{"id":32266,"date":"2025-01-03T15:23:17","date_gmt":"2025-01-03T15:23:17","guid":{"rendered":"https:\/\/lifelonghearing.com\/sk\/?p=32266"},"modified":"2025-04-28T14:25:32","modified_gmt":"2025-04-28T14:25:32","slug":"kochlearna-implantacia-na-slovensku-a-vo-svete-v-minulosti-a-dnes","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/sk\/kochlearna-implantacia-na-slovensku-a-vo-svete-v-minulosti-a-dnes\/","title":{"rendered":"Kochle\u00e1rna implant\u00e1cia na Slovensku a vo svete \u2013 v minulosti a dnes"},"content":{"rendered":"

Porovnanie kochle\u00e1rnej implant\u00e1cie u\u00a0n\u00e1s a\u00a0vo svete spolu s\u00a0realiz\u00e1ciou implant\u00e1cie u\u00a0mal\u00fdch\u00a0det\u00ed<\/span><\/b><\/p><\/h1><\/div>

Prv\u00fd modren\u00fd viackan\u00e1lov\u00fd kochle\u00e1rny implant\u00e1t bol v\u00a0zahrani\u010d\u00ed implantovan\u00fd v\u00a0roku 1977. Na Slovensku sme si museli na t\u00fato inov\u00e1ciu v\u00a0oblasti rie\u0161enia \u0165a\u017ekej senzorineur\u00e1lnej poruchy sluchu po\u010dka\u0165 e\u0161te\u00a016 rokov, pri\u010dom tento rok sme osl\u00e1vili 30 rokov kochle\u00e1rnej implant\u00e1cie v\u00a0na\u0161ej krajine. Kochle\u00e1rna implant\u00e1cia sa naj\u010dastej\u0161ie indikuje u\u00a0det\u00ed s obojstrannou prelingv\u00e1lnou hluchotou alebo \u0165a\u017ekou poruchou sluchu do 5 rokov veku. V\u00a0zahrani\u010d\u00ed odpor\u00fa\u010daj\u00fa tak\u00e9to deti implantova\u0165 medzi 10. a\u017e 12. mesiacom veku, na Slovensku by vek die\u0165a\u0165a v \u010dase prvej kochle\u00e1rnej implant\u00e1cie (pokia\u013e hluchota nie je sp\u00f4soben\u00e1 meningit\u00eddou) nemal by\u0165 ni\u017e\u0161\u00ed ako 12 mesiacov veku.<\/span><\/strong><\/p>\n<\/div>

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Foto: Veronika Klimonov\u00e1<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>
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Sluch je jedin\u00fdm \u013eudsk\u00fdm zmyslom, ktor\u00fd mo\u017eno kompenzova\u0165 prostredn\u00edctvom \u00a0technol\u00f3gie. Kochle\u00e1rny implant\u00e1t (KI) je doslova z\u00e1zra\u010dn\u00e9 zariadenie, ktor\u00e9 darovalo sluch takmer 800 tis\u00edcom \u013eu\u010fom s \u0165a\u017ekou stratou sluchu po celom svete (MED-EL, 2024[1]<\/a>). Jeho v\u00fdvoj bol komplikovan\u00fd a\u00a0samozrejmos\u0165ou boli aj konkuren\u010dn\u00e9 boje.\"\"<\/p>\n

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Foto: Audionika, 2024[2]<\/a><\/p>\n

Franc\u00fazsky t\u00edm elektrofyziol\u00f3ga A. Djournoa a\u00a0otorinolaryngol\u00f3ga Ch. Eyri\u00e8sa je v\u0161eobecne pova\u017eovan\u00fd za prv\u00fd, ktor\u00fd v\u00a0roku 1957 implantoval elektr\u00f3du do vn\u00fatorn\u00e9ho ucha, \u010d\u00edm\u00a0 elektricky stimuloval sluchov\u00fd nerv. T\u00edto odborn\u00edci predpovedali bezprostredn\u00fd v\u00fdvoj KI a v z\u00e1vere svojej prvej spr\u00e1vy uviedli, \u017ee elektrick\u00e1 stimul\u00e1cia kochley by nepochybne mohla vytvori\u0165 mechanizmus pre elektrick\u00e9 po\u010dutie. N\u00e1sledne americk\u00fd otol\u00f3g W. House \u2013 in\u0161pirovan\u00fd prv\u00fdm zaveden\u00edm elektr\u00f3dy vo Franc\u00fazsku a neurochirurg J. Doyle v\u00a0roku 1961 v Kalifornii implantovali prv\u00fd skuto\u010dn\u00fd KI, ktor\u00fd mal strieborn\u00fa viacdr\u00f4tov\u00fa elektr\u00f3du. V j\u00fani 1973 sa v San Franciscu organizovala prv\u00e1 medzin\u00e1rodn\u00e1 konferencia o elektrickej stimul\u00e1cii sluchov\u00e9ho nervu ako o lie\u010dbe \u0165a\u017ekej senzorineur\u00e1lnej poruchy sluchu u\u00a0\u013eud\u00ed, na z\u00e1klade \u010doho sa ust\u00e1lil pojem kochle\u00e1rny implant\u00e1t, ktor\u00fd bol definit\u00edvne zaveden\u00fd do lek\u00e1rskej terminol\u00f3gie. Kv\u00f4li n\u00edzkej \u00faspe\u0161nosti v rozli\u0161ovan\u00ed re\u010di s jednou elektr\u00f3dou, boli vyvinut\u00e9 in\u00e9 typy zariaden\u00ed s viacer\u00fdmi elektr\u00f3dami. Franc\u00fazsky otorinolaryngol\u00f3g C. H. Chouard realizoval v\u00a0roku 1976 implant\u00e1ciu zariadenia so siedmimi elektr\u00f3dami u\u00a0\u0161iestich pacientov s\u00a0\u0165a\u017ekou obojstrannou poruchou sluchu. Dal ho patentova\u0165 s\u00a0tvrden\u00edm, \u017ee syst\u00e9m s\u00a0viacer\u00fdmi s\u00fapravami elektr\u00f3d implantovate\u013en\u00fdch do kochley na r\u00f4znych miestach umo\u017en\u00ed mozgu identifikova\u0165 r\u00f4zne frekvencie v po\u010dute\u013enom rozsahu. Spom\u00ednan\u00e9 experimenty definit\u00edvne od\u0161tartovali obdobie komercializ\u00e1cie KI vo viacer\u00fdch krajin\u00e1ch po celom svete (MED-EL, 2024[3]<\/a>; Mudry, Mills, 2013[4]<\/a>; Eshraghi a\u00a0kol., 2012[5]<\/a>). N\u00e1sledne spolo\u010dnos\u0165 MED-EL vyrobila ako prv\u00e1 modern\u00fd mikroelektronick\u00fd viackan\u00e1lov\u00fd kochle\u00e1rny implant\u00e1t v\u00a0roku 1977 (MED-EL, 2024[6]<\/a>). Na opa\u010dnej strane sveta sa austr\u00e1lsky otol\u00f3g Graeme Clark pridal so svojou vlastnou verziou viackan\u00e1lov\u00e9ho kochle\u00e1rneho implant\u00e1tu pribli\u017ene o osem mesiacov nesk\u00f4r (MED-EL, 2024[7]<\/a>).<\/p>\n

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Foto: MED-EL, 2024[8]<\/a><\/p>\n

O\u00a016 rokov nesk\u00f4r sa kochle\u00e1rna implant\u00e1cia dostala kone\u010dne i\u00a0na Slovensko. V\u00a0na\u0161ej krajine sa program kochle\u00e1rnej implant\u00e1cie za\u010dal rozv\u00edja\u0165 u\u017e od roku 1986, pri\u010dom cie\u013eom bolo zavies\u0165 met\u00f3du kochle\u00e1rnej implant\u00e1cie na Slovensku a umo\u017eni\u0165 tak nepo\u010duj\u00facim po\u010du\u0165 (SCKI, 2018[9]<\/a>), av\u0161ak prv\u00e1 implant\u00e1cia KI sa uskuto\u010dnila a\u017e 8.\u00a0j\u00fala 1994 na ORL oddelen\u00ed na Zochovej ulici v\u00a0Bratislave. Prv\u00fdm pacientom bol 12-ro\u010dn\u00fd chlapec, ktor\u00fd ohluchol po lie\u010dbe siln\u00fdmi antibiotikami. Jeho matka, neurologi\u010dka, sa dozvedela o kochle\u00e1rnych implant\u00e1toch a po\u017eiadala Ministerstvo zdravotn\u00edctva o financovanie implant\u00e1cie v Nemecku. Ministerstvo po\u017eiadalo o odborn\u00fd posudok u\u017e renomovan\u00e9ho \u0161pecialistu na ORL, Prof. MUDr. Milana Profanta, CSc., ktor\u00fd namiesto financovania oper\u00e1cie v zahrani\u010d\u00ed odporu\u010dil pozva\u0165 chirurga KI na Slovensko, aby realizoval implant\u00e1ciu v Univerzitnej nemocnici v\u00a0Bratislave. Profesor Ernst Lehnhardt (z Hannoveru) urobil prv\u00fa oper\u00e1ciu a nau\u010dil profesora Milana Profanta tejto opera\u010dnej technike (Kohl, 2024[10]<\/a>; Dial\u00f3gy o\u00a0sluchu, 2024[11]<\/a>).<\/p>\n

Prv\u00e9 dve kochle\u00e1rne implant\u00e1cie boli teda vykonan\u00e9 u det\u00ed so z\u00edskanou hluchotou po meningit\u00edde, respekt\u00edve \u00faraze hlavy, po ktor\u00fdch nasledovali implant\u00e1cie u dospel\u00fdch postlingv\u00e1lne nepo\u010duj\u00facich. Nesk\u00f4r boli do programu KI v Bratislave zaraden\u00e9 aj deti s prelingv\u00e1lnou hluchotou (Dial\u00f3gy o\u00a0sluchu, 2024[12]<\/a>). Docentka Zuzana Kab\u00e1tov\u00e1 uv\u00e1dza, \u017ee na Slovensku je v\u00a0s\u00fa\u010dasnosti p\u00e4\u0165 pracov\u00edsk, kde sa rob\u00ed kochle\u00e1rna implant\u00e1cia (v troch mest\u00e1ch \u2013 Bratislava, Ru\u017eomberok, Ko\u0161ice a na 5 oddeleniach) (TASR, 2024[13]<\/a>). Profesor Profant vykonal ako hos\u0165uj\u00faci chirurg aj viac ako 600 \u010fal\u0161\u00edch implant\u00e1ci\u00ed v\u00a0zahrani\u010d\u00ed, a to na troch kontinentoch, v 27 mest\u00e1ch a v 18 r\u00f4znych krajin\u00e1ch (Kohl, 2024[14]<\/a>). Dostupnos\u0165 KI je pod\u013ea profesora Profanta na ve\u013emi dobrej \u00farovni, pri\u010dom implantovan\u00fd je pod\u013ea neho ka\u017ed\u00fd, kto KI potrebuje, respekt\u00edve ka\u017ed\u00fd, kto sa dostane k vy\u0161etreniu. Na Slovensku je od roku 2006 zaveden\u00fd skr\u00edning sluchu novorodencov, ktor\u00fd dok\u00e1\u017ee pr\u00edpadn\u00fa poruchu sluchu odhali\u0165 (UNB, 2024[15]<\/a>). V s\u00fa\u010dasnosti vyu\u017e\u00edva kochle\u00e1rny implant\u00e1t na Slovensku do 1000 pacientov (vi\u010f. Dial\u00f3gy o\u00a0sluchu, 2024[16]<\/a>; TASR, 2024[17]<\/a>; UNB, 2024[18]<\/a>).<\/p>\n

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Foto: UNB, 2024[19]<\/a><\/p>\n

Od \u010dias prvej kochle\u00e1rnej implant\u00e1cie na Slovensku do\u0161lo tie\u017e k v\u00fdrazn\u00fdm zmen\u00e1m vo v\u00fdberov\u00fdch krit\u00e9ri\u00e1ch. V po\u010diato\u010dnom obdob\u00ed sa implantovali iba \u00faplne nepo\u010duj\u00faci dospel\u00ed a deti. Nesk\u00f4r, na z\u00e1klade dobr\u00fdch v\u00fdsledkov a v\u00e4\u010d\u0161\u00edch sk\u00fasenost\u00ed, boli implantovan\u00ed aj pacienti so zvy\u0161kami sluchu, aby mali \u0161ancu na v\u00fdrazn\u00e9 zlep\u0161enie svojich komunika\u010dn\u00fdch schopnost\u00ed. V\u00a0roku 1995 bolo implantovan\u00e9 prv\u00e9 prelingv\u00e1lne nepo\u010duj\u00face die\u0165a a\u00a0v\u00a0roku 1999 bolo implantovan\u00e9 prv\u00e9 die\u0165a mlad\u0161ie ako 2 roky. Indika\u010dn\u00e9 krit\u00e9ri\u00e1 sa roz\u0161\u00edrili na obojstrann\u00fa implant\u00e1ciu det\u00ed a\u00a0dospel\u00fdch, pri\u010dom prv\u00e1 bilater\u00e1lna implant\u00e1cia sa uskuto\u010dnila v\u00a0roku 2000. Taktie\u017e sa indika\u010dn\u00e9 krit\u00e9ri\u00e1 roz\u0161\u00edrili na v\u00fdber pacientov s jednostrannou hluchotou a tinnitom. V\u00a0roku 2011 bolo na Slovensku u\u017e 260 nepo\u010duj\u00facich s\u00a0KI. Najstar\u0161ia pacientka bola implantovan\u00e1 vo veku 82 rokov. Zmenila sa aj opera\u010dn\u00e1 technika (komplikovan\u00e9 chlopne a rezy boli nahraden\u00e9 jednoduch\u00fdm retroaurikul\u00e1rnym rezom, kochleost\u00f3miu vo v\u00e4\u010d\u0161ine pr\u00edpadov nahradil pr\u00edstup cez okr\u00fahle okienko a \u0161tandardom je i monitorovanie tv\u00e1rov\u00e9ho nervu). V rokoch 2009 \u2013 2010 bol vytvoren\u00fd i vedeck\u00fd t\u00edm (prof. Profant a prof. Klime\u0161), ktor\u00fd sa zaober\u00e1 \u0161t\u00fadiom genetiky por\u00fach sluchu. Pre efekt\u00edvnu rehabilit\u00e1ciu det\u00ed boli do sloven\u010diny prelo\u017een\u00e9 viacer\u00e9 medzin\u00e1rodn\u00e9 testy a met\u00f3dy (napr. CAP, Little Ears), pri\u010dom rehabilit\u00e1cia je zameran\u00e1 na rozvoj re\u010di a sluchov\u00fdch schopnost\u00ed (Dial\u00f3gy o\u00a0sluchu, 2024[20]<\/a>; SCKI, 2018[21]<\/a>).<\/p>\n

Na rozdiel od zahrani\u010dn\u00e9ho \u0161tandardu sa v\u0161ak indika\u010dn\u00e9 krit\u00e9ri\u00e1 pre KI u\u00a0najmen\u0161\u00edch det\u00ed na Slovensku mierne l\u00ed\u0161ia. Vo svete sa kochle\u00e1rna implant\u00e1cia u mal\u00fdch det\u00ed \u010dasto vykon\u00e1va v ni\u017e\u0161om veku ako na Slovensku. V mnoh\u00fdch krajin\u00e1ch, vr\u00e1tane USA, Eur\u00f3py a Austr\u00e1lie, je be\u017en\u00e9 implantova\u0165 deti do 12 mesiacov veku. Sk\u00fasenosti toti\u017e ukazuj\u00fa, \u017ee \u010d\u00edm sk\u00f4r sa implant\u00e1cia vykon\u00e1, t\u00fdm lep\u0161ie s\u00fa v\u00fdsledky, najm\u00e4 v oblasti re\u010di a\u00a0porozumenia.<\/p>\n

Ako uv\u00e1dza Priv.-Doz. Dr. Astrid Magele, MBA, ved\u00faca lek\u00e1rka na klinike ORL Univerzitnej nemocnice St. P\u00f6lten, \u201ev pr\u00edpadoch dedi\u010dnej bilater\u00e1lnej hluchoty odpor\u00fa\u010dame implant\u00e1ciu KI \u010do najsk\u00f4r. Vedeck\u00e9 d\u00e1ta poukazuj\u00fa na fakt, \u017ee kochle\u00e1rna implant\u00e1cia okolo desiateho a\u017e dvan\u00e1steho mesiaca veku vytv\u00e1ra ide\u00e1lne podmienky na dosiahnutie \u010do najlep\u0161ieho porozumenia re\u010di\u201c (lifelonghearing, 2024[22]<\/a>). Tento n\u00e1zor potvrdzuje aj National Deaf Children\u00b4s Society (Anglicko, \u0160k\u00f3tsko), pri\u010dom poukazuje na fakt, \u017ee v\u00a0s\u00fa\u010dasnosti je be\u017en\u00e9, \u017ee deti s\u00fa implantovan\u00e9 pred dov\u0155\u0161en\u00edm 12 mesiacov veku. Ide o z\u00edskan\u00e9 d\u00f4kazy \u2013 \u010d\u00edm sk\u00f4r je die\u0165a implantovan\u00e9, t\u00fdm v\u00e4\u010d\u0161\u00ed \u00fa\u017eitok z\u00a0KI m\u00e1. Niektor\u00ed odborn\u00edci presadzuj\u00fa e\u0161te v\u010dasnej\u0161iu implant\u00e1ciu. Otorinolaryngol\u00f3g Colin L. W. Driscoll, M.D. (Mayo Clinic Children's Center v Rochesteri, Minnesota) tvrd\u00ed, \u017ee identifik\u00e1cia a lie\u010dba sluchov\u00e9ho postihnutia by mali prebieha\u0165 \u010do najsk\u00f4r, vr\u00e1tane kochle\u00e1rnej implant\u00e1cie u det\u00ed u\u017e od 6 mesiacov veku, ktor\u00e9 maj\u00fa stredn\u00fa a\u017e \u0165a\u017ek\u00fa stratu sluchu. \u201eZvy\u0161uj\u00face sa mno\u017estvo d\u00e1t ukazuje, \u017ee \u010d\u00edm sk\u00f4r sa implant\u00e1t vlo\u017e\u00ed, t\u00fdm lep\u0161ie s\u00fa v\u00fdsledky v oblasti re\u010di a\u00a0jazyka vo v\u0161eobecnosti\u201c, tvrd\u00ed (Mayoclinic, 2019[23]<\/a>).<\/p>\n

Kochle\u00e1rna implant\u00e1cia u\u00a0det\u00ed s obojstrannou prelingv\u00e1lnou hluchotou alebo \u0165a\u017ekou poruchou sluchu do 5 rokov veku sa na Slovensku indikuje sp\u00f4sobom, \u017ee vek die\u0165a\u0165a v \u010dase prvej kochle\u00e1rnej implant\u00e1cie (pokia\u013e hluchota nie je sp\u00f4soben\u00e1 meningit\u00eddou) by nemal by\u0165 ni\u017e\u0161\u00ed ako 12 mesiacov, a\u00a0to v pr\u00edpade nedostato\u010dn\u00e9ho benefitu pri pou\u017e\u00edvan\u00ed na\u010d\u00favacieho apar\u00e1tu (kochle\u00e1rne \u0165a\u017ek\u00e9 po\u0161kodenie sluchu na \u00farovni 75 dB a viac, prah sluchu s nasl\u00fachac\u00edm apar\u00e1tom hor\u0161\u00ed ako 50 dB, polovi\u010dn\u00e9 porozumenie pri detskej re\u010dovej audiometrii s\u00a0na\u010d\u00favac\u00edmi pr\u00edstrojmi: 65 dB sign\u00e1l) (Ministerstvo zdravotn\u00edctva Slovenskej republiky, 2024[24]<\/a>; Infosluch, 2023[25]<\/a>).<\/p>\n

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Foto: \u00a9Private<\/p><\/div>\n

Ak die\u0165a u\u017e v\u00a0p\u00f4rodnici nepre\u0161lo skr\u00edningom sluchu, resp. malo nev\u00fdbavn\u00e9 otoakustick\u00e9 emisie (OAE)<\/a> na jednom alebo oboch u\u0161iach, riadime sa na Slovensku pravidlom 1 \u2013 3 \u2013 6. V\u00a0prvom mesiaci\u00a0\u017eivota die\u0165a\u0165a by sa mali opakovane realizova\u0165 vy\u0161etrenia OAE, a pokia\u013e preuk\u00e1\u017eu poruchu sluchu, v tre\u0165om mesiaci je u\u017e vhodn\u00e9 absolvova\u0165 objekt\u00edvne vy\u0161etrenie sluchu, respekt\u00edve komplexn\u00fa diagnostiku v\u00a0centre pre deti s\u00a0poruchou sluchu. Ide\u00e1lne do \u0161iesteho mesiaca veku die\u0165a\u0165a by mala by\u0165 porucha sluchu kompenzovan\u00e1 v\u00fdkonn\u00fdmi na\u010d\u00favac\u00edmi pr\u00edstrojmi (Majt\u00e1nov\u00e1, 2019[26]<\/a>). Zdravotn\u00e9 pois\u0165ovne na Slovensku v\u0161ak polroka sk\u00famaj\u00fa, \u010di die\u0165a\u0165u kompenzuj\u00fa sluch pr\u00e1ve na\u010d\u00favacie pr\u00edstroje, ktor\u00e9 zvuk zosil\u0148uj\u00fa. N\u00e1sledne je logick\u00e9, \u017ee sa na Slovensku ku kochle\u00e1rnej implant\u00e1cii be\u017ene deti nedostan\u00fa sk\u00f4r ako po 12 mesiacoch veku, a to aj v pr\u00edpade, \u017ee ide o dedi\u010dn\u00e9 poruchy (preto\u017ee taktie\u017e na v\u00fdsledky genetick\u00fdch testov sa dlho \u010dak\u00e1) alebo obojstranne \u0165a\u017ek\u00fa poruchu sluchu preuk\u00e1zan\u00fa i objekt\u00edvnym vy\u0161etren\u00edm. K tomu podfinancovan\u00e9 zdravotn\u00edctvo, nedostatok odborn\u00edkov, pracov\u00edsk, neinformovanos\u0165 a slab\u00e1 osveta prispievaj\u00fa k od\u010fa\u013eovaniu kochle\u00e1rnej implant\u00e1cie u\u00a0det\u00ed s obojstrannou prelingv\u00e1lnou hluchotou alebo \u0165a\u017ekou poruchou sluchu. V porovnan\u00ed so zahrani\u010dn\u00fdmi \u0161t\u00fadiami by bolo vhodn\u00e9 tieto fakty prehodnoti\u0165 na odbornej \u00farovni v oblasti limitov.<\/p>\n

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Foto: Veronika Klimonov\u00e1<\/p><\/div>\n

Autor: Miroslava Zemanov\u00e1<\/p>\n

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[1]<\/a>\u00a0https:\/\/hearpeers.medel.com\/en\/learn\/hearing-solutions\/pioneers-passion-and-perserverance-the-history-of-cochlear-implants<\/a><\/p>\n

[2]<\/a> https:\/\/www.audionika.cz\/medel\/stranka\/o-firme-med-el<\/a><\/p>\n

[3]<\/a>\u00a0https:\/\/hearpeers.medel.com\/en\/learn\/hearing-solutions\/pioneers-passion-and-perserverance-the-history-of-cochlear-implants<\/a><\/p>\n

[4]<\/a> https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/1688121<\/a><\/p>\n

[5]<\/a> https:\/\/anatomypubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ar.22580<\/a><\/p>\n

[6]<\/a> https:\/\/www.medel.com\/about-medel\/our-history<\/a><\/p>\n

[7]<\/a>\u00a0https:\/\/hearpeers.medel.com\/en\/learn\/hearing-solutions\/pioneers-passion-and-perserverance-the-history-of-cochlear-implants<\/a><\/p>\n

[8]<\/a>\u00a0https:\/\/hearpeers.medel.com\/en\/learn\/hearing-solutions\/pioneers-passion-and-perserverance-the-history-of-cochlear-implants<\/a><\/p>\n

[9]<\/a> https:\/\/www.scki.sk\/cen.htm<\/a><\/p>\n

[10]<\/a> https:\/\/lifelonghearing.com\/sk\/veda-sk\/slovensko-a-30-rokov-kochlearnej-implantacie\/<\/a><\/p>\n

[11]<\/a> https:\/\/www.dialogyosluchu.sk\/tridsat-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[12]<\/a> https:\/\/www.dialogyosluchu.sk\/tridsat-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[13]<\/a> https:\/\/www.teraz.sk\/slovensko\/pred-30-rokmi-prvykrat-implantovali-pa\/807067-clanok.html<\/a><\/p>\n

[14]<\/a> https:\/\/lifelonghearing.com\/sk\/veda-sk\/slovensko-a-30-rokov-kochlearnej-implantacie\/<\/a><\/p>\n

[15]<\/a> https:\/\/www.unb.sk\/30-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[16]<\/a> https:\/\/www.dialogyosluchu.sk\/tridsat-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[17]<\/a> https:\/\/www.teraz.sk\/slovensko\/pred-30-rokmi-prvykrat-implantovali-pa\/807067-clanok.html<\/a><\/p>\n

[18]<\/a> https:\/\/www.unb.sk\/30-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[19]<\/a> https:\/\/www.unb.sk\/30-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[20]<\/a> https:\/\/www.dialogyosluchu.sk\/tridsat-rokov-kochlearnej-implantacie-na-slovensku\/<\/a><\/p>\n

[21]<\/a> https:\/\/www.scki.sk\/cen.htm<\/a><\/p>\n

[22]<\/a> https:\/\/lifelonghearing.com\/sk\/uncategorized-sk\/hovoriace-pero-audio-pen-na-rehabilitaciu-sluchu\/<\/a><\/p>\n

[23]<\/a>\u00a0https:\/\/www.mayoclinic.org\/medical-professionals\/pediatrics\/news\/cochlear-implants-early-intervention-to-optimize-language-outcomes\/mac-20452729<\/a><\/p>\n

[24]<\/a> https:\/\/www.health.gov.sk\/Zdroje?\/Sources\/kategorizacia\/zkszm\/202404\/Limity-SZM-202404.pdf<\/a><\/p>\n

[25]<\/a> https:\/\/infosluch.sk\/2161\/implantacne-kriteria-pre-kochlearny-implantat\/<\/a><\/p>\n

[26]<\/a> https:\/\/www.nepocujucedieta.sk\/aktuality\/o-sluchu-vseobecne\/pravidlo-1-3-6-pri-poruche-sluchu-ide-o-cas<\/a><\/p>\n<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

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