programming visit."},"stages":[{"code":"implant_surgery","label":"Surgical implantation of the internal receiver and electrode array","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery."}}],"qualifier":"Unilateral primary implantation; bilateral or sequential implants are not included."},"success":{"metric":"Postlingually deafened adults: sentence recognition in quiet","value":70,"unit":"percent correct (median)","horizon":"12 months after activation","population":"Postlingually deafened adults with severe-to-profound hearing loss, unilateral primary implant","evidence_status":"limited"},"techniques":[{"name":"Mastoidectomy with posterior tympanotomy and round window or cochleostomy insertion","suits_whom":"Standard approach for most adults.","recovery":"Typically 1-2 weeks for ordinary recovery before activation at about 3-5 weeks."},{"name":"Soft-surgery / hearing-preservation technique","suits_whom":"Patients with useful residual low-frequency hearing.","recovery":"Similar recovery; aims to preserve residual hearing."},{"name":"Suprameatal or minimally invasive approach","suits_whom":"Selected patients with favorable cochlear and mastoid anatomy.","recovery":"Similar or slightly faster recovery."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":1.5,"max":3,"unit":"hours","qualifier":"Unilateral primary cochlear implantation under general anesthesia, skin to skin."},"initial_assessment_documents":["Recent pure-tone audiogram","Speech recognition test results with hearing aids","Temporal bone CT scan","MRI of inner ear and auditory nerves","ENT report on cause and duration of deafness","Hearing aid fitting history (if available)"],"travel_trips":{"min":2,"max":3,"one_trip_possible":false,"qualifier":"Surgery trip of 7-14 days, then return for activation at 3-5 weeks; further programming visit at 2-4 months, often local."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Talk with an experienced cochlear-implant surgeon before deciding on an implant","scope":"procedure","source":{"url":"https://www.nidcd.nih.gov/health/cochlear-implants","host":"nidcd.nih.gov","quote":"The decision to receive an implant should involve discussions with medical specialists, including an experienced cochlear-implant surgeon.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Have two consultations with the treating surgeon before any surgery","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check facility and staff accreditation or certification, because some abroad may lack it","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Some facilities and healthcare professionals abroad might lack accreditation or certification.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C5","text":"Check that you can ask the treating clinician questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C6","text":"Ask for examples of the practitioners’ experience with the planned surgery","scope":"treatment_type","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Ask for examples of the practitioners’ experience with the surgery you are intending to have.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Fewer than two consultations with the treating surgeon are offered before surgery","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"Offer pushes a quick decision through forceful persuasion or time-limited deals","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Holds the surgeon's specific aftercare instructions for your home doctor to follow","document":"discharge letter","source":{"url":"https://guysandstthomas.nhs.uk/health-information/recovering-cochlear-implant-surgery","host":"guysandstthomas.nhs.uk","quote":"If there are more specific instructions from your surgeon, they will be in your letter when you leave hospital.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Given before you leave hospital; home doctors need it to identify the implant","document":"cochlear implant id card","source":{"url":"https://www.southtees.nhs.uk/resources/cochlear-implantation-surgery-being-discharged-from-hospital","host":"southtees.nhs.uk","quote":"After your operation, your cochlear implant ID card is given to you before you leave the hospital.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"technique_details":{"status":"ok","items":[{"id":"mastoidectomy","name":"Mastoidectomy with posterior tympanotomy and round window or cochleostomy insertion","how_it_works":{"text":"Surgeons remove mastoid bone and open the cochlea for the electrode","source":{"url":"https://med.virginia.edu/otolaryngology/information-for-patients/cochlear-implant-program/cochlear-implant-surgery/","host":"med.virginia.edu","quote":"The mastoid bone is removed and small hole is made in the cochlea prior to insertion of the electrode array.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":7,"unit":"days","label":"1–7 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