{"id":250,"date":"2020-06-03T16:08:49","date_gmt":"2020-06-03T14:08:49","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=250"},"modified":"2025-05-01T13:05:49","modified_gmt":"2025-05-01T13:05:49","slug":"vyhody-oboustranne-implantace","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/vyhody-oboustranne-implantace\/","title":{"rendered":"V\u00fdhody oboustrann\u00e9 implantace"},"content":{"rendered":"

Bilateral implants as a standard care for people with hearing loss<\/h1><\/div>

D\u011bti, kter\u00e9 se narod\u00ed s hlubokou ztr\u00e1tou sluchu, dost\u00e1vaj\u00ed kochle\u00e1rn\u00ed implant\u00e1ty do obou u\u0161\u00ed ji\u017e ve velmi n\u00edzk\u00e9m v\u011bku. Dosp\u011bl\u00ed, kte\u0159\u00ed p\u0159ijdou o sluch, jsou \u010dasto mnohem v\u00e1hav\u011bj\u0161\u00ed. P\u0159esto m\u016f\u017ee oboustrann\u00e1 implantace prosp\u011bt i u\u017eivatel\u016fm, kte\u0159\u00ed dostali sv\u016fj prvn\u00ed kochle\u00e1rn\u00ed implant\u00e1t ji\u017e p\u0159ed mnoha lety.<\/strong><\/p>\n<\/div>

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V sou\u010dasnosti jsou kochle\u00e1rn\u00ed implant\u00e1ty do obou u\u0161\u00ed – oboustrann\u00e9 implant\u00e1ty – pova\u017eov\u00e1ny za standardn\u00ed p\u00e9\u010di o pacienty s hlubokou ztr\u00e1tou sluchu. V za\u010d\u00e1tc\u00edch kochle\u00e1rn\u00ed implantace to p\u0159itom bylo nemysliteln\u00e9. P\u0159ed zaveden\u00edm implant\u00e1tu do jednoho ucha bylo t\u0159eba mnoho p\u0159edopera\u010dn\u00edch test\u016f. L\u00e9ka\u0159i cht\u011bli m\u00edt jistotu, \u017ee sluchov\u00fd nerv, kter\u00fd je p\u0159edpokladem \u00fasp\u011b\u0161n\u00e9 kochle\u00e1rn\u00ed implantace, z\u016fstane pln\u011b funk\u010dn\u00ed. A cht\u011bli naj\u00edt “lep\u0161\u00ed ucho”.<\/p>\n

Pokud byly v\u00fdsledky sluchov\u00fdch test\u016f u obou u\u0161\u00ed podobn\u00e9, obvykle doporu\u010dovali ucho s men\u0161\u00ed sluchovou deprivac\u00ed nebo ucho s v\u00edce zbytkov\u00e9ho sluchu. Pro pacienty to bylo obt\u00ed\u017en\u00e9 rozhodnut\u00ed, proto\u017ee implanta\u010dn\u00ed technologie a chirurgick\u00e9 techniky v t\u00e9 dob\u011b obvykle vedly ke ztr\u00e1t\u011b zbytkov\u00e9ho sluchu. M\u011bli tedy na v\u00fdb\u011br mezi sluchovou prot\u00e9zou nebo ponech\u00e1n\u00edm toho, co z jejich sluchu zbylo. U\u017eivatel\u00e9 bez v\u00fdjimky uv\u00e1d\u011bli, \u017ee pro n\u011b bylo velkou \u00falevou znovu sly\u0161et a moci se op\u011bt \u00fa\u010dastnit spole\u010densk\u00e9ho \u017eivota se sv\u00fdmi rodinami a p\u0159\u00e1teli.<\/p>\n

Pr\u016fkopn\u00edci mezi u\u017eivateli<\/h2>\n

Jedn\u00edm z prvn\u00edch u\u017eivatel\u016f byl l\u00e9k\u00e1rn\u00edk Rolf, kter\u00fd byl s kochle\u00e1rn\u00edm implant\u00e1tem MED-EL Combi 40 velmi spokojen\u00fd. Byl spokojen natolik, \u017ee cht\u011bl implant\u00e1t i do druh\u00e9ho ucha. Jeho p\u0159\u00e1n\u00ed nakonec splnila v roce 1998 klinika ENT. Ve stejn\u00e9m roce n\u00e1sledoval mal\u00fd Max, tehdy \u010dty\u0159let\u00fd, jen\u017e se stal prvn\u00edm d\u00edt\u011btem s oboustrann\u00fdmi kochle\u00e1rn\u00edmi implant\u00e1ty. V\u00fdsledky u dosp\u011bl\u00fdch u\u017eivatel\u016f oboustrann\u00fdch kochle\u00e1rn\u00edch implant\u00e1t\u016f byly natolik p\u0159esv\u011bd\u010div\u00e9, \u017ee se l\u00e9ka\u0159i rozhodli vsazovat oboustrann\u00e9 implant\u00e1ty i d\u011btem.<\/p>\n

Od t\u00e9 doby mnoho klinik nab\u00edz\u00ed oboustrannou implantaci nov\u011b diagnostikovan\u00fdm nesly\u0161\u00edc\u00edm d\u011btem: bu\u010f je prov\u00e1d\u011bna simult\u00e1nn\u011b b\u011bhem jednoho chirurgick\u00e9ho z\u00e1kroku, vy\u017eaduj\u00edc\u00edho pouze jednu anest\u00e9zii, nebo v r\u00e1mci po sob\u011b jdouc\u00edch implantac\u00ed s kr\u00e1tkou prodlevou mezi chirurgick\u00fdmi z\u00e1kroky v rozmez\u00ed \u0161esti a\u017e 18 m\u011bs\u00edc\u016f.<\/p>\n

Pl\u00e1nov\u00e1n\u00ed v\u00edkend\u016f s kochle\u00e1rn\u00edmi implant\u00e1ty<\/h2>\n

P\u00e1tek odpoledne, 15 h Vol\u00e1 rozru\u0161en\u00e1 matka: \u201eNiko v\u016fbec nesly\u0161\u00ed. Z\u00edtra m\u00e1 narozeninovou oslavu, je mu sedm, pozvali jsme klauna i v\u0161echny jeho kamar\u00e1dy. M\u016f\u017eeme k v\u00e1m pros\u00edm hned p\u0159ij\u00edt?!” Na p\u0159elomu stolet\u00ed ne\u0161lo o neobvykl\u00fd telefon\u00e1t. U\u017eivatel\u00e9 kochle\u00e1rn\u00edch implant\u00e1t\u016f byli obvykle hluboce nesly\u0161\u00edc\u00ed na ob\u011b u\u0161i, ale v\u011bt\u0161ina z nich m\u011bla pouze jeden implant\u00e1t. N\u011bkdy \u0161lo jen o zkroucen\u00fd kontakt baterie nebo nespr\u00e1vn\u011b nastaven\u00fd sp\u00edna\u010d na procesoru. Pokud u\u017eivatel\u00e9 nedok\u00e1zali vy\u0159e\u0161it probl\u00e9m sami, museli by str\u00e1vit v\u00edkend v tichu, pokud by nebyli k dispozici odborn\u00edci na kochle\u00e1rn\u00ed implant\u00e1ty z MED-EL, kte\u0159\u00ed prov\u00e1d\u011bli rychl\u00e9 opravy. Zejm\u00e9na pro d\u011bti byla takov\u00e1 situace psychickou katastrofou. Ale i pro dosp\u011bl\u00e9 to m\u016f\u017ee b\u00fdt n\u00e1ro\u010dn\u00e9.<\/p>\n

N\u011bkdy dokonce m\u016f\u017ee j\u00edt i o zdravotn\u00ed riziko. Jeden u\u010ditel na z\u00e1kladn\u00ed \u0161kole si jednou st\u011b\u017eoval: \u201ePokud nesly\u0161\u00edc\u00edmu d\u00edt\u011bti s jedn\u00edm implant\u00e1tem do\u0161ly baterie, volali jsme rodi\u010d\u016fm. M\u011bli jsme strach, \u017ee by cestou dom\u016f na ulici nic nesly\u0161elo.<\/p>\n

V\u00fdhody druh\u00e9 strany<\/h2>\n

Rolf m\u011bl pravdu, kdy\u017e trval tom, \u017ee chce druh\u00fd implant\u00e1t. P\u0159in\u00e1\u0161\u00ed to skute\u010dn\u011b v\u00edce v\u00fdhod ne\u017e jen jistotu z\u00e1lohy a z\u00e1ruku, \u017ee budete m\u00edt implant\u00e1t v lep\u0161\u00edm uchu. Nejd\u016fle\u017eit\u011bj\u0161\u00edmi v\u00fdhodami oboustrann\u00e9 implantace jsou lokalizace zvuku a schopnost zjistit, zda je zdroj zvuku um\u00edst\u011bn na lev\u00e9 nebo prav\u00e9 stran\u011b hlavy.<\/p>\n

V\u0161echny dal\u0161\u00ed p\u0159ednosti vypl\u00fdvaj\u00ed z t\u011bchto dvou v\u00fdhod, podobn\u00fdch v\u00fdhod\u00e1m binaur\u00e1ln\u00edho sluchu u lid\u00ed se dv\u011bma pln\u011b funk\u010dn\u00edma u\u0161ima[1]<\/a>. Pozorovali to odborn\u00edci na W\u00fcrzburgsk\u00e9 univerzitn\u00ed klinice u sv\u00fdch prvn\u00edch dvou pacient\u016f s oboustrann\u00fdmi kochle\u00e1rn\u00edmi implant\u00e1ty. Sv\u00e1 zji\u0161t\u011bn\u00ed publikovali ve v\u011bdeck\u00e9 studii. Porozum\u011bn\u00ed \u0159e\u010di na pozad\u00ed \u0161umu se p\u0159i pou\u017eit\u00ed oboustrann\u00fdch kochle\u00e1rn\u00edch implant\u00e1t\u016f u v\u0161ech \u00fa\u010dastn\u00edk\u016f studie v\u00fdrazn\u011b zlep\u0161ilo. N\u00e1sledovalo mnoho studi\u00ed o porozum\u011bn\u00ed \u0159e\u010di a lokalizaci zvuku. V\u011bdci se shodovali jako nikdy d\u0159\u00edve: oboustrann\u00e1 implantace m\u00e1 pro u\u017eivatele kochle\u00e1rn\u00edch implant\u00e1t\u016f s oboustrannou hluchotou jednozna\u010dn\u00e9 v\u00fdhody.<\/p>\n

\"A

Nejv\u00fdznamn\u011bj\u0161\u00ed v\u00fdhodou oboustrann\u00e9 implantace je spr\u00e1vn\u00e1 lokalizace, kter\u00e1 obzvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e1 v nebezpe\u010dn\u00fdch situac\u00edch.<\/p><\/div>\n

Co nejd\u0159\u00edve<\/h2>\n

Specialist\u00e9 na kochle\u00e1rn\u00ed implant\u00e1ty Joachim M\u00fcller, Franz Sch\u00f6n a Jan Helms, auto\u0159i prvn\u00ed studie o oboustrann\u00e9 kochle\u00e1rn\u00ed implantaci, dosp\u011bli k z\u00e1v\u011bru, \u017ee p\u0159\u00ednos druh\u00e9ho implant\u00e1tu se zd\u00e1 b\u00fdt nez\u00e1visl\u00fd na \u010dasov\u00e9m obdob\u00ed mezi prvn\u00ed a druhou implantac\u00ed. Toto zji\u0161t\u011bn\u00ed je v\u0161ak zm\u00edr\u0148ov\u00e1no t\u00edm, co v\u00edme o neuron\u00e1ln\u00edch v\u00fdvojov\u00fdch procesech. \u201eN\u00e1\u0161 mozek z\u00e1vis\u00ed na kontaktech mezi nervov\u00fdmi bu\u0148kami, takzvan\u00fdmi synapsemi,\u201c vysv\u011btluje v rozhovoru pro \u010dasopis \u201eSchnecke\u201c neurolog z Univerzity medic\u00edny v Hannoveru Andrej Kral.[2]<\/a>. Lidsk\u00fd mozek a jeho synapse jsou flexibiln\u00ed a dok\u00e1\u017e\u00ed se u\u010dit. Ztr\u00e1ta sluchu m\u016f\u017ee spustit proces u\u010den\u00ed a reorganizaci mozku. Tento proces umo\u017e\u0148uje efektivn\u00ed vyu\u017eit\u00ed zbytkov\u00e9ho sluchu.<\/p>\n

\u201eZtr\u00e1ta sluchu m\u00e1 zvl\u00e1\u0161t\u011b siln\u00fd dopad v d\u011btstv\u00ed, kdy\u017e se mozek vyv\u00edj\u00ed,\u201c \u0159\u00edk\u00e1 Kral. \u201eZt\u011bt\u0161ina synaps\u00ed … z\u00e1vis\u00ed na sluchu.\u201c Nau\u010dit se sly\u0161et jako dosp\u011bl\u00fd je mnohem obt\u00ed\u017en\u011bj\u0161\u00ed: \u201eVy\u017eaduje to slo\u017eit\u00e9 neuron\u00e1ln\u00ed soustroj\u00ed, slo\u017eit\u00fd mozkov\u00fd po\u010d\u00edta\u010d. Schopnost sly\u0161et se m\u016f\u017ee rozvinout pouze tehdy, pokud se \u010dlov\u011bk nau\u010d\u00ed poslouchat v ran\u00e9m v\u011bku. Rann\u00fd sluchov\u00fd z\u00e1\u017eitek u\u017e nelze po dokon\u010den\u00ed kritick\u00e9 f\u00e1ze v\u00fdvoje nikdy nahradit. Proto by m\u011bla ztr\u00e1ta sluchu v d\u011btstv\u00ed b\u00fdt l\u00e9\u010dena co nejd\u0159\u00edve. \u201c<\/p>\n

Kral cituje v\u00fdsledky kolegyn\u011b v\u00fdzkumnice Angeliky Illgov\u00e9: spolu se sv\u00fdm t\u00fdmem v n\u011bmeck\u00e9m Centru sluchu v Hannoveru zjistila, \u017ee d\u011bti narozen\u00e9 s oboustrannou hluchotou, kter\u00fdm byl druh\u00fd implant\u00e1t vsazen o n\u011bco pozd\u011bji, ne\u017e ten prvn\u00ed, vykazovaly u druh\u00e9ho implant\u00e1tu pomalej\u0161\u00ed pokrok.<\/p>\n

Opo\u017ed\u011bn\u00fd start – p\u0159esto \u00fasp\u011bch<\/h2>\n

S odkazem na tuto a podobn\u00e9 publikace nebyla u d\u011bt\u00ed, kter\u00e9 z\u00edskaly sv\u016fj prvn\u00ed implant\u00e1t ji\u017e p\u0159ed del\u0161\u00ed dobou, zva\u017eov\u00e1na mo\u017enost osazen\u00ed druh\u00e9ho. A to navzdory zji\u0161t\u011bn\u00edm w\u00fcrzburgsk\u00e9 skupiny, kter\u00e9 poukazovaly na \u00fasp\u011b\u0161nost i p\u0159i dlouh\u00fdch intervalech mezi implantacemi. V rozhovoru z roku 2013 Andrej Kral, kter\u00fd je profesorem audiologick\u00fdch neurov\u011bd v Hannoveru, p\u0159em\u00fd\u0161lel o tom, \u017ee by binaur\u00e1ln\u00ed schopnosti p\u0159i pozd\u011bj\u0161\u00ed druh\u00e9 implantaci mohly b\u00fdt podpo\u0159eny logopedickou a jazykovou terapi\u00ed.[3]<\/a><\/p>\n

Jednou ze speci\u00e1ln\u00edch binaur\u00e1ln\u00edch dovednost\u00ed, u n\u00ed\u017e se p\u0159edpokl\u00e1dalo, \u017ee se vyv\u00edj\u00ed pouze v prvn\u00edch letech \u017eivota, byla lokalizace zvuku. Ve studii z roku 2018 se touto schopnost\u00ed u d\u011bt\u00ed s oboustrann\u00fdmi kochle\u00e1rn\u00edmi implant\u00e1ty zab\u00fdvala v\u011bdkyn\u011b Catherine Killianov\u00e1[4]<\/a>. V r\u00e1mci sv\u00e9 studie Killianov\u00e1 a jej\u00ed kolegov\u00e9 testovali v\u00edce ne\u017e 100 d\u011bt\u00ed s oboustrann\u00fdmi implant\u00e1ty, u nich\u017e byla mezi prvn\u00ed a druhou implantac\u00ed \u010dasov\u00e1 prodleva a\u017e dvan\u00e1ct let.<\/p>\n

\u201e\u201e\u010casov\u00e1 prodleva by proto u d\u011bt\u00ed s oboustrannou hlubokou ztr\u00e1tou sluchu m\u011bla b\u00fdt minimalizov\u00e1na,\u201c shrnula Killianov\u00e1 v\u00fdsledky sv\u00e9 studie a vysv\u011btlila: del\u0161i interval mezi implantacemi … vedl u d\u011bt\u00ed pou\u017e\u00edvaj\u00edc\u00edch oboustrann\u00e9 kochle\u00e1rn\u00ed implant\u00e1ty k ni\u017e\u0161\u00ed p\u0159esnosti lokalizace zdroje zvuku. Podle v\u00fdsledk\u016f studie do\u0161lo u d\u011bt\u00ed po druh\u00e9 implantaci ke zlep\u0161en\u00ed i v p\u0159\u00edpad\u011b, \u017ee druh\u00fd kochle\u00e1rn\u00ed implant\u00e1t byl osazen po deseti \u010di v\u00edce letech.<\/p>\n

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Na technologii z\u00e1le\u017e\u00ed!<\/strong><\/p>\n

V\u011bdci z Bradfortu a Leedsu ve sv\u00e9 studii [5]<\/a> rovn\u011b\u017e zd\u016fraznili, \u017ee bezpe\u010dnost lokalizace zvuku u t\u011bchto d\u011bt\u00ed v\u00fdznamn\u011b z\u00e1visela na typu implant\u00e1tu. U\u017eivatel\u00e9 kochle\u00e1rn\u00edch implant\u00e1t\u016f MED-EL vykazovali p\u0159esn\u011bj\u0161\u00ed lokalizac\u00ed a dok\u00e1zali zvl\u00e1dnout i p\u011btilet\u00fd interval mezi implantacemi.<\/p>\n<\/blockquote>\n

\n

[1]<\/a> V\u00edce informac\u00ed: More than the sum of its parts<\/a><\/p>\n

[2]<\/a>Research for good hearing, implantable hearing systems \u2013 interview with Prof. Dr. Andrej Kral, traken from: Schnecke, edition 82, p. 11f, December 2013<\/p>\n

[3]<\/a>ref: Research for good hearing, implantable hearing systems \u2013 interview with Prof. Dr. Andrej Kral, traken from: Schnecke, edition 82, p. 11f, December 2013<\/p>\n

[4]<\/a> Killian C, Scally A, Killian E, Totten C, Raine C, Factors Affecting Sound-Source Localization in Children with Simutaneous or sequential bilateral cochlear implantation. U\u0161i a sluch. 5 Doi: 10.1097\/AUD.0000000000000666<\/p>\n

[5]<\/a>Killian C, Scally A, Killian E, Totten C, Raine C, Factors Affecting Sound-Source Localization in Children with Simutaneous or sequential bilateral cochlear implantation. Ear Hear, 2018 5. \u0159\u00edjna. Doi: 10.1097\/AUD.0000000000000666<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

Oboustrann\u00e1 implantace m\u016f\u017ee b\u00fdt prosp\u011b\u0161n\u00e1 dokonce i pro u\u017eivatele, jim\u017e byl prvn\u00ed kochle\u00e1rn\u00ed implant\u00e1t osazen ji\u017e p\u0159ed mnoha lety.<\/p>\n","protected":false},"author":5,"featured_media":32150,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[492],"tags":[419,417],"class_list":["post-250","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi","tag-bilateral","tag-ci"],"yoast_head":"\nV\u00fdhody oboustrann\u00e9 implantace - 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\/vyhody-oboustranne-implantace\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"V\u00fdhody oboustrann\u00e9 implantace - 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