{"id":2876,"date":"2021-04-12T16:32:37","date_gmt":"2021-04-12T14:32:37","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=2876"},"modified":"2025-04-17T04:59:44","modified_gmt":"2025-04-17T04:59:44","slug":"novy-program-pro-kochlearni-implantaty-med-el","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/cs\/novy-program-pro-kochlearni-implantaty-med-el\/","title":{"rendered":"Nov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL"},"content":{"rendered":"

Nov\u00fd program kochle\u00e1rn\u00edch implant\u00e1t\u016f MED-EL pro vy\u0161\u0161\u00ed v\u011brnost zvuku<\/h1><\/div>

V roce 2020 p\u0159edstavila spole\u010dnost MED-EL \u2013 spolu s dal\u0161\u00edmi nov\u00fdmi produkty \u2013 nov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty: program pro osazen\u00ed MAESTRO 9.0. Pomoc\u00ed tohoto programu lze prov\u00e9st nastaven\u00ed syst\u00e9m\u016f kochle\u00e1rn\u00edch implant\u00e1t\u016f podle individu\u00e1ln\u00ed anatomie u\u017eivatele, co\u017e d\u00e1le zlep\u0161uje v\u011brnost zvuku t\u011bchto syst\u00e9m\u016f.<\/strong><\/p>\n<\/div>

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V\u011brnost zvuku s nov\u00fdm programem pro nastaven\u00ed kochle\u00e1rn\u00edch implant\u00e1t\u016f MED-EL<\/h2>\n

Prok\u00e1zaly to mnoh\u00e9 studie: \u010d\u00edm p\u0159irozen\u011bj\u0161\u00ed je zvukov\u00fd dojem kochle\u00e1rn\u00edho implant\u00e1tu, t\u00edm rychlej\u0161\u00ed jsou v\u00fdsledky sly\u0161en\u00ed a t\u00edm lep\u0161\u00edho porozum\u011bn\u00ed \u0159e\u010di lze s t\u00edmto syst\u00e9mem nakonec dos\u00e1hnout. S v\u011brnost\u00ed zvuku se tak\u00e9 zvy\u0161uje po\u017eitek z hudby a schopnost lokalizovat zdroj zvuk\u016f. V\u011brnost zvuku syst\u00e9mu kochle\u00e1rn\u00edho implant\u00e1tu je d\u016fle\u017eit\u00e1 zejm\u00e9na pro ty u\u017eivatele kochle\u00e1rn\u00edho implant\u00e1tu, kte\u0159\u00ed pou\u017e\u00edvaj\u00ed na druh\u00e9m uchu naslouch\u00e1tko nebo sly\u0161\u00ed p\u0159irozen\u011b, aby mohli optim\u00e1ln\u011b realizovat sluchov\u00e9 vjemy obou stran s co nejmen\u0161\u00edm kognitivn\u00edm \u00fasil\u00edm.<\/p>\n

Tato zvukov\u00e1 v\u011brnost je umo\u017en\u011bna co nejni\u017e\u0161\u00edm “Location-Frequency-Mismatch”, jak to odborn\u00edci naz\u00fdvaj\u00ed: jednotliv\u00e9 slo\u017eky zvuku mus\u00ed b\u00fdt ve vnit\u0159n\u00edm uchu stimulov\u00e1ny p\u0159esn\u011b tam, kde je zvuk byl sly\u0161et p\u0159irozen\u011b. Stimula\u010dn\u00ed sign\u00e1l by m\u011bl vytv\u00e1\u0159et co nejp\u0159irozen\u011bj\u0161\u00ed nervov\u00fd sign\u00e1l.<\/p>\n

Aby spole\u010dnost MED-EL<\/a>\u00a0d\u00e1le zlep\u0161ila v\u011brnost zvuku sv\u00fdch kochle\u00e1rn\u00edch implant\u00e1t\u016f, zavedla pro sou\u010dasn\u00fd syst\u00e9m anatomicky zalo\u017een\u00e9 p\u0159izp\u016fsoben\u00ed neboli ABF. P\u0159itom se ur\u010d\u00ed um\u00edst\u011bn\u00ed jednotliv\u00fdch elektrodov\u00fdch kontakt\u016f v kochle\u00e1rn\u00edm syst\u00e9mu, ur\u010d\u00ed se p\u0159irozen\u011b se vyskytuj\u00edc\u00ed v\u00fd\u0161ky t\u00f3n\u016f, kter\u00e9 se zde nach\u00e1zej\u00ed, a p\u0159i\u0159ad\u00ed se odpov\u00eddaj\u00edc\u00ed kontakt.<\/p>\n

Z\u00e1kladem pro ABF je v\u00fdsledek po\u010d\u00edta\u010dov\u00e9 tomografie, kter\u00e1 se \u010dasto prov\u00e1d\u00ed jako kontrola po implantaci. Analyzuje se pomoc\u00ed otologick\u00e9ho pl\u00e1novac\u00edho softwaru OTOPLAN, kter\u00fd vyvinula \u0161v\u00fdcarsk\u00e1 spole\u010dnost CAScination ve spolupr\u00e1ci s firmou MED-EL, p\u0159en\u00e1\u0161\u00ed se do osazovac\u00edho programu MAESTRO 9.0 a p\u0159ed\u00e1v\u00e1 se do individu\u00e1ln\u00edho nastaven\u00ed zvukov\u00e9ho procesoru kochle\u00e1rn\u00edho implant\u00e1tu.<\/p>\n

Lep\u0161\u00ed p\u0159i\u0159azen\u00ed frekvence v kochle\u00e1rn\u00edm implant\u00e1tu<\/h2>\n

D\u0159\u00edve se v\u00fd\u0161ky t\u00f3n\u016f rozd\u011blovaly podle logaritmick\u00e9ho kl\u00ed\u010de k jednotliv\u00fdm kan\u00e1l\u016fm kochle\u00e1rn\u00edho implant\u00e1tu, a tedy k jednotliv\u00fdm kontakt\u016fm aktivn\u00edch elektrod. Tak lze dos\u00e1hnout skute\u010dn\u00e9ho p\u0159i\u0159azen\u00ed zvuku, pokud lze elektrodu s optim\u00e1ln\u011b nastavenou d\u00e9lkou zcela zasunout do pr\u016fm\u011brn\u00e9ho kochle\u00e1rn\u00edho implant\u00e1tu; to znamen\u00e1, \u017ee lze dos\u00e1hnout stimulace p\u0159es t\u00e9m\u011b\u0159 dv\u011b c\u00edvky nebo 630 stup\u0148\u016f. K\u00f3dov\u00e1n\u00ed sign\u00e1lu jemn\u00e9 struktury – FSP, FS4 nebo FS4-p-k\u00f3dov\u00e1n\u00ed – v druh\u00e9 c\u00edvce zdokonaluje dojem v\u00fd\u0161ky t\u00f3nu.<\/p>\n

Pomoc\u00ed CT sn\u00edmku, kter\u00fd je jedn\u00edm z rutinn\u00edch vy\u0161et\u0159en\u00ed p\u0159i kochle\u00e1rn\u00ed implantaci, a pomoc\u00ed speci\u00e1ln\u00edho prohl\u00ed\u017ee\u010de DICOM OTOPLAN m\u016f\u017ee l\u00e9ka\u0159 n\u011bkolika kliknut\u00edmi ur\u010dit ide\u00e1ln\u00ed d\u00e9lku elektrody i pro vnit\u0159n\u00ed ucho, kter\u00e9 vybo\u010duje z pr\u016fm\u011bru. Na jedn\u00e9 stran\u011b je konven\u010dn\u00ed p\u0159id\u011blov\u00e1n\u00ed frekvenc\u00ed u t\u011bchto u\u017eivatel\u016f spr\u00e1vn\u00e9 pouze v podm\u00edn\u011bn\u00e9m rozsahu. Na druh\u00e9 stran\u011b u individu\u00e1ln\u00edch u\u017eivatel\u016f se zvl\u00e1\u0161t\u011b velk\u00fdmi hlem\u00fd\u017edi a zvl\u00e1\u0161t\u011b hlubok\u00fdm zasunut\u00edm je kontaktn\u00ed alokace ni\u017e\u0161\u00edch frekvenc\u00ed vynikaj\u00edc\u00ed, ale st\u0159edn\u00ed a vysok\u00fd zvukov\u00fd rozsah je alokov\u00e1n jen \u010d\u00e1ste\u010dn\u011b spr\u00e1vn\u011b.<\/p>\n

“Pokud v\u00edme, kde p\u0159esn\u011b se v kochle\u00e1rn\u00edm t\u011blese nach\u00e1z\u00ed kter\u00e1 elektroda, m\u016f\u017eeme ka\u017ed\u00e9mu jednotliv\u00e9mu kontaktu p\u0159i\u0159adit p\u0159esn\u011b spr\u00e1vn\u00fd frekven\u010dn\u00ed rozsah pro ka\u017ed\u00e9ho jednotliv\u00e9ho u\u017eivatele,” vysv\u011btluje Peter Nopp, \u0159editel v\u00fdvoje v oblasti k\u00f3dov\u00e1n\u00ed sign\u00e1lu ve spole\u010dnosti MED-EL. P\u0159esn\u011b to nyn\u00ed umo\u017e\u0148uje nejnov\u011bj\u0161\u00ed verze programu OTOPLAN s vyu\u017eit\u00edm poopera\u010dn\u00edho CT sn\u00edmku. “OTOPLAN rozpozn\u00e1 pouh\u00fdm stisknut\u00edm tla\u010d\u00edtka skute\u010dnou polohu ka\u017ed\u00e9ho kan\u00e1lu a frekvenci, kter\u00e1 se v n\u011bm nach\u00e1z\u00ed.”<\/p>\n

Pomoc\u00ed syst\u00e9mu OTOPLAN by tak\u00e9 bylo mo\u017en\u00e9 zjistit, zda elektrody nebyly zcela zavedeny, tak\u017ee jeden nebo n\u011bkolik kan\u00e1l\u016f se nach\u00e1z\u00ed mimo kochle\u00e1rn\u00ed oblast, a m\u011bly by b\u00fdt proto deaktivov\u00e1ny.<\/p>\n

Anatomy Based Fitting (ABF) pro kochle\u00e1rn\u00ed implant\u00e1ty s MAESTRO 9.0<\/h2>\n

Nov\u00e1 verze syst\u00e9mu MAESTRO um\u00ed tyto informace p\u0159eb\u00edrat z aplikace OTOPLAN. Nopp vysv\u011btluje n\u00e1sleduj\u00edc\u00ed postup: “V nastaven\u00ed posuneme frekven\u010dn\u00ed p\u00e1sma tak, abychom minimalizovali rozd\u00edly mezi p\u0159id\u011blen\u00fdmi a um\u00edst\u011bn\u00fdmi frekvencemi.” To je mo\u017en\u00e9 pro u\u017eivatele v\u0161ech typ\u016f CI MED-EL v kombinaci se zvukov\u00fdmi procesory\u00a0SONNET 2<\/a> nebo RONDO 3.<\/a>
\nU kr\u00e1tk\u00fdch elektrod nebo p\u0159i ne\u00fapln\u00e9m zaveden\u00ed v\u0161ak mohou b\u00fdt rozd\u00edly st\u00e1le patrn\u00e9: \u010d\u00edm krat\u0161\u00ed je pokryt\u00fd rozsah kochle\u00e1rn\u00edch elektrod, t\u00edm v\u011bt\u0161\u00ed je rozd\u00edl, zejm\u00e9na u n\u00edzk\u00fdch frekvenc\u00ed. Proto je podm\u00ednkou dobr\u00e9ho p\u0159izp\u016fsoben\u00ed pomoc\u00ed ABF, aby elektroda dos\u00e1hla alespo\u0148 do druh\u00e9 c\u00edvky kochle\u00e1rn\u00edho p\u0159\u00edstroje.<\/p>\n

ABF se zam\u011b\u0159uje p\u0159edev\u0161\u00edm na frekvence v rozsahu 1000 a\u017e 3000 Hertz\u016f, proto\u017ee ty jsou pro porozum\u011bn\u00ed \u0159e\u010di rozhoduj\u00edc\u00ed. ABF nem\u00e1 \u017e\u00e1dn\u00fd vliv na nastaven\u00ed \u00farovn\u011b, i kdy\u017e n\u011bkter\u00e1 frekven\u010dn\u00ed p\u00e1sma v n\u00edzk\u00fdch frekven\u010dn\u00edch rozsaz\u00edch se mohou uk\u00e1zat \u0161ir\u0161\u00ed ne\u017e p\u0159i b\u011b\u017en\u00e9m, logaritmick\u00e9m rozlo\u017een\u00ed frekvenc\u00ed: kombinace s k\u00f3dov\u00e1n\u00edm sign\u00e1lu Fine Hearing FSP, FS4 nebo FS4-p umo\u017enila dobr\u00e9 rozli\u0161en\u00ed v\u00fd\u0161ek i tam.<\/p>\n

Samoz\u0159ejm\u011b je t\u0159eba zv\u00e1\u017eit, zda si zku\u0161en\u00ed u\u017eivatel\u00e9 kochle\u00e1rn\u00edch implant\u00e1t\u016f p\u0159ej\u00ed m\u00edt nastaven\u00ed upraveno podle ABF. Peter Nopp, kter\u00fd m\u00e1 v\u00edce ne\u017e 30 let praxe v oblasti CI upozor\u0148uje, \u017ee “zku\u0161en\u00ed u\u017eivatel\u00e9 si na nastaven\u00ed frekven\u010dn\u00edch p\u00e1sem zvykli”. Dopl\u0148uje, \u017ee je mo\u017en\u00e9 p\u0159edpokl\u00e1dat dlouhou f\u00e1zi p\u0159izp\u016fsobov\u00e1n\u00ed. “U nov\u00fdch u\u017eivatel\u016f se v\u0161ak domn\u00edv\u00e1me, \u017ee pomoc\u00ed anatomicky zalo\u017een\u00e9ho nastaven\u00ed ABF m\u016f\u017eeme dos\u00e1hnout rychlej\u0161\u00edho sezn\u00e1men\u00ed se se sluchem s kochle\u00e1rn\u00edm implant\u00e1tem, a t\u00edm i celkov\u011b lep\u0161\u00edho vyu\u017eit\u00ed syst\u00e9mu.”<\/p>\n

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Nov\u00e1 kvalita zvuku z nov\u00e9ho programu pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL<\/p><\/div><\/dt>\n

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Prozat\u00edmn\u00ed vrchol dlouh\u00e9ho v\u00fdvoje kochle\u00e1rn\u00edch implant\u00e1t\u016f<\/h2>\n

Spole\u010dnost MED-EL v\u017edy usilovala o to, aby jej\u00ed syst\u00e9my kochle\u00e1rn\u00edch implant\u00e1t\u016f umo\u017e\u0148ovaly co nejp\u0159irozen\u011bj\u0161\u00ed dojem ze sly\u0161en\u00ed – v\u017edy na z\u00e1klad\u011b aktu\u00e1ln\u00edch v\u011bdeck\u00fdch poznatk\u016f o sluchov\u00e9m procesu. Prvn\u00edm takov\u00fdm poznatkem byl poznatek ma\u010farsk\u00e9ho biofyzika a nositele Nobelovy ceny Georga von B\u00e9rk\u00e9syho, \u017ee r\u016fzn\u00e9 v\u00fd\u0161ky zvuku stimuluj\u00ed r\u016fzn\u00e9 oblasti hlem\u00fd\u017ed\u011b: vy\u0161\u0161\u00ed zvuky tzv. z\u00e1kladnu v bl\u00edzkosti p\u0159echodu ze st\u0159edn\u00edho ucha do vnit\u0159n\u00edho ucha, hlub\u0161\u00ed zvuky naopak sm\u011brem k hrotu hlem\u00fd\u017ed\u011b, tzv. apexu. Na z\u00e1klad\u011b toho Donald D. Greenwood v roce 1961 odvodil z v\u00fdsledk\u016f psychoakustick\u00fdch pokus\u016f o diferenciaci v\u00fd\u0161ky t\u00f3nu matematickou funkci, kter\u00e1 vypo\u010d\u00edt\u00e1v\u00e1 m\u00edsto ve vnit\u0159n\u00edm uchu odpov\u011bdn\u00e9 za ur\u010dit\u00fd frekven\u010dn\u00ed rozsah. Tento vztah byl pou\u017eit v prvn\u00edch v\u00edcekan\u00e1lov\u00fdch kochle\u00e1rn\u00edch implant\u00e1tech.<\/p>\n

Proto\u017ee tyto prvn\u00ed kochle\u00e1rn\u00ed implant\u00e1ty pou\u017e\u00edvaly pouze relativn\u011b kr\u00e1tk\u00e9 elektrody, byly v kochle\u00e1rn\u00edm syst\u00e9mu zpo\u010d\u00e1tku stimulov\u00e1ny pouze frekvence nad 500 Hz. Ji\u017e v roce 1994 v\u0161ak spole\u010dnost MED-EL p\u0159edstavila prvn\u00ed kochle\u00e1rn\u00ed implant\u00e1t s elektrodami dlouh\u00fdmi 31 mm, kter\u00e9 mohou dos\u00e1hnout a stimulovat celou d\u00e9lku hlem\u00fd\u017ed\u011b. Tato funkce byla pozd\u011bji ozna\u010dena jako CCC, co\u017e znamen\u00e1 “Complete Cochlear Coverage” (\u00fapln\u00e9 pokryt\u00ed hlem\u00fd\u017ed\u011b).<\/p>\n

P\u0159i p\u0159irozen\u00e9m sly\u0161en\u00ed jsou procesy z druh\u00e9 c\u00edvky kochle\u00e1rn\u00edho implant\u00e1tu je\u0161t\u011b slo\u017eit\u011bj\u0161\u00ed: zvuky jsou zde tak\u00e9 chronologicky \u010dlen\u011bny podle stimula\u010dn\u00edho rytmu. Zvuk o frekvenci 110 hertz\u016f vyvol\u00e1 ve sluchov\u00e9m nervu ka\u017edou sekundu 110 paket\u016f ak\u010dn\u00edch potenci\u00e1l\u016f, zvuk o frekvenci 440 hertz\u016f vyvol\u00e1 440 paket\u016f. Kochle\u00e1rn\u00ed implant\u00e1ty MED-EL s technologi\u00ed FineHearing nab\u00edzej\u00ed od roku 2006 exkluzivn\u00ed k\u00f3dovac\u00ed strategie napodobuj\u00edc\u00ed tento mechanismus.<\/p>\n

Dlouhou dobu bylo mo\u017en\u00e9 zobrazovac\u00ed diagnostikou pouze zobrazit p\u0159esn\u00e9 um\u00edst\u011bn\u00ed elektrody v kochle\u00e1rn\u00edm implant\u00e1tu a odli\u0161nost jednotliv\u00fdch hlem\u00fd\u017e\u010f\u016f od typicky vytvo\u0159en\u00fdch, ale nebylo mo\u017en\u00e9 je zahrnout do nastaven\u00ed. Pomoc\u00ed syst\u00e9mu OTOPLAN lze p\u0159ed operac\u00ed zm\u011b\u0159it individu\u00e1ln\u00ed kochleu a naj\u00edt ide\u00e1ln\u00ed d\u00e9lku elektrody. Nejnov\u011bj\u0161\u00ed verze programu OTOPLAN dok\u00e1\u017ee po implantaci tak\u00e9 zm\u011b\u0159it p\u0159esnou polohu jednotliv\u00fdch kontakt\u016f a p\u0159id\u011blit odpov\u00eddaj\u00edc\u00ed v\u00fd\u0161ky; nov\u00fd program MAESTRO 9.0 pro kochle\u00e1rn\u00ed implant\u00e1ty m\u016f\u017ee toto p\u0159id\u011blen\u00ed p\u0159evz\u00edt pro anatomick\u00e9 p\u0159izp\u016fsoben\u00ed zvukov\u00fdch procesor\u016f SONNET 2 a RONDO 3.<\/p>\n

Dal\u0161\u00ed vylep\u0161en\u00ed v nov\u00e9m programu pro kochle\u00e1rn\u00ed implant\u00e1t MED-EL MAESTRO 9.0<\/h2>\n

V nov\u00e9m programu pro osazov\u00e1n\u00ed MAESTRO 9.0 bylo provedeno v\u00edce ne\u017e 70 zm\u011bn: vylep\u0161en\u00e9 procesy nebo p\u0159ehledn\u011bj\u0161\u00ed zn\u00e1zorn\u011bn\u00ed – v\u011bt\u0161ina z nich je u\u017eite\u010dn\u00e1 p\u0159edev\u0161\u00edm pro specialisty, kte\u0159\u00ed s programem p\u0159\u00edmo pracuj\u00ed. N\u011bkter\u00e9 novinky jsou v\u0161ak p\u0159\u00edm\u00fdm vylep\u0161en\u00edm pro samotn\u00e9 u\u017eivatele kochle\u00e1rn\u00edch implant\u00e1t\u016f. Jednou z nich je nov\u00e1 mo\u017enost testov\u00e1n\u00ed mikrofonu SONNET 2 a RONDO 3: p\u0159i ka\u017ed\u00e9 sch\u016fzce v r\u00e1mci osazov\u00e1n\u00ed lze zkontrolovat, zda oba mikrofony ve zvukov\u00e9m procesoru pracuj\u00ed dob\u0159e a stejn\u011b. To je d\u016fle\u017eit\u00e9 pro mlad\u00e9 u\u017eivatele kochle\u00e1rn\u00edch implant\u00e1t\u016f, kte\u0159\u00ed nemohou tak dob\u0159e \u0159e\u0161it zm\u011bny sluchu. Porovn\u00e1n\u00ed obou mikrofon\u016f zajist\u00ed, \u017ee sn\u00edm\u00e1n\u00ed zvuku bude st\u00e1le zam\u011b\u0159eno spr\u00e1vn\u00fdm sm\u011brem.<\/p>\n

U p\u0159\u00edm\u00e9ho zvukov\u00e9ho vstupu (DAI), kter\u00fd se pou\u017e\u00edv\u00e1 tak\u00e9 v syst\u00e9mech FM, a u telec\u00edvky pro sn\u00edm\u00e1n\u00ed zvukov\u00fdch sign\u00e1l\u016f pomoc\u00ed indukce umo\u017e\u0148uj\u00ed dal\u0161\u00ed mo\u017enosti nastaven\u00ed lep\u0161\u00ed vz\u00e1jemn\u00e9 porovn\u00e1n\u00ed obou zvukov\u00fdch vstup\u016f. Nov\u00fd zvukov\u00fd procesor RONDO 3 je vybaven vestav\u011bnou bateri\u00ed: lze jej otestovat pomoc\u00ed MAESTRO 9.0. To znamen\u00e1, \u017ee term\u00edn servisn\u00ed prohl\u00eddky lze dohodnout d\u0159\u00edve, ne\u017e zkr\u00e1cen\u00e1 doba trv\u00e1n\u00ed funkce ovlivn\u00ed ka\u017edodenn\u00ed \u017eivot u\u017eivatele.<\/p>\n

Samotn\u00e9 audio procesory obsahuj\u00ed procesor, “mini po\u010d\u00edta\u010d”. Prost\u0159ednictv\u00edm mal\u00fdch zm\u011bn v programov\u00e1n\u00ed tohoto procesoru lze budouc\u00ed poznatky a vylep\u0161en\u00ed \u010das od \u010dasu vyu\u017e\u00edt i u procesor\u016f, kter\u00e9 jsou ji\u017e v provozu. Pro SONNET 2 a RONDO 3 nab\u00edz\u00ed MAESTRO 9.0 mo\u017enost jednoduch\u00e9 aktualizace p\u0159i nejbli\u017e\u0161\u00edm osazov\u00e1n\u00ed – u ostatn\u00edch procesor\u016f je to stejn\u011b jako d\u0159\u00edve mo\u017en\u00e9 v r\u00e1mci technick\u00e9ho servisu.<\/p>\n

Nejrozs\u00e1hlej\u0161\u00edm dal\u0161\u00edm v\u00fdvojem, kter\u00fd se stal dostupn\u00fdm s MAESTRO 9.0, je v\u0161ak mo\u017enost anatomick\u00e9ho osazen\u00ed (ABF) a bimod\u00e1ln\u00edho osazen\u00ed.<\/p>\n

V\u00edce informac\u00ed o nov\u00e9m programu pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL najdete na\u00a0www.medel.com<\/a>.<\/p>\n

\u00a0<\/span><\/p>\n<\/div>

<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

Nov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL s n\u00e1zvem MAESTRO 9.0 prohlubuje v\u011brnost pod\u00e1n\u00ed a vylep\u0161uje u\u017eivatelsk\u00fd z\u00e1\u017eitek ze sly\u0161en\u00ed<\/p>\n","protected":false},"author":4,"featured_media":32026,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[470],"tags":[416,417,422,485],"class_list":["post-2876","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda","tag-accessories","tag-ci","tag-hearing-implant-reliability","tag-rondo"],"yoast_head":"\nNov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL - Czech<\/title>\n<meta name=\"description\" content=\"Nov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL s n\u00e1zvem MAESTRO 9.0 prohlubuje v\u011brnost pod\u00e1n\u00ed a vylep\u0161uje u\u017eivatelsk\u00fd z\u00e1\u017eitek ze sly\u0161en\u00ed\" \/>\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\/novy-program-pro-kochlearni-implantaty-med-el\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nov\u00fd program pro kochle\u00e1rn\u00ed implant\u00e1ty MED-EL - 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