{"id":20575,"date":"2022-07-04T08:00:33","date_gmt":"2022-07-04T06:00:33","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=20575"},"modified":"2025-04-17T04:51:36","modified_gmt":"2025-04-17T04:51:36","slug":"naslouchatko-nebo-sluchovy-implantat","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/naslouchatko-nebo-sluchovy-implantat\/","title":{"rendered":"Naslouch\u00e1tko nebo sluchov\u00fd implant\u00e1t?"},"content":{"rendered":"

Kdy jsou sluchov\u00e9 implant\u00e1ty lep\u0161\u00edm \u0159e\u0161en\u00edm ne\u017e naslouch\u00e1tko?<\/h1><\/div>

Sluchov\u00e9 implant\u00e1ty a b\u011b\u017en\u00e1 naslouch\u00e1tka se neust\u00e1le zlep\u0161uj\u00ed a hranice pou\u017eit\u00ed t\u011bchto r\u016fzn\u00fdch syst\u00e9m\u016f se neust\u00e1le m\u011bn\u00ed.<\/strong><\/p>\n<\/div>

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\u201eP\u0159ibli\u017en\u011b 19 procent populace trp\u00ed ztr\u00e1tou sluchu, kter\u00e1 vy\u017eaduje l\u00e9\u010dbu,\u201c vysv\u011btluje Dr. Thomas Keintzel, prim\u00e1\u0159 ORL odd\u011blen\u00ed kliniky Klinikum Wels-Grieskirchen. \u201eL\u00e9\u010dba pomoc\u00ed naslouch\u00e1tek je zde st\u00e1le zlat\u00fdm standardem.\u201c Konven\u010dn\u00ed naslouch\u00e1tka zesiluj\u00ed zvuk \u2013 v z\u00e1vislosti na v\u00fd\u0161ce a hlasitosti \u2013 tak, aby jej u\u017eivatel mohl l\u00e9pe vn\u00edmat. T\u00edm by v\u0161ak u\u017eivatel\u00e9 nem\u011bli kon\u010dit: \u201eKrom\u011b podpory za\u0159\u00edzen\u00ed se jako z\u00e1sadn\u00ed faktor \u00fasp\u011bchu prosadilo \u0161kolen\u00ed.\u201c<\/p>\n

Existuj\u00ed v\u0161ak n\u011bkter\u00e9 zdravotn\u00ed pot\u00ed\u017ee, kter\u00e9 \u00fasp\u011b\u0161n\u00e9 pou\u017e\u00edv\u00e1n\u00ed konven\u010dn\u00edch naslouch\u00e1tek<\/a> zt\u011b\u017euj\u00ed nebo znemo\u017e\u0148uj\u00ed. Nap\u0159\u00edklad z\u00fa\u017een\u00fd nebo opakovan\u011b zan\u00edcen\u00fd zvukovod, osifikace ve st\u0159edn\u00edm uchu nebo ztr\u00e1ta st\u0159edou\u0161n\u00edch k\u016fstek. V n\u011bkter\u00fdch p\u0159\u00edpadech m\u016f\u017ee pomoci operace, ale 75 procent v\u0161ech probl\u00e9m\u016f vy\u017eaduje podporu sluchadla, uv\u00e1d\u00ed prim\u00e1\u0159 Keintzel. \u201ePou\u017eit\u00ed implant\u00e1t\u016f pro kostn\u00ed veden\u00ed a aktivn\u00ed st\u0159edou\u0161n\u00ed implant\u00e1ty se v\u0161ak prosadilo jako cenn\u00e1 alternativa ke konven\u010dn\u00edmu nasazov\u00e1n\u00ed naslouch\u00e1tek.\u201c<\/p>\n

Kdy\u017e samotn\u00e9 zes\u00edlen\u00ed nesta\u010d\u00ed<\/h2>\n

Z audiologick\u00e9ho hlediska dosahuj\u00ed b\u011b\u017en\u00e1 naslouch\u00e1tka p\u0159i v\u00e1\u017en\u00e9m po\u0161kozen\u00ed vnit\u0159n\u00edho ucha sv\u00fdch limit\u016f. Krom\u011b p\u0159em\u011bny zvukov\u00fdch vibrac\u00ed na nervov\u00e9 sign\u00e1ly m\u00e1 vnit\u0159n\u00ed ucho funkci, kter\u00e1 se t\u00e9m\u011b\u0159 rovn\u00e1 \u201ep\u0159edzesilova\u010di\u201c. To se ozna\u010duje jako komprese vnit\u0159n\u00edho ucha. V p\u0159\u00edpad\u011b senzorick\u00e9 ztr\u00e1ty sluchu se tato schopnost postupn\u011b ztr\u00e1c\u00ed. Proto mus\u00ed naslouch\u00e1tka zesilovat v\u00edce tich\u00e9 zvuky ne\u017e hlasit\u00e9.<\/p>\n

Tato ztr\u00e1ta komprese sluchov\u011b posti\u017een\u00e9ho ucha zp\u016fsobuje \u201edynamick\u00e9 sn\u00ed\u017een\u00ed\u201c. Rozd\u00edl mezi nejti\u0161\u0161\u00edm zvukem (sotva sly\u0161iteln\u00fdm) a nejhlasit\u011bj\u0161\u00edm zvukem (pr\u00e1h bolesti) se zmen\u0161uje. V d\u016fsledku toho se tak\u00e9 ztr\u00e1c\u00ed kontrast mezi r\u016fzn\u00fdmi akustick\u00fdmi sign\u00e1ly: u\u017eivatel se zes\u00edlen\u00edm st\u00e1le sly\u0161\u00ed v\u0161e, ale n\u011bkter\u00e9 zvuky, porozum\u011bn\u00ed \u0159e\u010di a rozhovory se navzdory sluchadlu st\u00e1vaj\u00ed st\u00e1le v\u00edce vy\u010derp\u00e1vaj\u00edc\u00edmi.<\/p>\n

U posti\u017een\u00e9ho ucha doch\u00e1z\u00ed tak\u00e9 ke zm\u011bn\u00e1m \u010dasov\u00e9ho rozli\u0161en\u00ed (tzv. \u201esluchov\u00e9 maskov\u00e1n\u00ed\u201c), k n\u011bmu\u017e doch\u00e1z\u00ed, kdy\u017e p\u0159evl\u00e1daj\u00edc\u00ed zvuk zakr\u00fdv\u00e1 zvuk m\u011bk\u010d\u00ed. V\u0161echny tyto vlivy dohromady znamenaj\u00ed, \u017ee od ztr\u00e1ty sluchu kolem 50 decibel\u016f je \u0159e\u010d v hlu\u010dn\u00e9m prost\u0159ed\u00ed st\u00e1le m\u00e9n\u011b srozumiteln\u00e1, a to i s naslouch\u00e1tky.[1]<\/a><\/p>\n

Modern\u00ed technologie v b\u011b\u017en\u00fdch naslouch\u00e1tc\u00edch pom\u00e1haj\u00ed<\/h2>\n

Konven\u010dn\u00ed naslouch\u00e1tka pracuj\u00ed s r\u016fzn\u00fdmi triky, kter\u00e9 zlep\u0161uj\u00ed akustick\u00fd kontrast, a v\u017edy se zam\u011b\u0159uj\u00ed na porozum\u011bn\u00ed \u0159e\u010di. Frekven\u010dn\u00ed filtry se pou\u017e\u00edvaj\u00ed k utlumen\u00ed v\u00fd\u0161ek, kter\u00e9 nejsou pro nerozli\u0161ov\u00e1n\u00ed \u0159e\u010di podstatn\u00e9 nebo potenci\u00e1ln\u011b obsahuj\u00ed mnoho \u0161umu v pozad\u00ed. Potla\u010den\u00ed \u0161umu zkoum\u00e1 ka\u017ed\u00fd segment v\u00fd\u0161ky t\u00f3nu z hlediska \u0159e\u010dov\u00fdch sign\u00e1l\u016f a podle toho jej zesiluje nebo ztlumuje. Sm\u011brov\u00e9 mikrofonn\u00ed syst\u00e9my zpracov\u00e1vaj\u00ed zvuky z p\u0159edpokl\u00e1dan\u00e9ho sm\u011bru mluv\u010d\u00edho. V\u0161echny tyto funkce jsou tak\u00e9 integrov\u00e1ny do zvukov\u00fdch procesor\u016f sluchov\u00fdch implant\u00e1t\u016f.<\/p>\n

Neust\u00e1le se zdokonaluj\u00edc\u00ed technologie pro zlep\u0161en\u00ed \u0159e\u010di umo\u017e\u0148uj\u00ed, aby i u\u017eivatel\u00e9 s v\u00e1\u017en\u011b naru\u0161enou funkc\u00ed vnit\u0159n\u00edho ucha rozum\u011bli \u0159e\u010di pomoc\u00ed naslouch\u00e1tek. V ur\u010dit\u00e9m okam\u017eiku i sou\u010dasn\u00e1 \u0161pi\u010dkov\u00e1 sluchadla naraz\u00ed na sv\u00e9 limity. Prim\u00e1\u0159 Keinzel m\u00e1 radu pro pacienty, kte\u0159\u00ed se ji\u017e nec\u00edt\u00ed l\u00e9pe: \u201eV takov\u00e9m p\u0159\u00edpad\u011b lze ke zlep\u0161en\u00ed porozum\u011bn\u00ed \u0159e\u010di pou\u017e\u00edt p\u0159\u00edmou elektrickou stimulaci prost\u0159ednictv\u00edm kochle\u00e1rn\u00edho implant\u00e1tu.\u201c<\/p>\n

Porozum\u011bn\u00ed \u0159e\u010di je kl\u00ed\u010dov\u00e9!<\/h2>\n

\u201eKrom\u011b neust\u00e1l\u00e9ho technick\u00e9ho zdokonalov\u00e1n\u00ed naslouch\u00e1tek i sluchov\u00fdch implant\u00e1t\u016f se posunuly i hranice indikace,\u201c popisuje prim\u00e1\u0159 Keintzel. Pokud je porozum\u011bn\u00ed \u0159e\u010di, komunikace a dobr\u00e1 kvalita \u017eivota mo\u017en\u00e1 s naslouch\u00e1tky, nen\u00ed p\u0159\u00edli\u0161 d\u016fvod\u016f pro operaci. Sly\u0161en\u00ed se sluchov\u00fdm implant\u00e1tem (nebo CI) nav\u00edc vy\u017eaduje n\u00e1cvikovou f\u00e1zi: centr\u00e1ln\u00ed sluchov\u00fd syst\u00e9m se mus\u00ed nau\u010dit odpov\u00eddaj\u00edc\u00edm zp\u016fsobem p\u0159ev\u00e1d\u011bt technicky generovan\u00e9 sign\u00e1ly.<\/p>\n

\u201eZ\u00e1sadn\u00edm rozhodovac\u00edm krit\u00e9riem m\u016f\u017ee b\u00fdt porozum\u011bn\u00ed \u0159e\u010di s naslouch\u00e1tkem.\u201c Obecn\u011b plat\u00ed, \u017ee pokud je porozum\u011bn\u00ed \u0159e\u010di s dob\u0159e nastaven\u00fdmi naslouch\u00e1tky hor\u0161\u00ed, ne\u017e by se dalo o\u010dek\u00e1vat s CI, doporu\u010duje se implantace. Nejprve je v\u0161ak t\u0159eba se ujistit, \u017ee naslouch\u00e1tko je optim\u00e1ln\u011b p\u0159izp\u016fsoben\u00e9 a vhodn\u00e9 pro u\u017eivatele.<\/p>\n

Pokud u\u017eivatel CI st\u00e1le pou\u017e\u00edv\u00e1 sluchadlo na druh\u00e9 stran\u011b, l\u00e9ka\u0159 doporu\u010d\u00ed implantaci na druh\u00e9 stran\u011b v p\u0159\u00edpad\u011b, \u017ee sluchadlo nevede ke zlep\u0161en\u00ed porozum\u011bn\u00ed \u0159e\u010di.<\/p>\n

U d\u011bt\u00ed je rozhoduj\u00edc\u00edm faktorem v\u00fdvoj sluchu a \u0159e\u010di. \u201eU d\u011bt\u00ed, kter\u00e9 se narodily jako nesly\u0161\u00edc\u00ed nebo u d\u011bt\u00ed, kter\u00e9 ohluchly p\u0159ed osvojen\u00edm si \u0159e\u010di, mus\u00ed toto rozhodnut\u00ed zohlednit mnoho faktor\u016f, jako je v\u00fdvojov\u00e9 stadium d\u00edt\u011bte, jeho komunika\u010dn\u00ed kompetence atd.\u201c zd\u016fraz\u0148uje prim\u00e1\u0159 Keintzel. \u201eV ka\u017ed\u00e9m p\u0159\u00edpad\u011b u d\u011bt\u00ed, kter\u00e9 se narodily jako jednostrann\u011b nesly\u0161\u00edc\u00ed, by rodi\u010de m\u011bli zn\u00e1t omezen\u00ed jednostrann\u00e9ho sly\u0161en\u00ed \u2013 sn\u00ed\u017een\u00e9 porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed, absence sm\u011brov\u00e9ho sly\u0161en\u00ed, a to v\u0161e v citliv\u00e9 f\u00e1zi osvojov\u00e1n\u00ed jazyka.\u201c<\/p>\n

Co m\u016f\u017eete o\u010dek\u00e1vat od kochle\u00e1rn\u00edho implant\u00e1tu<\/h2>\n

CI obch\u00e1z\u00ed vady vnit\u0159n\u00edho ucha a p\u0159\u00edmo stimuluje nervovou strukturu sluchov\u00e9ho org\u00e1nu. Sluchov\u00e9 centrum se mus\u00ed nau\u010dit interpretovat tyto um\u011bl\u00e9 sign\u00e1ly, proto u\u017eivatel pot\u0159ebuje obdob\u00ed rehabilitace a n\u00e1cviku. Na rakousk\u00e9m ORL kongresu v roce 2021 prim\u00e1\u0159 Keintzel demonstroval \u00fasp\u011b\u0161nost kochle\u00e1rn\u00ed implantace. [2]<\/a>Po jednom roce aktivace CI rozum\u00ed t\u0159i \u010dtvrtiny v\u0161ech u\u017eivatel\u016f stejn\u011b dob\u0159e jako typick\u00e9 osoby se sluchov\u00fdm posti\u017een\u00edm se ztr\u00e1tou sluchu 50 decibel\u016f. \u201eZtr\u00e1ta porozum\u011bn\u00ed \u0159e\u010di, kterou lze po nasazen\u00ed CI o\u010dek\u00e1vat, tedy nen\u00ed v\u011bt\u0161\u00ed ne\u017e u st\u0159edn\u011b t\u011b\u017ek\u00e9 ztr\u00e1ty sluchu.\u201c To je v\u00fdsledek i u osob, kter\u00e9 byly d\u0159\u00edve zcela hluch\u00e9.<\/p>\n

Prof. Dr. Ulrich Hoppe, vedouc\u00ed l\u00e9ka\u0159 ORL univerzitn\u00ed nemocnice v Erlangenu, na stejn\u00e9 akci uk\u00e1zal srovn\u00e1n\u00ed porozum\u011bn\u00ed \u0159e\u010di mezi u\u017eivateli CI a naslouch\u00e1tek. V\u011bt\u0161ina u\u017eivatel\u016f CI rozum\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed stejn\u011b jako pacienti se ztr\u00e1tou sluchu 25 a\u017e 50 decibel\u016f se naslouch\u00e1tky. Ve skute\u010dnosti v\u0161ichni u\u017eivatel\u00e9 CI rozum\u011bj\u00ed l\u00e9pe ne\u017e typi\u010dt\u00ed u\u017eivatel\u00e9 naslouch\u00e1tek se ztr\u00e1tou sluchu 65 decibel\u016f.<\/p>\n

Pro kandid\u00e1ta na CI je v\u017edy d\u016fle\u017eit\u00e9 d\u016fkladn\u00e9 zv\u00e1\u017een\u00ed, ale tak\u00e9 rychl\u00e9 rozhodnut\u00ed. Zku\u0161en\u00fd ORL specialista Keintzel vysv\u011btluje pro\u010d: \u201eV\u010dasn\u00e1 kochle\u00e1rn\u00ed implantace vede ke zkr\u00e1cen\u00ed doby rehabilitace a je spojena s lep\u0161\u00edm v\u00fdkonem a v\u00fdrazn\u00fdm zlep\u0161en\u00edm kvality \u017eivota.\u201c<\/p>\n

Dal\u0161\u00ed audiologick\u00e9 informace a podrobn\u00e1 krit\u00e9ria k tomuto t\u00e9matu v: Keintzel T, Limity konven\u010dn\u00edho poskytov\u00e1n\u00ed sluchadel, Jatros Pneumologie & HNO, Universimed-Verlag, 01\/2022, str. 34-36.<\/em><\/p>\n

\n

[1]<\/a>\u00a0Wardegna a kol., 2015<\/p>\n

[2]<\/a>\u00a0\u00dadaje z: Reichell 2015, aus: Kie\u00dfling et al; Versorgung mit H\u00f6rger\u00e4ten und H\u00f6rimplantaten; Thieme-Verlag 2018; ISBN 978-3-13-240200-3<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Sluchov\u00e9 implant\u00e1ty a b\u011b\u017en\u00e1 naslouch\u00e1tka se neust\u00e1le zlep\u0161uj\u00ed a hranice pou\u017eit\u00ed t\u011bchto r\u016fzn\u00fdch syst\u00e9m\u016f se neust\u00e1le m\u011bn\u00ed.<\/p>\n","protected":false},"author":4,"featured_media":31917,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[417,421,412],"class_list":["post-20575","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda","tag-ci","tag-ci-and-hearing-aid","tag-hearing-implants"],"yoast_head":"\nNaslouch\u00e1tko nebo sluchov\u00fd implant\u00e1t? - Czech<\/title>\n<meta name=\"description\" content=\"Naslouch\u00e1tka a sluchov\u00e9 implant\u00e1ty se neust\u00e1le zdokonaluj\u00ed. 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