{"id":217,"date":"2020-06-03T10:07:45","date_gmt":"2020-06-03T08:07:45","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=217"},"modified":"2025-04-17T05:09:43","modified_gmt":"2025-04-17T05:09:43","slug":"vice-nez-soucet-jeho-casti","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/vice-nez-soucet-jeho-casti\/","title":{"rendered":"V\u00edce ne\u017e sou\u010det jeho \u010d\u00e1st\u00ed"},"content":{"rendered":"

Co m\u016f\u017ee p\u0159in\u00e9st sly\u0161en\u00ed ob\u011bma u\u0161ima<\/h1><\/div>

Na\u0161e druh\u00e9 ucho je v\u00edce ne\u017e jen z\u00e1loha pro n\u00e1\u0161 sluch: v\u00fdznamn\u011b usnad\u0148uje n\u00e1\u0161 ka\u017edodenn\u00ed \u017eivot. Proto odborn\u00edci v\u017edy doporu\u010duj\u00ed obnoven\u00ed sluchu v obou u\u0161\u00edch.<\/strong><\/p>\n<\/div>

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V roce 1984 zve\u0159ejnili ameri\u010dt\u00ed v\u011bdci Fred H. Bess a Anne Marie Tharpe \u00fadaje o \u00fa\u010dinc\u00edch jednostrann\u00e9 ztr\u00e1ty sluchu u d\u011bt\u00ed, kter\u00e9 byly podpo\u0159eny mnoha dal\u0161\u00edmi studiemi v n\u00e1sleduj\u00edc\u00edch letech: D\u011bti s jednostrannou ztr\u00e1tou sluchu jsou n\u00e1chyln\u011bj\u0161\u00ed k probl\u00e9m\u016fm v jazykov\u00e9m a \u0159e\u010dov\u00e9m v\u00fdvoji, ve vzd\u011bl\u00e1v\u00e1n\u00ed a v soci\u00e1ln\u011b-emo\u010dn\u00edm v\u00fdvoji ve srovn\u00e1n\u00ed se sv\u00fdmi vrstevn\u00edky s norm\u00e1ln\u00edm sluchem na obou u\u0161\u00edch. Rovn\u011b\u017e prok\u00e1zali v\u00fdrazn\u011b hor\u0161\u00ed porozum\u011bn\u00ed \u0159e\u010di a schopnost lokalizace zvuku.<\/p>\n

To samoz\u0159ejm\u011b tak\u00e9 ovliv\u0148uje akademick\u00fd v\u00fdkon: mezi t\u011bmito d\u011btmi bylo procento \u017e\u00e1k\u016f, kte\u0159\u00ed pot\u0159ebovali opakovat alespo\u0148 jeden rok, vy\u0161\u0161\u00ed ne\u017e pr\u016fm\u011br a a\u017e 60 % z nich vy\u017eadovalo extra dou\u010dov\u00e1n\u00ed po dobu n\u011bkolika let. D\u011bti s jednostrannou ztr\u00e1tou sluchu, kter\u00fdm se nedostalo \u017e\u00e1dn\u00e9 zvl\u00e1\u0161tn\u00ed p\u00e9\u010de, \u010delily v\u00e1\u017en\u011bj\u0161\u00edm akademick\u00fdm probl\u00e9m\u016fm ne\u017e d\u011bti s bilater\u00e1ln\u00ed hlubokou ztr\u00e1tou sluchu.<\/p>\n

Dosp\u011bl\u00ed s jednostrannou ztr\u00e1tou sluchu nevykazuj\u00ed tak nep\u0159\u00edzniv\u00fd vliv na v\u00fdvoj jazyka nebo na akademick\u00e9 v\u00fdsledky, p\u0159esto se pot\u00fdkaj\u00ed s obt\u00ed\u017eemi v rodinn\u00e9m a profesn\u00edm \u017eivot\u011b. Dosp\u011bl\u00ed i d\u011bti s jednostrann\u00fdmi poruchami sluchu obecn\u011b trp\u00ed sn\u00ed\u017eenou kvalitou \u017eivota.<\/p>\n

Otestov\u00e1no<\/h2>\n

\u201eV\u017edy jsem miloval hudbu,\u201c p\u0159ipou\u0161t\u00ed Ewald Thurner, oblastn\u00ed mana\u017eer spole\u010dnosti MED-EL V\u00edde\u0148. Vzpom\u00edn\u00e1 na sv\u00e1 teen l\u00e9ta: \u201eM\u016fj otec m\u011bl obrovsk\u00fd star\u00fd magnetofon. Kdy\u017e jste pou\u017eili dva mikrofony, mohli jste nahr\u00e1vat stereofonn\u011b.\u201c Zvl\u00e1\u0161tn\u00ed technick\u00fd efekt na n\u011bj hluboce zap\u016fsobil: \u201eMagnetofon m\u011bl mono tla\u010d\u00edtko: Kdy\u017e jsem zav\u0159el o\u010di a poslouchal stereofonn\u00ed z\u00e1znam, skoro jsem vid\u011bl orchestr hr\u00e1t p\u0159ede mnou. Kdy\u017e jsem stiskl tla\u010d\u00edtko Mono, sv\u011bt kolem m\u011b se najednou omezil na \u00fazkou linii v m\u00e9 hlav\u011b.\u201c Krout\u00ed hlavou, jako by cht\u011bl set\u0159\u00e1st tyto vzpom\u00ednky. \u201eTento efekt na m\u011b hluboce zap\u016fsobil, zkou\u0161el jsem to znovu a znovu.\u201c<\/p>\n

\u201eKdyby m\u011bl magnetofon \u201ajednostrann\u00e9\u2018 tla\u010d\u00edtko, chyb\u011blo by je\u0161t\u011b v\u00edce zvukov\u00fdch informac\u00ed ne\u017e p\u0159i nastaven\u00ed mono,\u201c je Thurner p\u0159esv\u011bd\u010den. Abyste pln\u011b porozum\u011bli jednostrann\u00e9mu sluchu, m\u016f\u017eete vyt\u00e1hnout jeden reproduktor stereofonn\u00edho syst\u00e9mu a nepou\u017e\u00edt voln\u00fd v\u00fdstup.<\/p>\n

Snadnost binaur\u00e1ln\u00edho sluchu<\/h2>\n

\u201eD\u00edky kombinaci binaur\u00e1ln\u00ed sumace, binaur\u00e1ln\u00edho maskov\u00e1n\u00ed a efektu akustick\u00e9ho st\u00ednu je sluch a porozum\u011bn\u00ed snadn\u00e9. To je to, co lidi s bilater\u00e1ln\u00edm sluchem bav\u00ed\u201c, p\u00ed\u0161e Judith EC Lieu ve sv\u00e9 v\u011bdeck\u00e9 pr\u00e1ci o v\u00fdhod\u00e1ch bilater\u00e1ln\u00edho sluchu. Binaur\u00e1ln\u00ed sumace je snadno srozumiteln\u00e1 a zvl\u00e1\u0161t\u011b patrn\u00e1 u jemn\u00fdch zvuk\u016f: Kdy\u017e sly\u0161\u00edte dv\u011bma u\u0161ima, sly\u0161\u00edte v\u0161e dvakr\u00e1t, a proto hlasit\u011bji. Aristotelova citace \u201eCelek je v\u00edce ne\u017e sou\u010det jeho \u010d\u00e1st\u00ed\u201c \u2013 plat\u00ed tak\u00e9 pro bilater\u00e1ln\u00ed, tj. binaur\u00e1ln\u00ed sluch. Chcete-li vysv\u011btlit dal\u0161\u00ed faktory, mus\u00edte se pod\u00edvat na fyzik\u00e1ln\u00ed z\u00e1kony.<\/p>\n

V\u011bdci z renomovan\u00e9ho \u00dastavu pro v\u00fdzkum akustiky ve V\u00eddni, kter\u00fd je sou\u010d\u00e1st\u00ed Rakousk\u00e9 akademie v\u011bd, studuj\u00ed fyzik\u00e1ln\u00ed a psychoakustick\u00e9 vztahy sluchu se sluchadly i bez nich. Fyzika pova\u017euje hlavu za p\u0159ek\u00e1\u017eku zvukov\u00fdch vln, kter\u00e1 vytv\u00e1\u0159\u00ed st\u00edn na ur\u010dit\u00fdch frekvenc\u00edch. U n\u011bkter\u00fdch v\u00fd\u0161ek to vede k rozd\u00edl\u016fm \u00farovn\u00ed mezi ob\u011bma u\u0161ima (obr. 1). Zvuk se nav\u00edc m\u016f\u017ee dostat do obou u\u0161\u00ed ve stejnou chv\u00edli, pokud je zdroj zvuku um\u00edst\u011bn p\u0159esn\u011b uprost\u0159ed, za nebo nad poslucha\u010dem. Jak\u00e9koli jin\u00e9 um\u00edst\u011bn\u00ed povede k minim\u00e1ln\u00edmu \u010dasov\u00e9mu zpo\u017ed\u011bn\u00ed mezi ob\u011bma u\u0161ima (obr. 2). Odborn\u00edci tomu \u0159\u00edkaj\u00ed interaur\u00e1ln\u00ed \u010dasov\u00fd rozd\u00edl.<\/p>\n

\"Illustration

Illustration interaural time difference<\/p><\/div>\n

\u010c\u00e1sti na\u0161eho ucha, kter\u00e9 zpracov\u00e1vaj\u00ed zvuk, pou\u017e\u00edvaj\u00ed tyto drobn\u00e9 rozd\u00edly k ur\u010den\u00ed polohy zdroje zvuku. Pokud existuje v\u00edce ne\u017e jeden zdroj zvuku, pom\u00e1h\u00e1 tento jev potla\u010dit ru\u0161iv\u00fd hluk.<\/p>\n

N\u00e1\u0161 mozek se chce u\u010dit \u2013 chce sly\u0161et<\/h2>\n

Jednostrann\u00e1 hluchota m\u00e1 na mozek dalekos\u00e1hl\u00e9 \u00fa\u010dinky. Profesor Andrej Kral je p\u0159edn\u00edm audiologick\u00fdm neurologem na Hannover Medical School v N\u011bmecku. V rozhovoru pro n\u011bmeck\u00fd \u010dasopis na\u010drtl plasticitu mozku: \u201eZtr\u00e1ta sluchu, kter\u00e1 vede k nerovnov\u00e1ze mezi ob\u011bma u\u0161ima nebo mezi frekvencemi, je obzvl\u00e1\u0161t\u011b \u00fa\u010dinn\u00fdm spou\u0161t\u011b\u010dem proces\u016f plasticity.\u201c<\/p>\n

Sluchov\u00e1 \u010d\u00e1st mozku bude reorganizov\u00e1na a nepou\u017eit\u00e9 \u010d\u00e1sti na\u0161eho centr\u00e1ln\u00ed sluchov\u00e9 oblasti budou pou\u017eity pro dal\u0161\u00ed sluchov\u00e9 funkce. To plat\u00ed pro cel\u00fd n\u00e1\u0161 \u017eivot, \u00fa\u010dinky jsou obzvl\u00e1\u0161t\u011b siln\u00e9 v d\u011btstv\u00ed: \u201eV\u011bt\u0161ina synaps\u00ed ve sluchov\u00e9 k\u016f\u0159e se za\u010d\u00edn\u00e1 rozv\u00edjet po narozen\u00ed a spol\u00e9h\u00e1 se na sluchov\u00e9 vstupy. Pokud chyb\u00ed, dojde ke zpo\u017ed\u011bn\u00ed synaptick\u00e9ho v\u00fdvoje a mnoho synaps\u00ed pozd\u011bji ustoup\u00ed.\u201c<\/p>\n

\u201eVe studii z roku 2013 jsme prok\u00e1zali, \u017ee v\u00fdrazn\u00e9 rozd\u00edly mezi lev\u00fdm a prav\u00fdm uchem vedou k reorganizaci plasticity mozku a v d\u016fsledku toho k \u201asiln\u011bj\u0161\u00edmu\u2018 a \u201aslab\u0161\u00edmu\u2018 uchu,\u201c vysv\u011btluje Kral dlouhodob\u011b \u00fa\u010dinky jednostrann\u00e9ho sluchu. Stejn\u011b jako ostatn\u00ed sluchov\u00e9 schopnosti se binaur\u00e1ln\u00ed sluch rozv\u00edj\u00ed hlavn\u011b v d\u011btstv\u00ed.<\/p>\n

Sluchov\u00e9 implant\u00e1ty pro binaur\u00e1ln\u00ed sluch<\/strong><\/h2>\n

U d\u011bt\u00ed se sluchov\u00fdm posti\u017een\u00edm doporu\u010duj\u00ed odborn\u00edci a profesn\u00ed sdru\u017een\u00ed v mnoha zem\u00edch sluchadla v obou u\u0161\u00edch. Mnoho n\u00e1rodn\u00edch zdravotnick\u00fdch \u00fa\u0159ad\u016f poskytuje binaur\u00e1ln\u00ed sluchadla nebo implant\u00e1ty pracuj\u00edc\u00edm dosp\u011bl\u00fdm, proto\u017ee sluch dv\u011bma u\u0161ima zlep\u0161\u00ed jejich porozum\u011bn\u00ed \u0159e\u010di, zejm\u00e9na pokud je p\u0159\u00edtomen v pozad\u00ed hluk.<\/p>\n

Technickou podporu pro u\u017eivatele kochle\u00e1rn\u00edch implant\u00e1t\u016f m\u00e1 na starosti od roku 1993 Ewald Thurner, kter\u00fd je profesion\u00e1ln\u00edm in\u017een\u00fdrem. Prvn\u00ed bilater\u00e1ln\u00ed kochle\u00e1rn\u00ed implantace, vzpom\u00edn\u00e1, byla v roce 1996. \u201eS kochle\u00e1rn\u00edm implant\u00e1tem v jednom uchu dos\u00e1hli u\u017eivatel\u00e9, kte\u0159\u00ed p\u0159edt\u00edm nic nesly\u0161eli, celkem dobr\u00e9ho porozum\u011bn\u00ed \u0159e\u010di. Sledov\u00e1n\u00ed ka\u017edodenn\u00edch rozhovor\u016f jim v\u0161ak vy\u017eadovalo mnoho naslouchac\u00edho \u00fasil\u00ed. Tato nutnost poslechov\u00e9ho sna\u017een\u00ed byla drasticky sn\u00ed\u017eena pomoc\u00ed oboustrann\u00e9 implantace. Poslech se jednodu\u0161e stal snaz\u0161\u00edm.\u201c<\/p>\n

V\u00fdzkum ji\u017e dlouho prokazuje v\u00fdhody binaur\u00e1ln\u00edho sluchu, \u0159\u00edk\u00e1 V\u00fdzkumn\u00fd \u00fastav akustiky. \u201e\u010cetn\u00e9 klinick\u00e9 studie jasn\u011b prok\u00e1zaly v\u00fdhody bilater\u00e1ln\u00edch kochle\u00e1rn\u00edch implant\u00e1t\u016f. Ve srovn\u00e1n\u00ed s jednostrann\u00fdmi p\u0159\u00edjemci CI maj\u00ed oboustrann\u00ed u\u017eivatel\u00e9 lep\u0161\u00ed lokaliza\u010dn\u00ed schopnosti zvuku a lep\u0161\u00ed m\u00edru porozum\u011bn\u00ed \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed.\u201c<\/p>\n

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V\u00fdhody binaur\u00e1ln\u00edho sluchu a oboustrann\u00e9 implantace<\/strong><\/p>\n

    \n
  • Lokalizace: Je mo\u017en\u00e9 akusticky ur\u010dit, odkud zvuk p\u0159ich\u00e1z\u00ed. To je zvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e9 v nebezpe\u010dn\u00fdch situac\u00edch.<\/li>\n
  • Porozum\u011bn\u00ed \u0159e\u010di v hluku: Mnoho ka\u017edodenn\u00edch situac\u00ed a velk\u00e1 \u010d\u00e1st na\u0161eho spole\u010densk\u00e9ho \u017eivota se odehr\u00e1v\u00e1 v hlu\u010dn\u00e9m prost\u0159ed\u00ed<\/li>\n
  • Sumace hlasitosti: Poslech dv\u011bma u\u0161ima zvy\u0161uje hlasitost zvuku. To m\u016f\u017ee b\u00fdt nezbytn\u00e9 pro sly\u0161en\u00ed jemn\u00fdch zvuk\u016f.<\/li>\n
  • Vyv\u00e1\u017een\u00fd sluch \u2013 trojrozm\u011brn\u00fd sluchov\u00fd dojem<\/li>\n
  • V\u017edy sly\u0161\u00edte a rozum\u00edte dob\u0159e, bez ohledu na to, odkud zvuk vych\u00e1z\u00ed<\/li>\n
  • Rychlej\u0161\u00ed v\u00fdvoj sluchu a \u0159e\u010di u d\u011bt\u00ed<\/li>\n
  • \u201eSnadn\u011bj\u0161\u00ed\u201c poslech: sn\u00ed\u017een\u00e9 naslouchac\u00ed \u00fasil\u00ed vede ke sn\u00ed\u017een\u00ed \u00fanavy a lep\u0161\u00ed koncentraci<\/li>\n
  • V\u011bt\u0161\u00ed bezpe\u010dnost v ka\u017edodenn\u00edch situac\u00edch, proto\u017ee poslucha\u010di l\u00e9pe sly\u0161\u00ed a lokalizuj\u00ed varovn\u00e9 sign\u00e1ly<\/li>\n
  • \u017d\u00e1dn\u00e1 jednostrann\u00e1 deprivace: dlouhodob\u00fd nedostatek sluchov\u00e9 informace pro sluchov\u00fd nerv, tj. nedostatek neuron\u00e1ln\u00ed stimulace a deprivace, m\u016f\u017ee m\u00edt dalekos\u00e1hl\u00e9 d\u016fsledky pro ur\u010dit\u00e9 neuron\u00e1ln\u00ed a kortik\u00e1ln\u00ed oblasti mozku. Mohlo by to v\u00e9st k po\u0161kozen\u00ed nezbytn\u00fdch sluchov\u00fdch struktur nebo k rozvoji fantomov\u00fdch vjem\u016f.<\/li>\n
  • Pozitivn\u00ed \u00fa\u010dinky na lidi n\u00e1chyln\u00e9 k tinnitu (hu\u010den\u00ed v u\u0161\u00edch), kter\u00fd je \u010dasto vid\u011bt u ztr\u00e1ty sluchu.<\/li>\n<\/ul>\n<\/blockquote>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

    Na\u0161e druh\u00e9 ucho je v\u00edce ne\u017e jen z\u00e1loha pro n\u00e1\u0161 sluch: v\u00fdznamn\u011b usnad\u0148uje n\u00e1\u0161 ka\u017edodenn\u00ed \u017eivot. Proto odborn\u00edci v\u017edy doporu\u010duj\u00ed obnoven\u00ed sluchu v obou u\u0161\u00edch.<\/p>\n","protected":false},"author":5,"featured_media":32083,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[419,412],"class_list":["post-217","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda","tag-bilateral","tag-hearing-implants"],"yoast_head":"\nV\u00edce ne\u017e sou\u010det jeho \u010d\u00e1st\u00ed - 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\/vice-nez-soucet-jeho-casti\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"V\u00edce ne\u017e sou\u010det jeho \u010d\u00e1st\u00ed - Czech\" \/>\n<meta property=\"og:description\" content=\"Na\u0161e druh\u00e9 ucho je v\u00edce ne\u017e jen z\u00e1loha pro n\u00e1\u0161 sluch: v\u00fdznamn\u011b usnad\u0148uje n\u00e1\u0161 ka\u017edodenn\u00ed \u017eivot. 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