{"id":206,"date":"2020-06-02T16:51:02","date_gmt":"2020-06-02T14:51:02","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=206"},"modified":"2025-04-17T05:10:06","modified_gmt":"2025-04-17T05:10:06","slug":"reseni-sluchu-pro-jednostrannou-hluchotu","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/reseni-sluchu-pro-jednostrannou-hluchotu\/","title":{"rendered":"\u0158e\u0161en\u00ed sluchu pro jednostrannou hluchotu"},"content":{"rendered":"

R\u016fzn\u00e1 \u0159e\u0161en\u00ed sluchu ve srovn\u00e1n\u00ed<\/h1><\/div>

Pro osoby s jednostrannou hluchotou je k dispozici hned n\u011bkolik \u0159e\u0161en\u00ed. V\u00fdsledky studie hornorakousk\u00e9 nemocnice Wels-Grieskirchen v\u00e1m mohou pomoci ve va\u0161em rozhodov\u00e1n\u00ed.<\/strong><\/p>\n<\/div>

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Aktu\u00e1ln\u00ed studie ukazuj\u00ed, \u017ee: komunika\u010dn\u00ed schopnosti osob se z\u00e1va\u017enou ztr\u00e1tou sluchu na jednom uchu (jednostrann\u00e1 hluchota) jsou hor\u0161\u00ed, ne\u017e se p\u0159edpokl\u00e1dalo. Chyben\u00ed p\u0159\u00edm\u00e9ho sly\u0161en\u00ed spolu s omezen\u00fdm ch\u00e1p\u00e1n\u00edm \u0159e\u010di jsou pova\u017eov\u00e1ny za hlavn\u00ed faktory sni\u017euj\u00edc\u00ed komunika\u010dn\u00ed schopnosti t\u011bchto osob, dal\u0161\u00ed v po\u0159ad\u00ed je pot\u00e9 omezen\u00e1 prostorov\u00e1 orientace. Studie tak\u00e9 ukazuj\u00ed, \u017ee pacienti s jednostrannou hluchotou (SSD) poci\u0165uj\u00ed v\u00fdznamn\u00e1 omezen\u00ed ve sv\u00e9m profesn\u00edm \u017eivot\u011b. I pouh\u00e9 pou\u017e\u00edv\u00e1n\u00ed telefonu s norm\u00e1ln\u011b sly\u0161\u00edc\u00edm uchem pro n\u011b m\u016f\u017ee znamenat probl\u00e9m.<\/p>\n

Volba ide\u00e1ln\u00ed pozice pro sezen\u00ed na sch\u016fdk\u00e1ch nebo ve t\u0159\u00edd\u011b je prvn\u00edm krokem v procesu p\u0159ekon\u00e1v\u00e1n\u00ed t\u011bchto p\u0159ek\u00e1\u017eek, stejn\u011b jako vyu\u017e\u00edv\u00e1n\u00ed r\u016fzn\u00fdch sluchov\u00fdch a komunika\u010dn\u00edch pom\u016fcek [1]<\/a>. Pokud si pacienti p\u0159ej\u00ed trval\u00e9 \u0159e\u0161en\u00ed probl\u00e9m\u016f se sly\u0161en\u00edm, m\u011bli by zv\u00e1\u017eit mo\u017enost technick\u00e9ho sluchov\u00e9ho za\u0159\u00edzen\u00ed. Pro pacienty s jednostrannou hluchotou jsou k dispozici sluchadla CROS, konven\u010dn\u00ed sluchadla, sluchov\u00e9 implant\u00e1ty pro kostn\u00ed p\u0159evod a kochle\u00e1rn\u00ed implant\u00e1ty.<\/p>\n

CROS \u2013 Contralateral Routing of Signal (Kontralater\u00e1ln\u00ed sm\u011brov\u00e1n\u00ed sign\u00e1lu)<\/h2>\n

CROS je kombinac\u00ed sluchadla na nesly\u0161\u00edc\u00edm uchu, kter\u00e9 na posti\u017een\u00e9 stran\u011b zachyt\u00e1v\u00e1 zvukov\u00fd sign\u00e1l, a druh\u00e9ho sluchadla, kter\u00e9 tento zachycen\u00fd sign\u00e1l p\u0159en\u00e1\u0161\u00ed na sly\u0161\u00edc\u00ed ucho. Zvuk m\u016f\u017ee b\u00fdt p\u0159en\u00e1\u0161en p\u0159es br\u00fdle nebo \u2013 d\u00edky modern\u00edm technologi\u00ed \u2013 bezdr\u00e1tov\u011b. Toto \u0159e\u0161en\u00ed zprost\u0159edkov\u00e1v\u00e1 pacient\u016fm ve\u0161ker\u00fd zvukov\u00fd sign\u00e1l, kter\u00fd p\u0159ich\u00e1z\u00ed do nesly\u0161\u00edc\u00edho ucha. Pacienti v\u0161ak nejsou schopni rozpoznat, odkud zvuk p\u0159ich\u00e1z\u00ed. M\u00edra porozum\u011bn\u00ed \u0159e\u010di ve velk\u00e9m hluku se li\u0161\u00ed a z\u00e1vis\u00ed na individu\u00e1ln\u00ed situaci. Pokud je konverza\u010dn\u00ed partner v bl\u00edzkosti nesly\u0161\u00edc\u00edho ucha, porozum\u011bn\u00ed jeho \u0159e\u010di m\u016f\u017ee b\u00fdt lep\u0161\u00ed. Pokud je v\u0161ak konverza\u010dn\u00ed partner v bl\u00edzkosti sly\u0161\u00edc\u00edho ucha a okoln\u00ed hluk p\u0159ich\u00e1z\u00ed ze sm\u011bru nesly\u0161\u00edc\u00edho ucha, m\u016f\u017ee b\u00fdt m\u00edra porozum\u011bn\u00ed se sluchadly CROS hor\u0161\u00ed.<\/p>\n

U\u017eivatel\u00e9 \u010dasto p\u0159ehl\u00ed\u017e\u00ed v\u00fdhody tohoto \u0159e\u0161en\u00ed. P\u0159edev\u0161\u00edm d\u011bti \u010dasto odm\u00edtaj\u00ed no\u0161en\u00ed sluchadel na obou u\u0161\u00edch.[2]<\/a> Syst\u00e9my pro kostn\u00ed p\u0159evod zvuku jsou technick\u00fdm vylep\u0161en\u00edm syst\u00e9mu CROS.<\/p>\n

Pou\u017eit\u00ed kostn\u00edho p\u0159evodu zvuku p\u0159i jednostrann\u00e9 hluchot\u011b<\/h2>\n

Syst\u00e9m pro kostn\u00ed p\u0159evod zvuku pacient nos\u00ed na nesly\u0161\u00edc\u00edm uchu, kde tento syst\u00e9m zachyt\u00e1v\u00e1 zvukov\u00e9 sign\u00e1ly, p\u0159ev\u00e1d\u00ed je na vibrace a ty n\u00e1sledn\u011b p\u0159en\u00e1\u0161\u00ed na sp\u00e1nkovou kost lebky. P\u0159es kosti lebky pak zvuk putuje a\u017e do sly\u0161\u00edc\u00edho ucha na opa\u010dn\u00e9 stran\u011b hlavy pacienta. Syst\u00e9my pro kostn\u00ed veden\u00ed zvuku mohou b\u00fdt seskupeny do speci\u00e1ln\u00edch sluchadel a sluchov\u00fdch implant\u00e1t\u016f kotven\u00fdch v kosti. Oba syst\u00e9my maj\u00ed sv\u00e9 v\u00fdhody i nev\u00fdhody.<\/p>\n

V z\u00e1sad\u011b toto \u0159e\u0161en\u00ed funguje na z\u00e1klad\u011b p\u0159enosu zvukov\u00e9ho sign\u00e1lu do sly\u0161\u00edc\u00edho vnit\u0159n\u00edho ucha, \u010d\u00edm\u017e vlastn\u011b simuluje princi sluchadel CROS za pou\u017eit\u00ed pouze jednoho sluchadla. Pacienti s t\u00edmto typem sluchadel ud\u00e1vaj\u00ed zlep\u0161en\u00ed sly\u0161en\u00ed, ani\u017e by si v\u0161ak mohli u\u017e\u00edvat v\u00fdhod binaur\u00e1ln\u00edho sly\u0161en\u00ed: Je to proto, \u017ee ve\u0161ker\u00e9 zvukov\u00e9 sign\u00e1ly jsou vn\u00edm\u00e1ny jen jednou stranou \u2013 jedn\u00edm vnit\u0159n\u00edm uchem.<\/p>\n

Kochle\u00e1rn\u00ed implant\u00e1ty pro pln\u00e9 obnoven\u00ed sluchu u pacient\u016f s jednostrannou hluchotou<\/h2>\n
\"SSD

Jednostrann\u011b nesly\u0161\u00edc\u00edm lidem se sluchov\u00fdm implant\u00e1tem se v\u00fdrazn\u011b zlep\u0161uje kvalita \u017eivota. \u00a9MED-EL<\/p><\/div>\n

Kochle\u00e1rn\u00ed implant\u00e1t (CI) obch\u00e1z\u00ed nesly\u0161\u00edc\u00ed vnit\u0159n\u00ed ucho a stimuluje p\u0159\u00edmo vl\u00e1kna sluchov\u00e9ho nervu. Aby mohl pacient t\u011b\u017eit z v\u00fdhod kochle\u00e1rn\u00edho implant\u00e1tu, je nav\u00edc doporu\u010dena sluchov\u00e1 rehabilitace a v p\u0159\u00edpad\u011b d\u011bt\u00ed tak\u00e9 brzk\u00fd sluchov\u00fd tr\u00e9nink s \u0159e\u010dov\u00fdm terapeutem.<\/p>\n

V p\u0159\u00edpad\u011b pacient\u016f s kochle\u00e1rn\u00edm implant\u00e1tem a jednostrannou hluchotou je mo\u017en\u00e9, \u017ee bude trvat o n\u011bco d\u00e9le, ne\u017e bude jejich centr\u00e1ln\u00ed nervov\u00e1 soustava schopna spr\u00e1vn\u011b rozpoznat a pochopit zvukov\u00fd sign\u00e1l. Je to kv\u016fli tomu, \u017ee u nich do\u0161lo k p\u0159eveden\u00ed ve\u0161ker\u00e9ho sly\u0161en\u00ed na jedno sly\u0161\u00edc\u00ed ucho. U osob, kter\u00e9 \u017eij\u00ed s jednostrannou hluchotou del\u0161\u00ed dobu, m\u016f\u017ee doch\u00e1zet k reorganizaci korov\u00fdch oblast\u00ed mozku [3]<\/a> Tento jev m\u016f\u017ee prodlou\u017eit proces sluchov\u00e9 rehabilitace. Pokud p\u0159ed n\u00e1stupem jednostrann\u00e9 hluchoty pacient nem\u011bl za\u017eit\u00e9 binaur\u00e1ln\u00ed sly\u0161en\u00ed, jsou doporu\u010dov\u00e1na speci\u00e1ln\u00ed cvi\u010den\u00ed pro lokalizaci zvuku a porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed. Vekou v\u00fdhodou kochle\u00e1rn\u00edch implant\u00e1t\u016f oproti syst\u00e9m\u016fm pro kostn\u00ed veden\u00ed je jejich schopnost elektronick\u00e9 obnovy sly\u0161en\u00ed v nesly\u0161\u00edc\u00edm uchu, \u010d\u00edm\u017e poskytnou z\u00e1klad pro pln\u00e9 binaur\u00e1ln\u00ed sly\u0161en\u00ed u t\u00e9to skupiny pacient\u016f.<\/p>\n

Porovn\u00e1n\u00ed syst\u00e9m\u016f \u2013 prvn\u00ed studie<\/h2>\n

V jedn\u00e9 studii z roku 2015 srovn\u00e1vala skupina expert\u016f z ORL kliniky ve Wels-Grieskirchenu v Rakousku, veden\u00ed l\u00e9ka\u0159em Thomasem Georgem Keintzelem [4]<\/a>, skupiny pacient\u016f s jednostrannou hluchotou (SSD) pou\u017e\u00edvaj\u00edc\u00ed kochle\u00e1rn\u00ed implant\u00e1t s druho skupinou pacient\u016f s jednostrannou hluchotou (SSD), kte\u0159\u00ed vyu\u017e\u00edvaj\u00edc\u00ed semi-implantovan\u00fdch sluchov\u00fdch implant\u00e1t\u016f BONEBRIDGE kotven\u00fdch v kosti. U pacient\u016f se hodnotila m\u00edra porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed a lokalizace zvuku Subjektivn\u00ed zlep\u0161en\u00ed kvality jejich \u017eivota bylo hodnoceno za pomoci speci\u00e1ln\u00edho dotazn\u00edku.<\/p>\n

V\u00fdsledky prok\u00e1zaly, \u017ee u\u017eivatel\u00e9 obou syst\u00e9m\u016f ud\u00e1vaj\u00ed lep\u0161\u00ed porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00fdch podm\u00ednk\u00e1ch a tak\u00e9 zlep\u0161en\u00ed kvality \u017eivota d\u00edky sluchov\u00fdm implant\u00e1t\u016fm. Studie prok\u00e1zala zna\u010dn\u00fd rozd\u00edl ve schopnosti lokalizace zdroje zvukov\u00e9ho sign\u00e1lu, v n\u011bm\u017e u\u017eivatel\u00e9 kochle\u00e1rn\u00edch implant\u00e1t\u016f z\u00edskali o pozn\u00e1n\u00ed v\u00edce bod\u016f ne\u017e pacienti se sluchov\u00fdmi implant\u00e1ty kotven\u00fdmi v kosti. Ob\u011b skupiny pacient\u016f vykazuj\u00ed zna\u010dn\u00e9 zlep\u0161en\u00ed kvality \u017eivota.<\/p>\n

Klinick\u00e1 zku\u0161enost<\/h2>\n

P\u0159i v\u00fdb\u011bru syst\u00e9mu implant\u00e1tu pro konkr\u00e9tn\u00edho pacienta doporu\u010duje Thomas Keintzel zhodnotit, jestli je hlavn\u00edm c\u00edle zlep\u0161it m\u00edru porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed, nebo pacient tou\u017e\u00ed i po zlep\u0161en\u00ed prostorov\u00e9ho vn\u00edm\u00e1n\u00ed zvuku.\u201c<\/p>\n

\u00dasp\u011bch s implant\u00e1ty Bonebridge pro pacienty s jednostrannou hluchotou vy\u017eaduje dobr\u00fd sluch na druh\u00e9m uchu. Kr\u00e1tk\u00e1 f\u00e1ze rehabilitace a zlep\u0161en\u00ed porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed jsou argumenty pro Bonebridge, omezen\u00e9 prostorov\u00e9 vn\u00edm\u00e1n\u00ed zvuku je pak argumentem proti tomuto \u0159e\u0161en\u00ed.<\/p>\n

Thomas Keintzel vysv\u011btluje: \u201ePro dosa\u017een\u00ed \u00fasp\u011bchu kochle\u00e1rn\u00edho implant\u00e1tu u pacient\u016f s jednostrannou hluchotou by nem\u011bl b\u00fdt pacient bez sluchu po dobu del\u0161\u00ed ne\u017e 10 let. Pacienti mus\u00ed b\u00fdt odhodlan\u00ed a motivovan\u00ed \u00fa\u010dastnit se aktivn\u011b rehabilita\u010dn\u00edch cvi\u010den\u00ed a musrj\u00ed m\u00edt tak\u00e9 realistick\u00e1 o\u010dek\u00e1v\u00e1n\u00ed. Pokud tato krit\u00e9ria spl\u0148uj\u00ed, je pravd\u011bpodobn\u00e9, \u017ee tito pacienti s jednostrannou hluchotou zaznamenaj\u00ed po implantaci velk\u00e9 zlep\u0161en\u00ed ve smyslu porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed. Krom\u011b toho mohou z\u00edskat zp\u011bt i sv\u00e9 prostorov\u00e9 vn\u00edm\u00e1n\u00ed zvuku a t\u011b\u017eit tak z lep\u0161\u00ed prostorov\u00e9 orientace.<\/p>\n

\n

[1]<\/a> Lieu J. E. C., Management of Children with Unilateral Hearing Loss, Otolaryngol Clin N Am, 2015, http:\/\/dx.doi.org\/10.1016\/j.otc.2015.07.006.<\/p>\n

[2]<\/a> like1<\/sup><\/p>\n

[3]<\/a> See Research for good hearing, implantable hearing systems – interview with Prof. Dr. Andrej Kral, taken from: Schnecke, edition 82, p. 11f, December 2013<\/p>\n

[4]<\/a> See Article in hear to read<\/em>, special edition April 2015, p. 30ff.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

Pro osoby s jednostrannou hluchotou je k dispozici hned n\u011bkolik \u0159e\u0161en\u00ed. The results from a study of the Upper Austrian Hospital Wels-Grieskirchen may help you make a choice.<\/p>\n","protected":false},"author":5,"featured_media":32090,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[419,412,420],"class_list":["post-206","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda","tag-bilateral","tag-hearing-implants","tag-unilateral-hearing-loss"],"yoast_head":"\n\u0158e\u0161en\u00ed sluchu pro jednostrannou hluchotu - Czech<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lifelonghearing.com\/cs\/reseni-sluchu-pro-jednostrannou-hluchotu\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0158e\u0161en\u00ed sluchu pro jednostrannou hluchotu - Czech\" \/>\n<meta property=\"og:description\" content=\"Pro osoby s jednostrannou hluchotou je k dispozici hned n\u011bkolik \u0159e\u0161en\u00ed. 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