{"id":33038,"date":"2025-11-05T09:44:33","date_gmt":"2025-11-05T09:44:33","guid":{"rendered":"https:\/\/lifelonghearing.com\/hu\/?p=33038"},"modified":"2025-11-05T09:44:33","modified_gmt":"2025-11-05T09:44:33","slug":"jo-hallas-meg-otosclerosis-eseten-is","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/hu\/jo-hallas-meg-otosclerosis-eseten-is\/","title":{"rendered":"J\u00f3 hall\u00e1s m\u00e9g otosclerosis eset\u00e9n is"},"content":{"rendered":"

Hogyan seg\u00edtenek a cochle\u00e1ris implant\u00e1tumok \u00e9s m\u00e1s hall\u00e1sjav\u00edt\u00f3 implant\u00e1tumok az otosclerosis (csontosod\u00e1s) kezel\u00e9s\u00e9ben<\/em><\/strong><\/h1><\/div>

Az otosclerosisban szenved\u0151k 10\u201315%-\u00e1n\u00e1l sem a hall\u00f3k\u00e9sz\u00fcl\u00e9k, sem a kengyelm\u0171t\u00e9t (a k\u00f6z\u00e9pf\u00fclben elmerevedett hall\u00f3csont p\u00f3tl\u00e1sa) nem \u00e1ll\u00edtja helyre a hall\u00e1st. Sz\u00e1mukra a hall\u00e1simplant\u00e1tumok \u2013 gyakran a cochle\u00e1ris implant\u00e1tumok \u2013 jelentenek j\u00f3 alternat\u00edv\u00e1t.<\/strong><\/p>\n

Eva Kohl \u00e9s Yi Ge<\/em><\/p>\n<\/div>

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template_featured (3)<\/h6><\/div><\/div><\/div><\/div><\/div><\/div><\/div>

1893-ban Adam Politzer b\u00e9csi f\u00fcl\u00e9sz (otol\u00f3gus) \u00edrta le el\u0151sz\u00f6r az otosclerosist \u00f6n\u00e1ll\u00f3 betegs\u00e9gk\u00e9nt. \u00c1ltal\u00e1ban a k\u00f6z\u00e9pf\u00fcl \u00e9s a bels\u0151 f\u00fcl hat\u00e1r\u00e1n, a kengyel \u00e9s az ov\u00e1lis ablak tal\u00e1lkoz\u00e1s\u00e1n\u00e1l kezd\u0151dik. Itt a csont egy kocsony\u00e1s \u00e1llag\u00fa csontsz\u00f6vett\u00e9 alakul \u00e1t \u2013 innen ered az otospongiosis<\/strong> elnevez\u00e9s. Ez az elv\u00e1ltoz\u00e1s k\u00e9s\u0151bb tov\u00e1bbterjed \u00e9s elcsontosodik, ami a f\u00fcl szerkezeteinek merevs\u00e9g\u00e9hez vezet. Ennek k\u00f6vetkezt\u00e9ben vezet\u00e9ses hall\u00e1scs\u00f6kken\u00e9s<\/strong> alakul ki, ritk\u00e1bban idegi (sensorineuralis) hall\u00e1sveszt\u00e9s<\/strong> is. Egyes esetekben ez a folyamat r\u00e9szleges vagy teljes s\u00fckets\u00e9ggel v\u00e9gz\u0151dhet.<\/p>\n

Gyakran a hagyom\u00e1nyos hall\u00f3k\u00e9sz\u00fcl\u00e9kek vagy a kengyel prot\u00e9zissel t\u00f6rt\u00e9n\u0151 seb\u00e9szi p\u00f3tl\u00e1sa helyre tudja \u00e1ll\u00edtani a hall\u00e1st. Azonban minden h\u00e9t-t\u00edz \u00e9rintettb\u0151l egyn\u00e9l ez nem j\u00e1r sikerrel \u2013 sz\u00e1mukra m\u00e9g mindig el\u00e9rhet\u0151k az akt\u00edv hall\u00e1simplant\u00e1tumok<\/strong>.<\/p>\n

Az otosclerosisban szenved\u0151 betegekn\u00e9l \u00e1tlagosan 16 \u00e9v telik el az els\u0151 hall\u00e1scs\u00f6kken\u00e9s megjelen\u00e9s\u00e9t\u0151l addig, am\u00edg cochle\u00e1ris implant\u00e1tumot javasolnak. A s\u00fckets\u00e9g id\u0151tartama kulcsfontoss\u00e1g\u00fa t\u00e9nyez\u0151 a k\u00e9s\u0151bbi hall\u00e1si eredm\u00e9ny szempontj\u00e1b\u00f3l. B\u00e1r az implant\u00e1tum nem \u00e1ll\u00edtja meg a betegs\u00e9g el\u0151rehalad\u00e1s\u00e1t, seg\u00edt meg\u0151rizni a hall\u00f3ideg m\u0171k\u00f6d\u00e9s\u00e9t. Minden esetben jelent\u0151s hall\u00e1sjavul\u00e1s v\u00e1rhat\u00f3 a cochle\u00e1ris implant\u00e1tummal \u2013 k\u00fcl\u00f6n\u00f6sen, ha a be\u00fcltet\u00e9s kor\u00e1n t\u00f6rt\u00e9nik.<\/p>\n

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\u00a9Adobe Stock<\/p><\/div>\n

Az otosclerosis terjed\u00e9se, lefoly\u00e1sa \u00e9s hat\u00e1sai<\/h3>\n

A tipikus otosclerosisban szenved\u0151 beteg feh\u00e9r b\u0151r\u0171, 15 \u00e9s 45 \u00e9v k\u00f6z\u00f6tti. A f\u00e9rfiakn\u00e1l \u00e9s m\u00e1s b\u0151rsz\u00edn\u0171 emberekn\u00e9l ritk\u00e1bban fordul el\u0151 a betegs\u00e9g. Az els\u0151 t\u00fcnetek gyakran hormon\u00e1lis v\u00e1ltoz\u00e1sok idej\u00e9n jelentkeznek \u2013 p\u00e9ld\u00e1ul terhess\u00e9g alatt \u2013, de el\u0151id\u00e9zheti fert\u0151z\u0151 betegs\u00e9g (p\u00e9ld\u00e1ul kanyar\u00f3) vagy tart\u00f3s zajterhel\u00e9s is. Felt\u00e9telezhet\u0151 \u00f6r\u00f6kletes hajlam is. \u00c9rdekess\u00e9g, hogy t\u00edz otosclerosisos betegb\u0151l kilencn\u00e9l a k\u00f6z\u00e9pf\u00fclet k\u00f6r\u00fclvev\u0151 koponyacsontban bek\u00f6vetkez\u0151 k\u00f3ros csont- \u00e9s sz\u00f6vetszaporulat ellen\u00e9re sem jelentkeznek t\u00fcnetek.<\/p>\n

Ha t\u00fcnetek jelentkeznek, \u00e1ltal\u00e1ban m\u00e9ly hangokra jelentkez\u0151 vezet\u00e9ses hall\u00e1scs\u00f6kken\u00e9s alakul ki el\u0151sz\u00f6r, amely az \u00e9vek, \u00e9vtizedek sor\u00e1n fokozatosan romlik. Jellemz\u0151 t\u00fcnet az angol orvos, Thomas Willis<\/strong> ut\u00e1n elnevezett paracusis Willisii<\/em>: az \u00e9rintettek zajos k\u00f6rnyezetben jobban \u00e9rtik a besz\u00e9det, mint csendben. Az esetek ak\u00e1r egyharmad\u00e1ban a csontosod\u00e1s k\u00e9s\u0151bb a bels\u0151 f\u00fclre is \u00e1tterjed, ami kevert vagy idegi (sensorineuralis) hall\u00e1sveszt\u00e9st okoz. Ha a csontosod\u00e1s a bels\u0151 f\u00fclben (latinul: cochlea<\/em>) k\u00fcl\u00f6n\u00f6sen s\u00falyos m\u00e9rt\u00e9k\u0171, azt cochlearis ossificati\u00f3nak<\/em> nevezz\u00fck.<\/p>\n

Az otosclerosis \u00e1ltal\u00e1ban mindk\u00e9t f\u00fclet \u00e9rinti, de nem mindig azonos m\u00e9rt\u00e9kben s\u00falyos. Az \u00e9rintettek t\u00f6bbs\u00e9g\u00e9n\u00e9l f\u00fclz\u00fag\u00e1s (tinnitus)<\/strong> is kialakul, \u00e9s mintegy 40%-ukn\u00e1l enyhe sz\u00e9d\u00fcl\u00e9s is jelentkezik. Az esetek 10\u201315%-\u00e1ban a hall\u00f3csontok mozg\u00e9konyak maradnak, azonban a sz\u00f6vetburj\u00e1nz\u00e1s olyan anyagokat termel, amelyek k\u00e1ros\u00edtj\u00e1k a bels\u0151 f\u00fclet, \u00e9s idegi (sensorineuralis) hall\u00e1sveszt\u00e9st okoznak \u2013 ezt a form\u00e1t bels\u0151f\u00fcl-otosclerosisnak<\/strong> nevezz\u00fck.<\/p>\n

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\u201eHa sem a hall\u00f3k\u00e9sz\u00fcl\u00e9k, sem a stapedectomia nem k\u00e9pes visszaadni a hall\u00e1st, az otosclerosisban szenved\u0151k \u00e1ltal\u00e1ban t\u00f6bbf\u00e9le implant\u00e1tumrendszerrel is optim\u00e1lis eredm\u00e9nyt \u00e9rhetnek el.\u201d\u00a9priv\u00e1t arch\u00edvum<\/p><\/div>\n

Implant\u00e1tumok \u2013 fontos alternat\u00edv\u00e1k a ter\u00e1pi\u00e1ban!<\/h3>\n

A kezel\u0151 f\u00fcl-orr-g\u00e9g\u00e9sz orvosok otosclerosis eset\u00e9n gyakran az \u00fagynevezett \u201emegfigyel\u0151 v\u00e1rakoz\u00e1s\u201d<\/em> strat\u00e9gi\u00e1j\u00e1t k\u00f6vetik. A hagyom\u00e1nyos hall\u00f3k\u00e9sz\u00fcl\u00e9keket enyh\u00e9bb hall\u00e1scs\u00f6kken\u00e9s kompenz\u00e1l\u00e1s\u00e1ra tervezt\u00e9k. Azokn\u00e1l a betegekn\u00e9l azonban, akikn\u00e9l jelent\u0151s vezet\u00e9ses hall\u00e1sveszt\u00e9s \u00e1ll fenn, a stapedectomia<\/strong> gyakran j\u00f3 eredm\u00e9nyeket hoz. A stapedectomia sor\u00e1n \u2013 ahol az elv\u00e1ltoz\u00e1s \u00e1ltal\u00e1ban kezd\u0151dik \u2013 a kengyelt<\/strong> (latinul: stapes<\/em>, a h\u00e1rom k\u00f6z\u00e9pf\u00fclcsont egyike) r\u00e9szben vagy teljesen egy prot\u00e9zissel<\/strong> helyettes\u00edtik, amelyet passz\u00edv k\u00f6z\u00e9pf\u00fcl-implant\u00e1tumnak<\/strong> is neveznek.<\/p>\n

Azonban a betegek 10\u201315%-\u00e1n\u00e1l sem a hall\u00f3k\u00e9sz\u00fcl\u00e9k, sem a m\u0171t\u00e9t, illetve a kett\u0151 kombin\u00e1ci\u00f3ja nem eredm\u00e9nyezi a k\u00edv\u00e1nt hall\u00e1sjavul\u00e1st. \u201eSajnos egyel\u0151re nincs egys\u00e9ges szakmai \u00e1ll\u00e1spont arr\u00f3l, hogyan kezelhet\u0151k ezek a betegek a leghat\u00e9konyabban\u201d \u2013 magyar\u00e1zza Dr. Yi Ge<\/strong>, a MED-EL implant\u00e1tumgy\u00e1rt\u00f3 c\u00e9g orvosi r\u00e9szleg\u00e9nek vezet\u0151 szak\u00e9rt\u0151je. \u201eA legt\u00f6bb esetben ezek a p\u00e1ciensek k\u00fcl\u00f6nb\u00f6z\u0151 implant\u00e1tumrendszerekkel \u00e9rhetik el az optim\u00e1lis eredm\u00e9nyt.\u201d<\/p>\n

Val\u00f3j\u00e1ban szinte minden implant\u00e1tumt\u00edpushoz tal\u00e1lhat\u00f3k megfelel\u0151 jel\u00f6ltek az otosclerosisban szenved\u0151k k\u00f6z\u00f6tt. A BONEBRIDGE<\/strong> csontvezet\u00e9ses implant\u00e1tum k\u00fcl\u00f6n\u00f6sen alkalmas azok sz\u00e1m\u00e1ra, akikn\u00e9l tiszta vagy t\u00falnyom\u00f3r\u00e9szt vezet\u00e9ses hall\u00e1sveszt\u00e9s \u00e1ll fenn. Amint azonban a hall\u00e1sveszt\u00e9s el\u00e9ri a cochle\u00e1ris implant\u00e1ci\u00f3 (CI)<\/strong> indik\u00e1ci\u00f3s szintj\u00e9t, ez v\u00e1lik a leg\u00edg\u00e9retesebb megold\u00e1ss\u00e1.<\/p>\n

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A MED-EL t\u00f6bbf\u00e9le megold\u00e1st k\u00edn\u00e1l az otosclerosisban szenved\u0151 betegek sz\u00e1m\u00e1ra \u2013 a kengyelprot\u00e9zisekt\u0151l kezdve a csontvezet\u00e9ses megold\u00e1sokon \u00e1t eg\u00e9szen a cochle\u00e1ris implant\u00e1tumig. \u00a9MED-EL<\/p><\/div>\n

Az otosclerosis eset\u00e9ben is: fontos az id\u0151ben t\u00f6rt\u00e9n\u0151 be\u00fcltet\u00e9s!<\/h3>\n

Az otosclerosis sor\u00e1n k\u00f3ros m\u00e9rt\u00e9k\u0171 sz\u00f6vetszaporulat (fibrosis)<\/strong> \u00e9s csontk\u00e9pz\u0151d\u00e9s (osteogenesis)<\/strong> zajlik, ami seb\u00e9szeti kih\u00edv\u00e1st jelenthet a cochle\u00e1ris implant\u00e1tum elektr\u00f3d\u00e1j\u00e1nak behelyez\u00e9sekor. Ebben ny\u00fajt k\u00fcl\u00f6n\u00f6sen nagy seg\u00edts\u00e9get az egyed\u00fcl\u00e1ll\u00f3 OTOPLAN<\/strong> tervez\u0151eszk\u00f6z, amellyel a seb\u00e9szek megtervezhetik a MED-EL hall\u00e1simplant\u00e1tumok be\u00fcltet\u00e9s\u00e9t, \u00e9s ak\u00e1r az elektr\u00f3dahordoz\u00f3 optim\u00e1lis hossz\u00e1t is meghat\u00e1rozhatj\u00e1k. A sz\u00e9les elektr\u00f3dav\u00e1laszt\u00e9k lehet\u0151v\u00e9 teszi, hogy az implant\u00e1tum t\u00f6k\u00e9letesen illeszkedjen a m\u00e9g nem elcsontosodott cochlear\u00e9sz hossz\u00e1hoz, \u00edgy \u00e9rt\u00e9kes hall\u00e1si er\u0151forr\u00e1sok \u0151rizhet\u0151k meg a k\u00e9s\u0151bbi besz\u00e9d\u00e9rt\u00e9s jav\u00edt\u00e1sa \u00e9rdek\u00e9ben.<\/p>\n

Az otosclerosis progressz\u00edv folyamat, ak\u00e1rcsak az \u00e1ltala okozott hall\u00e1scs\u00f6kken\u00e9s. A cochle\u00e1ris implant\u00e1tumok, csak\u00fagy mint a hall\u00f3k\u00e9sz\u00fcl\u00e9kek, a kengyelm\u0171t\u00e9t vagy m\u00e1s hall\u00e1simplant\u00e1tumok, a c\u00e9ljuk szerint a hall\u00e1s \u00e9s a besz\u00e9d\u00e9rt\u00e9s jav\u00edt\u00e1s\u00e1t szolg\u00e1lj\u00e1k. Azonban nem k\u00e9pesek meg\u00e1ll\u00edtani vagy lelass\u00edtani a t\u00falzott csontk\u00e9pz\u0151d\u00e9st. A betegs\u00e9g lassan, a h\u00e1tt\u00e9rben tov\u00e1bbhaladhat, \u00e9s id\u0151vel befoly\u00e1solhatja a cochle\u00e1ris implant\u00e1tummal el\u00e9rt hall\u00e1st is. Ugyanakkor az elektromos stimul\u00e1ci\u00f3 seg\u00edt meg\u0151rizni a hall\u00f3ideg m\u0171k\u00f6d\u00e9s\u00e9t, \u00e9s megel\u0151zheti annak tov\u00e1bbi k\u00e1rosod\u00e1s\u00e1t.1\u20133<\/sup><\/p>\n

Az otosclerosisban szenved\u0151 betegek eset\u00e9ben a cochle\u00e1ris implant\u00e1tumokkal el\u00e9rt hall\u00e1si eredm\u00e9nyek bizony\u00edtottan nagyon j\u00f3k.4\u20135<\/sup> B\u00e1r a cochle\u00e1ris implant\u00e1tum haszn\u00e1lata megszok\u00e1st \u00e9s rehabilit\u00e1ci\u00f3t ig\u00e9nyel, a kutat\u00e1sok azt mutatj\u00e1k, hogy a megfelel\u0151en indik\u00e1lt CI-kezel\u00e9s jelent\u0151sen nagyobb el\u00e9gedetts\u00e9get eredm\u00e9nyez az otosclerosisos betegek k\u00f6r\u00e9ben, mint a kengyelrekonstrukci\u00f3s m\u0171t\u00e9tek. A j\u00f3 hall\u00e1si eredm\u00e9nyt befoly\u00e1sol\u00f3 t\u00e9nyez\u0151k ugyanazoknak t\u0171nnek, mint m\u00e1s cochle\u00e1ris implant\u00e1tum-haszn\u00e1l\u00f3kn\u00e1l, f\u00fcggetlen\u00fcl az alapbetegs\u00e9gt\u0151l. T\u00f6bbek k\u00f6z\u00f6tt: min\u00e9l r\u00f6videbb ideig volt teljesen siket az \u00e9rintett f\u00fcl, ann\u00e1l jobb a kimenetel. Ez\u00e9rt is nehezen \u00e9rthet\u0151, hogy az otosclerosisban szenved\u0151knek \u00e1tlagosan 16 \u00e9vet kell v\u00e1rniuk, mire egy cochle\u00e1ris implant\u00e1tum v\u00e9gre kivezeti f\u00fcl\u00fcket a csendb\u0151l.<\/p>\n<\/div>

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1 Kopelovich JC, et al., Intracochlearis elektromos stimul\u00e1ci\u00f3 elnyomja az apoptotikus jel\u00e1tvitelt patk\u00e1ny spir\u00e1lis ganglion neuronokban in vivo f\u00fclsiket\u00edt\u00e9s ut\u00e1n. Otolaryngol Fej Nyak Seb\u00e9szet. 2013. november; 149(5):745-752. doi: 10.1177 \/0194599813498702.<\/p>\n

2 Chen 1, et al. A cochlearis implant\u00e1tum \u00e1ltal k\u00f6zvet\u00edtett elektromos stimul\u00e1ci\u00f3 hat\u00e1sa spir\u00e1lis ganglionsejtekre velesz\u00fcletett siket feh\u00e9r macsk\u00e1kban. J Assoc Res Otolaryngol. 2010. dec.; 11 (4):587-603. doi: 10.1007\/s10162-010- 0234-3.<\/p>\n

3 Fallon JB, et al. A hosszan tart\u00f3 s\u00falyos hi\u00e1nyos id\u0151szakot k\u00f6vet\u0151 kr\u00f3nikus cochlearis elektromos stimul\u00e1ci\u00f3 hat\u00e1sa macsk\u00e1k els\u0151dleges hall\u00f3k\u00e9reg\u00e9nek szervez\u0151d\u00e9s\u00e9re. Eur\u00f3pai Idegtudom\u00e1nyi Foly\u00f3irat. 2014. m\u00e1rcius; 39(5):811-820. doi: 10.1111 \/ejn.12445<\/p>\n

4 Skarzynski PH, et al. A cochle\u00e1ris implant\u00e1ci\u00f3 eredm\u00e9nyei olyan, t\u00e1voli el\u0151rehaladott otosclerosisban szenved\u0151 betegekn\u00e9l, akik kor\u00e1bban stapes m\u0171t\u00e9ten estek \u00e1t. J Int Adv Otol 2024;20(2):101-107. doi:10.5152\/iao.2024.231332<\/p>\n

5 Assiri M, <\/strong>et al. Cochlearis implant\u00e1ci\u00f3 otosclerosisban szenved\u0151 betegek k\u00f6r\u00e9ben: a klinikai jellemz\u0151k \u00e9s eredm\u00e9nyek szisztematikus \u00e1ttekint\u00e9se. Az Arch Otorhinolaryngol. <\/em>2022;279(7):3327-3339. doi:10.1007\/s00405- 021-07036-5<\/p>\n

6 Kondo M, et al. Cochlearis implant\u00e1ci\u00f3 a t\u00e1voli el\u0151rehaladott otosclerosisban: szisztematikus \u00e1ttekint\u00e9s \u00e9s metaanal\u00edzis. Laringoszk\u00f3p. <\/em>2023;133(6):1288-1296. doi: 10.1002\/lary.30386<\/p>\n<\/div>

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Hogyan seg\u00edtenek a cochle\u00e1ris implant\u00e1tumok \u00e9s m\u00e1s hall\u00e1sjav\u00edt\u00f3 implant\u00e1tumok az otosclerosis (csontosod\u00e1s) kezel\u00e9s\u00e9ben<\/p>\n","protected":false},"author":8,"featured_media":33040,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[411],"tags":[],"class_list":["post-33038","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-egeszseg"],"yoast_head":"\nJ\u00f3 hall\u00e1s m\u00e9g otosclerosis eset\u00e9n is - Hungary<\/title>\n<meta name=\"description\" content=\"A m\u00e9rs\u00e9kelt \u00e9s s\u00falyos hall\u00e1sk\u00e1rosod\u00e1ssal \u00e9rintettek 80%-a fejl\u0151d\u0151 orsz\u00e1gban \u00e9l. 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