{"id":32605,"date":"2026-05-04T08:36:17","date_gmt":"2026-05-04T08:36:17","guid":{"rendered":"https:\/\/lifelonghearing.com\/hr\/?p=32605"},"modified":"2026-05-04T08:47:43","modified_gmt":"2026-05-04T08:47:43","slug":"dobar-sluh-unatoc-okostavanju","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/hr\/dobar-sluh-unatoc-okostavanju\/","title":{"rendered":"Dobar sluh unato\u010d oko\u0161tavanju"},"content":{"rendered":"

Kako kohlearni implantati i drugi slu\u0161ni implantati poma\u017eu kod otoskleroze<\/h1><\/div>

Kod 10 do 15% ljudi s otosklerozom, ni slu\u0161na pomagala ni operacija stremena ne vra\u0107aju sluh. Za njih su slu\u0161ni implantati dobra alternativa, i to \u010desto kohlearni implantati.<\/strong><\/p>\n

Eva Kohl i Yi Ge<\/em><\/p>\n<\/div>

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Godine 1893. be\u010dki otolog Adam Politzer prvi je opisao otosklerozu<\/em> kao neovisnu bolest. Obi\u010dno po\u010dinje na prijelazu izme\u0111u kosti srednjeg uha i unutarnjeg uha, izme\u0111u stremena i ovalnog prozora. Kost se formira oko nje kako bi formirala ko\u0161tanu masu sli\u010dnu \u017eeleu, otuda i naziv otospongioza. <\/em>Ta se o\u0161te\u0107enja \u0161ire i oko\u0161tavaju, a strukture se tamo ukru\u0107uju. To dovodi do pove\u0107anja provodljivog gubitka sluha, a rje\u0111e do senzorineuralnog gubitka sluha. Ponekad ovaj razvoj zavr\u0161ava funkcionalnom ili potpunom gluho\u0107om.<\/p>\n

\u010cesto konvencionalna slu\u0161na pomagala ili kirur\u0161ka zamjena stremena protezom mogu vratiti sluh. Me\u0111utim, kod jedne od sedam do deset pogo\u0111enih osoba to ne uspije: njima su i dalje dostupni aktivni slu\u0161ni implantati.<\/p>\n

Kod bolesnika s otosklerozom, u prosjeku, 16 godina prolazi od prvog gubitka sluha do preporu\u010denog kohlearnog implantata. Trajanje gluho\u0107e klju\u010dno je za kasniji uspjeh sluha s Cl. Iako progresija bolesti ne mo\u017ee zaustaviti implantat, on odr\u017eava funkciju slu\u0161nog \u017eivca. U svakom slu\u010daju, pogo\u0111eni ljudi mogu o\u010dekivati zna\u010dajna pobolj\u0161anja u otvrdnjavanju od Cl, osobito u ranoj implantaciji.<\/p>\n

\u0160irenje, tijek i u\u010dinci otoskleroze<\/h3>\n

Tipi\u010dni pacijent s otosklerozom je bijelac i izme\u0111u 15 i 45 godina. Manje je vjerojatno da \u0107e biti pogo\u0111eni mu\u0161karci i osobe drugih populacija. Prvi simptomi mogu se pojaviti tijekom hormonske pretvorbe – na primjer, tijekom trudno\u0107e, nakon zarazne bolesti, kao \u0161to su ospice, ili nakon te\u0161kog izlaganja buci. Raspravlja se o genetskom odnosu. Tako\u0111er je va\u017eno napomenuti: Devet od deset oboljelih od otoskleroze ostaje potpuno bez simptoma unato\u010d prekomjernom rastu kostiju i tkiva u kostima lubanje oko srednjeg uha!<\/p>\n

Ako se simptomi razviju, obi\u010dno po\u010dinje provodljivi gubitak sluha za niske zvukove, a zatim se progresivno pogor\u0161ava tijekom godina i desetlje\u0107a. Ono \u0161to je upe\u010datljivo je parakuza<\/em> nazvana po engleskom lije\u010dniku Thomasu Willisu: <\/em>jezik se bolje razumije u bu\u010dnom okru\u017eenju nego u miru. Kod (najvi\u0161e) jedne tre\u0107ine ljudi, oko\u0161tavanje kasnije prelazi u unutarnje uho, uzrokuju\u0107i kombinirani ili senzorineuralni gubitak sluha. Oko\u0161tavanje unutarnjeg uha, latinski: Cochlea, osobito te\u0161ka, naziva se kohlearno oko\u0161tavanje.<\/p>\n

Otoskleroza obi\u010dno poga\u0111a oba uha, ali nije uvijek tako te\u0161ka. Ve\u0107ina ljudi dodatno razvija zvonjavu u u\u0161ima, tako\u0111er nazvanu tinitus; oko 40% uz to ima blagu vrtoglavicu. Kod 10 do 15% ljudi slu\u0161ne ko\u0161\u010dice ostaju pokretne, no zbog rasta tkiva stvaraju se tvari koje o\u0161te\u0107uju unutarnje uho i uzrokuju senzorineuralni gubitak sluha: to se naziva otoskleroza unutarnjeg uha.<\/p>\n

Implantati – va\u017ene alternative u terapiji!<\/strong><\/h3>\n
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Yi Ge, MD, vi\u0161i menad\u017eer za medicinske aspekte u MED-EL-u: “Ako ni slu\u0161no pomagalo ni stapedektomija ne mogu vratiti sluh, oboljeli od otoskleroze obi\u010dno mogu imati optimalne koristi od razli\u010ditih implantacijskih sustava.” \u00a9private<\/p><\/div>\n

Lije\u010dnici ENT-a \u010desto slijede strategiju opservacijskog \u010dekanja kod pacijenata s otosklerozom. Konvencionalna slu\u0161na pomagala dizajnirana su kako bi nadoknadila blaga o\u0161te\u0107enja sluha. Kod pacijenata sa zna\u010dajnim konduktivnim gubitkom sluha, stapedektomija,<\/em> \u010desto posti\u017ee dobre rezultate, <\/em>uklju\u010duju\u0107i: stapektomiju<\/em>: Stremen, latinski: Stapes, <\/em>je ona od tri kosti srednjeg uha gdje obi\u010dno po\u010dinje oko\u0161tavanje. U slu\u010daju stapektomije, <\/em>ona se djelomi\u010dno ili potpuno zamjenjuje protezom – koja se naziva i pasivni implantat srednjeg uha<\/em>.<\/p>\n

Me\u0111utim, 10 do 15 posto pacijenata ne oporavi \u017eeljenu sposobnost sluha bilo slu\u0161nim aparatom ili kao rezultat ove operacije ili kombinacije dva. “Na\u017ealost, jo\u0161 uvijek ne postoji konsenzus o tome kako se takvi pacijenti mogu naju\u010dinkovitije lije\u010diti”, obja\u0161njava Yi Ge, MD, vi\u0161i menad\u017eer za medicinske aspekte u proizvo\u0111a\u010du implantata MED-EL. “U ve\u0107ini slu\u010dajeva ti pacijenti mogu imati optimalne koristi od razli\u010ditih implantolo\u0161kih sustava.”<\/p>\n

Zapravo, postoje dobri kandidati za gotovo svaki implantolo\u0161ki sustav me\u0111u oboljelima od otoskleroze. BONEBRIDGE<\/em> implantat za ko\u0161tanu provodljivost posebno je pogodan za veliku skupinu ljudi s \u010distim ili prete\u017eno provodnim gubitkom sluha. <\/em>Ali jednom kada gubitak sluha u uhu zadovolji kriterije za CI, postaje najperspektivnija alternativa.<\/p>\n

Tako\u0111er za otosklerozu: Pravovremena implantacija je va\u017ena!<\/strong><\/h3>\n

Otoskleroza uklju\u010duje prekomjeran rast mekog tkiva koje se naziva fibroza<\/em> i kosti koje se nazivaju osteogeneza. <\/em>To mo\u017ee postati kirur\u0161ki izazov prilikom umetanja Cl elektrode. To \u010dini jedinstveni alat za planiranje OTOPLAN jo\u0161 korisnijim, s kojim kirurzi mogu planirati implantaciju MED-EL slu\u0161nih sustava i \u010dak odrediti optimalnu duljinu nosa\u010da elektroda. Veliki izbor elektroda omogu\u0107uje optimalnu prilagodbu individualnoj duljini jo\u0161 uvijek nedovoljnog dijela pu\u017enice:<\/p>\n

Na taj se na\u010din mogu osigurati vrijedni resursi za kasnije razumijevanje govora s Cl-om.<\/p>\n

Otoskleroza je progresivni proces, kao i rezultiraju\u0107e o\u0161te\u0107enje sluha. Kohlearni implantati, kao \u0161to su slu\u0161na pomagala, spajalice ili drugi slu\u0161ni implantati, namijenjeni su pobolj\u0161anju sluha i razumijevanja govora. Me\u0111utim, oni ne mogu usporiti ili zaustaviti prekomjerni rast kostiju. Bolest mo\u017ee polako napredovati u pozadini i mo\u017ee tako\u0111er utjecati na sluh s Cl tijekom vremena. Me\u0111utim, elektri\u010dna stimulacija poma\u017ee o\u010duvati funkciju slu\u0161nog \u017eivca i sprije\u010diti njegovu daljnju degeneraciju. [1]<\/sup><\/a>[2]<\/sup><\/a>[3]<\/sup><\/a><\/p>\n

Oboljeli od otoskleroze dokazali su dobre rezultate sluha s kohlearnim implantatima. [4]<\/sup><\/a>[5]<\/sup><\/a> Iako kohlearni implantati \u010dine potrebnim naviku na slu\u0161anje i rehabilitaciju, rezultati istra\u017eivanja pokazuju da CIS, kada je indicirano, \u010dak dovodi do zna\u010dajno ve\u0107eg zadovoljstva kod osoba koje pate od otoskleroze nego rekonstrukcije stremena. [6]<\/sup> <\/a>Utjecajni \u010dimbenici za dobar sluh s Cl \u010dini se da su isti kao i kod drugih korisnika Cl, bez obzira na osnovnu bolest otoskleroze; izme\u0111u ostalog, kra\u0107e zahva\u0107eno uho nije moglo \u010duti ni\u0161ta, to je bolji uspjeh. Stoga je te\u017ee razumjeti za\u0161to oboljeli od otoskleroze moraju \u010dekati prosje\u010dno 16 godina dok Cl kona\u010dno ne izvu\u010de uho iz ti\u0161ine.
\n___________________________________________________________________________________________________________<\/p>\n

Reference<\/h3>\n

Reference<\/h3>\n

[1] Kopelovich JC, et al., Intrakohlearna elektri\u010dna stimulacija potiskuje apoptotsko signaliziranje u spiralnim ganglijskim neuronima \u0161takora nakon zaglu\u0161ivanja in vivo. Otolaringolni kirur\u0161ki zahvat na vratu. 2013 Studeni;149(5):745-752. DOI: 10.1177 \/0194599813498702.<\/p>\n

[2] Chen 1, et al. U\u010dinak elektri\u010dne stimulacije posredovane kohlearnim implantatima na spiralne ganglijske stanice kod uro\u0111enih gluhih bijelih ma\u010daka. Izvr\u0161ni direktor Res Otolaryngol. 2010 Prosinac;11 (4):587-603. DOI: 10.1007\/s10162-010- 0234-3.<\/p>\n

[3] Fallon JB, et al. U\u010dinci kroni\u010dne kohlearne elektri\u010dne stimulacije nakon duljeg razdoblja dubokog nedostatka na primarnu organizaciju slu\u0161nog korteksa kod ma\u010daka. Europski \u010dasopis za neuroznanost. 2014 O\u017eujak; 39(5):811-820. DOI: 10.1111 \/ejn.12445<\/p>\n

[4] Skarzynski PH, et al. Ishodi kohlearne implantacije u bolesnika s daleko uznapredovalom otosklerozom koji su prethodno bili podvrgnuti kirur\u0161kom zahvatu. J Int Adv Otol 2024.;20(2):101-107. doi:10.5152\/iao.2024.231332<\/p>\n

[5] Assiri M, <\/strong>et al. Kohlearna implantacija u bolesnika s otosklerozom: sustavni pregled klini\u010dkih karakteristika i ishoda. Va\u0161 Arch Otorhinolaringol. <\/em>2022.;279(7):3327-3339. DOI:10.1007\/S00405- 021-07036-5<\/p>\n

[6] Kondo M, et al. Kohlearna implantacija kod daleko napredne otoskleroze: sustavni pregled i metaanaliza. Laringoskop. <\/em>2023.;133(6):1288-1296. DOI: 10.1002\/lary.30386<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

Kod 10 do 15% ljudi s otosklerozom, ni slu\u0161na pomagala ni StapesOperation ne vra\u0107aju sluh. Za njih su slu\u0161ni implantati dobra alternativa, i to \u010desto kohlearni implantati.<\/p>\n","protected":false},"author":10,"featured_media":32682,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[411],"tags":[],"class_list":["post-32605","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravlje-hr"],"yoast_head":"\nDobar sluh unato\u010d oko\u0161tavanju - Croatian<\/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\/hr\/dobar-sluh-unatoc-okostavanju\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Dobar sluh unato\u010d oko\u0161tavanju - Croatian\" \/>\n<meta property=\"og:description\" content=\"Kod 10 do 15% ljudi s otosklerozom, ni slu\u0161na pomagala ni StapesOperation ne vra\u0107aju sluh. 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