{"id":25214,"date":"2023-12-19T13:10:00","date_gmt":"2023-12-19T12:10:00","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=25214"},"modified":"2025-04-17T04:34:26","modified_gmt":"2025-04-17T04:34:26","slug":"slyseni-i-bez-sluchoveho-nervu","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/slyseni-i-bez-sluchoveho-nervu\/","title":{"rendered":"Sly\u0161en\u00ed i bez sluchov\u00e9ho nervu"},"content":{"rendered":"

Sluchov\u00fd implant\u00e1t mozkov\u00e9ho kmene ABI: Sly\u0161en\u00ed po akustick\u00e9m neuromu<\/h1><\/div>

Spole\u010dnost MED-EL p\u0159edstavila sv\u016fj prvn\u00ed implant\u00e1t mozkov\u00e9ho kmene, zn\u00e1m\u00fd tak\u00e9 jako sluchov\u00fd implant\u00e1t mozkov\u00e9ho kmene ABI, p\u0159ed 20 lety. Stavebn\u00ed in\u017een\u00fdr Markus Friedl sly\u0161\u00ed s implant\u00e1tem SYNCHRONY ABI od rakousk\u00e9ho v\u00fdrobce ji\u017e dva roky.<\/strong><\/p>\n

Eva Kohlov\u00e1<\/p>\n<\/div>

<\/span><\/div><\/div><\/div><\/div><\/div>

Za opu\u0161t\u011bn\u00fdm pozemkem s pozemky se v d\u00e1lce do mrak\u016f ty\u010d\u00ed je\u0159\u00e1b. P\u0159ed n\u00edm, rozt\u0159\u00edd\u011bn\u00fd na hromady, \u010dek\u00e1 odpad zachr\u00e1n\u011bn\u00fd z v\u00fdkopu na odvoz. Navzdory velk\u00fdm stroj\u016fm je na staveni\u0161ti v pozdn\u00edm odpoledni p\u0159ekvapiv\u00fd klid. Jen ka\u017ed\u00fdch p\u00e1r minut zahu\u010d\u00ed motor n\u00e1kladn\u00edho auta, kter\u00e9 se val\u00ed po \u00fazk\u00e9 p\u0159\u00edjezdov\u00e9 cest\u011b. \"Pozor na n\u00e1kla\u010f\u00e1ky!\" varuje in\u017een\u00fdr Markus Friedl. Pracuje zde jako stavbyvedouc\u00ed. N\u00e1kladn\u00ed vozidla byste m\u011bli sly\u0161et, abyste mohli v\u010das prov\u00e9st \u00fahybn\u00fd man\u00e9vr, i kdy\u017e se zezadu bl\u00ed\u017e\u00ed n\u00e1kladn\u00ed vozidlo.<\/p>\n

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Markus Friedl vyu\u017e\u00edv\u00e1 potla\u010den\u00ed hluku zvukov\u00e9ho procesoru ABI i na sv\u00e9m hlu\u010dn\u00e9m pracovi\u0161ti. \u00a9Adobe Stock<\/p><\/div>\n

Asi pades\u00e1t metr\u016f za staveni\u0161t\u011bm p\u0159ijdete ke kontejneru pro spr\u00e1vu staveni\u0161t\u011b. V n\u011bm se nach\u00e1z\u00ed Friedlova kancel\u00e1\u0159 a tak\u00e9 zasedac\u00ed m\u00edstnost s pl\u00e1ny stavby. \"D\u011bl\u00e1m pr\u00e1ci, p\u0159i kter\u00e9 je d\u016fle\u017eit\u00e9 rozum\u011bt ostatn\u00edm,\" vysv\u011btluje. \"Tady na sch\u016fzk\u00e1ch i venku na stavb\u011b\". P\u0159ed 15 lety v\u0161ak p\u0159i\u0161el o sluch. Na lev\u00e9 stran\u011b je zcela hluch\u00fd a na druh\u00e9 stran\u011b m\u00e1 pouze zbytky sluchu. \"Bez naslouch\u00e1tka nesly\u0161\u00edm na prav\u00e9 stran\u011b t\u00e9m\u011b\u0159 nic. \u017d\u00e1dn\u00fd k\u00e1vovar. \u017d\u00e1dn\u00e9 splachov\u00e1n\u00ed z\u00e1chodu.\"<\/p>\n

Oboustrann\u00fd akustick\u00fd neurinom p\u0159ipravil dolnorakousk\u00e9ho rod\u00e1ka o sluch. Bohu\u017eel se zd\u00e1lo, \u017ee kochle\u00e1rn\u00ed implant\u00e1t pro n\u011bj nen\u00ed perspektivn\u00ed. Od prosince 2021 42let\u00fd stavebn\u00ed in\u017een\u00fdr m\u00edsto toho sly\u0161\u00ed pomoc\u00ed implant\u00e1tu mozkov\u00e9ho kmene, zkr\u00e1cen\u011b ABI. A\u010dkoli je tento implant\u00e1t funk\u010dn\u011b podobn\u00fd kochle\u00e1rn\u00edmu implant\u00e1tu, ve speci\u00e1ln\u00edm proveden\u00ed ABI se pou\u017e\u00edv\u00e1 jen z\u0159\u00eddka; vz\u00e1cn\u00e9 je i onemocn\u011bn\u00ed neurofibromat\u00f3za, kter\u00e9 u u\u017eivatele ABI zp\u016fsobilo neurinom a hluchotu.<\/p>\n

Neurofibromat\u00f3za, vz\u00e1cn\u00e9 onemocn\u011bn\u00ed<\/h2>\n

V\u0161e za\u010dalo n\u00e1hlou ztr\u00e1tou sluchu na prav\u00e9 stran\u011b, kdy\u017e bylo Friedlovi 28 let. \"Nejprve to bylo l\u00e9\u010deno jako n\u00e1hl\u00e1 ztr\u00e1ta sluchu. To, \u017ee se pot\u00e9 provedla i magnetick\u00e1 rezonance, byla \u010dist\u011b n\u00e1hoda.\" Na sluchov\u00fdch nervech na obou stran\u00e1ch byly objeveny nezhoubn\u00e9 n\u00e1dory. L\u00e9ka\u0159i diagnostikovali centr\u00e1ln\u00ed neurofibromat\u00f3zu.<\/p>\n

Neurofibromat\u00f3za, zkr\u00e1cen\u011b NF, je genetick\u00e1 mutace, kter\u00e1 se d\u011bd\u00ed p\u0159ibli\u017en\u011b v polovin\u011b p\u0159\u00edpad\u016f. Ve druh\u00e9 polovin\u011b p\u0159\u00edpad\u016f je zm\u011bna \"z\u00edskan\u00e1\", ozna\u010dovan\u00e1 tak\u00e9 jako \"spont\u00e1nn\u00ed\": V pr\u016fb\u011bhu embryon\u00e1ln\u00edho v\u00fdvoje do\u0161lo k mutaci p\u0159\u00edslu\u0161n\u00e9ho chromozomu. NF, kterou poprv\u00e9 popsal v roce 1882 n\u011bmeck\u00fd l\u00e9ka\u0159 Friedrich Daniel von Recklinghausen, pat\u0159\u00ed mezi takzvan\u00e1 \"vz\u00e1cn\u00e1 onemocn\u011bn\u00ed\". Jedn\u00e1 se o onemocn\u011bn\u00ed, kter\u00e1 jsou bu\u010f \u017eivot ohro\u017euj\u00edc\u00ed, nebo chronick\u00e1 a postihuj\u00ed maxim\u00e1ln\u011b 5 z 10 000 lid\u00ed.<\/p>\n

Odborn\u00edci rozli\u0161uj\u00ed t\u0159i typy neurofibromat\u00f3zy: NF1, NF2 a schwannomat\u00f3za. U ka\u017ed\u00e9ho z t\u011bchto onemocn\u011bn\u00ed je posti\u017een jin\u00fd gen. V\u0161em t\u0159em je spole\u010dn\u00fd sklon ke vzniku n\u00e1dor\u016f v nervov\u00e9m syst\u00e9mu.<\/p>\n

Centr\u00e1ln\u00ed neurofibromat\u00f3za \u010dasto po\u0161kozuje sluch<\/h2>\n

NF2, zn\u00e1m\u00e1 tak\u00e9 jako centr\u00e1ln\u00ed neurofibromat\u00f3za, kter\u00e1 je obzvl\u00e1\u0161t\u011b vz\u00e1cn\u00e1: posti\u017een je jeden \u010dlov\u011bk z 35 000. NF2 se vyzna\u010duje v\u00fdskytem nezhoubn\u00fdch n\u00e1dor\u016f tk\u00e1n\u011b nervov\u00fdch pochev - tzv. schwannom\u016f<\/a>.Ten m\u016f\u017ee postihovat r\u016fzn\u00e9 nervy a m\u016f\u017ee doj\u00edt i k poru\u0161e vid\u011bn\u00ed; typick\u00fdmi pr\u016fvodn\u00edmi jevy jsou bolesti hlavy a nevolnost. U pacient\u016f s NF2 jsou v\u0161ak v pop\u0159ed\u00ed nezhoubn\u00e9 n\u00e1dory na osm\u00e9m hlavov\u00e9m nervu, kter\u00fd je zodpov\u011bdn\u00fd za sluch a rovnov\u00e1hu. Tyto vestibul\u00e1rn\u00ed schwannomy - neboli akustick\u00e9 neurinomy - se mohou vyskytovat na obou stran\u00e1ch a tak\u00e9 opakovan\u011b.<\/p>\n

N\u011bkdy sta\u010d\u00ed takov\u00fd akustick\u00fd neurom pozorovat. Pokud v\u0161ak vyv\u00edj\u00ed tlak na nerv nebo okoln\u00ed tk\u00e1\u0148, m\u016f\u017ee to zp\u016fsobit r\u016fzn\u00e9 p\u0159\u00edznaky. N\u00e1dor je pak nutn\u00e9 odstranit.<\/p>\n

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Stavebn\u00ed in\u017een\u00fdr Markus Friedl: se sv\u00fdm implant\u00e1tem mozkov\u00e9ho kmene p\u0159i pr\u00e1ci \u00a9Eva Kohlov\u00e1<\/p><\/div>\n

To byl Friedl\u016fv p\u0159\u00edpad i v roce 2008. \"Cel\u00e1 moje rodina byla nerv\u00f3zn\u00ed.\" V\u017edy\u0165 p\u0159i t\u00e9to operaci se pracuje s nervem, kter\u00fd ovl\u00e1d\u00e1 sluch, rovnov\u00e1hu a mimiku. \"Ale j\u00e1 jsem se neb\u00e1l. Chirurgov\u00e9, kte\u0159\u00ed takovou operaci prov\u00e1d\u011bj\u00ed, jsou naprost\u00ed odborn\u00edci.\" ORL chirurg dokonce dok\u00e1zal zachovat zbytky sluchu na prav\u00e9 stran\u011b, ale na lev\u00e9 stran\u011b to ji\u017e nebylo mo\u017en\u00e9: \"S naslouch\u00e1tky na prav\u00e9m uchu mohu komunikovat v tich\u00e9m prost\u0159ed\u00ed jen tehdy, kdy\u017e se soust\u0159ed\u00edm.\"<\/p>\n

Zp\u011bt k oboustrann\u00e9mu sluchu<\/h2>\n

P\u0159ibli\u017en\u011b p\u0159ed p\u011bti lety se u dolnorakousk\u00e9ho rod\u00e1ka objevil nov\u00fd neurinom prav\u00e9ho ucha - ucha, kter\u00e9 pro n\u011bj v t\u00e9 dob\u011b p\u0159edstavovalo jedinou mo\u017enost, jak sly\u0161et. Ob\u00e1val se, \u017ee n\u00e1dor bude muset b\u00fdt odstran\u011bn a \u017ee by mohl p\u0159ij\u00edt o posledn\u00ed zbytky sluchu. \"To byl moment, kdy jsem za\u010dal zji\u0161\u0165ovat, jak\u00e9 jsou mo\u017enosti pro m\u00e9 lev\u00e9 ucho.\"<\/p>\n

I v p\u0159\u00edpad\u011b jednostrann\u00e9 hluchoty<\/a> dnes odborn\u00edci obvykle doporu\u010duj\u00ed posti\u017een\u00fdm sluchov\u00e9 implant\u00e1ty. To plat\u00ed zejm\u00e9na pro pacienty s NF2, proto\u017ee u nich st\u00e1le existuje zv\u00fd\u0161en\u00e9 riziko vzniku dal\u0161\u00edch neurinom\u016f. To byl i p\u0159\u00edpad Markuse Friedla, kdy\u017e se obr\u00e1til na v\u00edde\u0148skou HNO-Universit\u00e4tsklinik AKH. Prof. Dr. Christoph Arnoldner tam s pacientem probral r\u016fzn\u00e9 mo\u017enosti implantace. Vzhledem k tomu, \u017ee Friedl\u016fv lev\u00fd sluchov\u00fd nerv byl nejen posti\u017een n\u00e1dorem, ale byl tak\u00e9 ji\u017e mnoho let neaktivn\u00ed, rozhodl se Friedl rovnou pro implantaci mozkov\u00e9ho kmene.<\/p>\n

I kdy\u017e sluchov\u00fd nerv nefunguje: Sluch lze obnovit!<\/h2>\n

Sluch je prvn\u00ed a zat\u00edm jedin\u00fd lidsk\u00fd smyslov\u00fd org\u00e1n, kter\u00fd lze um\u011ble reprodukovat a nahradit. Kochle\u00e1rn\u00ed implantace, kter\u00e1 byla poprv\u00e9 provedena v roce 1977 ve V\u00eddni, je dnes rutinn\u00ed operac\u00ed. \u00dasp\u011b\u0161n\u011b se pou\u017e\u00edv\u00e1 i v p\u0159\u00edpadech jednostrann\u00e9 hluchoty a zbytk\u016f sluchu. P\u0159edpokladem je v\u0161ak funkce sluchov\u00e9ho nervu. Pokud do\u0161lo k jej\u00ed ztr\u00e1t\u011b nap\u0159\u00edklad v d\u016fsledku n\u00e1doru nebo operace, z\u016fst\u00e1v\u00e1 mo\u017enost implantace sluchov\u00e9ho mozkov\u00e9ho kmene (ABI). Zvukov\u00fd procesor a implant\u00e1t jsou podobn\u00e9 jako u b\u011b\u017en\u00e9ho kochle\u00e1rn\u00edho implant\u00e1tu. Elektroda v ABI je v\u0161ak ploch\u00e1 a je um\u00edst\u011bna p\u0159\u00edmo na mozkov\u00e9m kmeni. Odtud stimuluje sluchov\u00e9 oblasti v mozkov\u00e9 k\u016f\u0159e.<\/p>\n

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Implant\u00e1t mozkov\u00e9ho kmene SYNCHRONY ABI od spole\u010dnosti MED-EL \u00a9MED-EL<\/p><\/div>\n

Implant\u00e1t ABI spole\u010dnosti MED-EL pro dosp\u011bl\u00e9 pacienty s NF2 byl p\u0159edstaven p\u0159ed 20 lety. Prof. Dr. Robert Behr, b\u00fdval\u00fd p\u0159ednosta neurochirurgick\u00e9ho odd\u011blen\u00ed univerzitn\u00ed nemocnice ve Fuld\u011b a jeden z p\u0159edn\u00edch sv\u011btov\u00fdch odborn\u00edk\u016f na ABI, vzpom\u00edn\u00e1: \"V roce 2006 jsme zavedli implant\u00e1t ABI: \"V po\u010d\u00e1tc\u00edch se v\u011b\u0159ilo, \u017ee ABI bude pouze dopl\u0148kovou podporou pro odez\u00edr\u00e1n\u00ed ze rt\u016f. V otev\u0159en\u00e9 porozum\u011bn\u00ed \u0159e\u010di nebo volnou komunikaci se nev\u011b\u0159ilo.\" Po v\u00edce ne\u017e 1 000 implantac\u00edch ABI po cel\u00e9m sv\u011bt\u011b se tento n\u00e1zor zm\u011bnil. \"Technologie ABI a chirurgick\u00e9 metody se za posledn\u00edch 20 let neust\u00e1le vyv\u00edjely a umo\u017enily na\u0161im u\u017eivatel\u016fm sly\u0161et st\u00e1le l\u00e9pe,\" vysv\u011btluje zakladatelka a gener\u00e1ln\u00ed \u0159editelka spole\u010dnosti MED-EL Dr. Ingeborg Hochmairov\u00e1. Dnes vede mnoho u\u017eivatel\u016f ABI nez\u00e1visl\u00fd \u017eivot ve sv\u011bt\u011b sly\u0161\u00edc\u00edch.<\/p>\n

\"Kdy\u017e se baterie v procesoru vybij\u00ed, implant\u00e1t se sund\u00e1!\".<\/h2>\n

Stroh\u00e1 fakta o l\u00e9\u010debn\u00e9 metod\u011b jsou jedna v\u011bc, individu\u00e1ln\u00ed rozhodnut\u00ed pro implant\u00e1t je n\u011bco jin\u00e9ho. Pro Friedla \u0161lo v\u0161ak o jasn\u00e9 rozhodnut\u00ed: \"M\u011bl jsem ji\u017e zku\u0161enosti s n\u00e1ro\u010dn\u00fdmi operacemi k odstran\u011bn\u00ed n\u00e1dor\u016f. A \u0159\u00edkal jsem si, \u017ee m\u016fj sluch u\u017e se nem\u016f\u017ee zhor\u0161it.\" P\u0159i operaci m\u011bly b\u00fdt odstran\u011bny tak\u00e9 dva nov\u00e9 n\u00e1dory na lev\u00e9m nervu. \"Toto odstran\u011bn\u00ed mi d\u011blalo v\u011bt\u0161\u00ed starosti ne\u017e implantace. A implantace ABI je vz\u00e1cn\u00fd z\u00e1krok. Jsem si jist\u00fd, \u017ee se na n\u011bm pod\u00edlej\u00ed ti nejlep\u0161\u00ed odborn\u00edci z cel\u00e9ho sv\u011bta chirurgie.\" S ro\u0161\u0165\u00e1ck\u00fdm \u00fasm\u011bvem dod\u00e1v\u00e1: \"\u0160\u00e9fkucha\u0159 nedovol\u00ed u\u010dedn\u00edkovi s\u00e1hnout na pe\u010deni...\"<\/p>\n

Friedlovu operaci provedl neurochirurg Prof. Dr. Christian Matula, p\u0159ednosta ambulance baze lebn\u00ed ve v\u00edde\u0148sk\u00e9 univerzitn\u00ed nemocnici. Z hlediska ORL na ni dohl\u00ed\u017eel Prof. Dr. Christoph Arnoldner. Nov\u011b operovan\u00fd pacient mohl ji\u017e po n\u011bkolika dnech opustit kliniku a brzy se c\u00edtil op\u011bt fit.<\/p>\n

\"Doba pot\u00e9 byla je\u0161t\u011b vzru\u0161uj\u00edc\u00ed. Mozkov\u00fd kmen,\" kde byla um\u00edst\u011bna ploch\u00e1 elektroda ABI, \"nem\u00e1 zna\u010dku, kter\u00e1 by \u0159\u00edkala: Mus\u00edte tam d\u00e1t z\u00e1str\u010dku.\" Uspo\u0159\u00e1d\u00e1n\u00ed t\u00f3n\u016f nen\u00ed na mozkov\u00e9m kmeni tak p\u0159esn\u011b rozpoznateln\u00e9 jako ve vnit\u0159n\u00edm uchu. Proto m\u016f\u017ee zvyk\u00e1n\u00ed si na sluch s ABI trvat o n\u011bco d\u00e9le, ne\u017e by tomu obvykle bylo v p\u0159\u00edpad\u011b dne\u0161n\u00ed konven\u010dn\u00ed CI. \"Nikam nesp\u011bch\u00e1m,\" \u0159\u00edk\u00e1 Friedl klidn\u011b. \"A kdy\u017e se baterie vybij\u00ed, jsem s implant\u00e1tem u\u017e velmi spokojen\u00fd. Pro m\u011b je to jasn\u00fd sign\u00e1l, \u017ee mi u\u017e te\u010f hodn\u011b pom\u00e1h\u00e1 sly\u0161et.\"<\/p>\n

Kdo m\u016f\u017ee m\u00edt prosp\u011bch z ABI<\/h2>\n

ABI m\u016f\u017ee pomoci i lidem, kte\u0159\u00ed ohluchli z jin\u00fdch d\u016fvod\u016f, pokud byl sluchov\u00fd nerv nebo jeho funkce rovn\u011b\u017e po\u0161kozena: nap\u0159\u00edklad jin\u00fdmi n\u00e1dory, zvl\u00e1\u0161t\u011b rozs\u00e1hl\u00fdmi osifikacemi nebo \u00farazem hlavy. Od roku 2017 mohou ABI vyu\u017e\u00edt tak\u00e9 d\u011bti od 12 m\u011bs\u00edc\u016f v\u011bku, pokud se narodily bez funk\u010dn\u00edho sluchov\u00e9ho nervu.<\/p>\n

Takto vyu\u017e\u00edv\u00e1 sluchov\u00fd implant\u00e1t Markus Friedl: \"P\u0159i n\u011bkter\u00fdch setk\u00e1n\u00edch je st\u00e1le obt\u00ed\u017en\u00e9 rozum\u011bt. A se sv\u00fdmi dv\u011bma naslouch\u00e1tky sly\u0161\u00edm i hv\u00edzd\u00e1n\u00ed v\u011btru,\" p\u0159izn\u00e1v\u00e1. Pak se ale stavebn\u00ed in\u017een\u00fdr zasm\u011bje, kdy\u017e mluv\u00ed o \u00fa\u010dinn\u00e9m potla\u010den\u00ed hluku ve zvukov\u00e9m procesoru: \"Kdy\u017e je na staveni\u0161ti opravdu hodn\u011b hluku, je to pro m\u011b n\u011bkdy dokonce snaz\u0161\u00ed ne\u017e pro m\u00e9 kolegy s norm\u00e1ln\u00edm sluchem. Bez tohoto implant\u00e1tu bych dnes nemohl d\u011blat svou pr\u00e1ci.\"<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

Sluchov\u00fd implant\u00e1t mozkov\u00e9ho kmene ABI: Sly\u0161en\u00ed po akustick\u00e9m neuromu Spole\u010dnost MED-EL p\u0159edstavila sv\u016fj<\/p>\n","protected":false},"author":2,"featured_media":31774,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[],"class_list":["post-25214","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda"],"yoast_head":"\nSly\u0161en\u00ed i bez sluchov\u00e9ho nervu - Czech<\/title>\n<meta name=\"description\" content=\"Spole\u010dnost MED-EL p\u0159edstavila sv\u016fj prvn\u00ed implant\u00e1t mozkov\u00e9ho kmene, zn\u00e1m\u00fd tak\u00e9 jako sluchov\u00fd implant\u00e1t mozkov\u00e9ho kmene ABI, p\u0159ed 20 lety.\" \/>\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\/slyseni-i-bez-sluchoveho-nervu\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sly\u0161en\u00ed i bez sluchov\u00e9ho nervu - 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