{"id":32820,"date":"2024-07-10T11:04:59","date_gmt":"2024-07-10T11:04:59","guid":{"rendered":"https:\/\/lifelonghearing.com\/sk\/?p=32820"},"modified":"2025-04-28T14:38:08","modified_gmt":"2025-04-28T14:38:08","slug":"ako-prirodzene-pocuju-pouzivatelia-sluchovych-implantatov","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/sk\/ako-prirodzene-pocuju-pouzivatelia-sluchovych-implantatov\/","title":{"rendered":"Ako po\u010dujete s kochle\u00e1rnym implant\u00e1tom?"},"content":{"rendered":"

Od za\u010diatku mojej pr\u00e1ce v spolo\u010dnosti MED-EL som sa zaoberal ot\u00e1zkou: “Ako prirodzene po\u010duj\u00fa pou\u017e\u00edvatelia na\u0161ich sluchov\u00fdch implant\u00e1tov?”<\/p><\/h1><\/div>

Od za\u010diatku mojej pr\u00e1ce v spolo\u010dnosti MED-EL som sa zaoberal ot\u00e1zkou: “Ako prirodzene po\u010duj\u00fa pou\u017e\u00edvatelia na\u0161ich sluchov\u00fdch implant\u00e1tov?” Bolo mo\u017en\u00e9 vynikaj\u00face porozumenie jazyka a existovalo na to ve\u013ek\u00e9 mno\u017estvo vedeck\u00fdch d\u00f4kazov. Ot\u00e1zka “AKO po\u010dujete?” v\u0161ak zostala do zna\u010dnej miery nezodpovedan\u00e1.<\/strong><\/p>\n<\/div>

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Pred obnovou sluchov\u00e9ho implant\u00e1tu sa vykon\u00e1vaj\u00fa r\u00f4zne audiometrick\u00e9 merania. Subjekt\u00edvnou met\u00f3dou merania je elektroaudiometria (EAM). Za t\u00fdmto \u00fa\u010delom sa vonkaj\u0161\u00ed zvukovod napln\u00ed fyziologicky obohatenou slanou vodou, testovacia elektr\u00f3da sa umiestni do zvukovodu a u\u0161i sa zatvoria. Potom sa aplikuj\u00fa ve\u013emi jemne vyladen\u00e9 pr\u00fadov\u00e9 impulzy (prasknutie), ktor\u00e9 m\u00f4\u017eu vyvola\u0165 sluchov\u00e9 dojmy. Okrem in\u00e9ho sa to m\u00f4\u017ee pou\u017ei\u0165 na diagnostiku nepr\u00edtomnosti sluchov\u00e9ho nervu. Toto meranie sa kedysi vykon\u00e1valo rutinne \u2013 dnes sa od neho up\u00fa\u0161\u0165a, preto\u017ee absencia nervu je zriedkav\u00e1. \u00a0Pre m\u0148a ako mlad\u00e9ho zdravotn\u00edckeho technika bolo v tom \u010dase jasn\u00e9, \u017ee ak vlo\u017e\u00edm t\u00fato slan\u00fa elektr\u00f3du do ucha dvojro\u010dn\u00e9ho die\u0165a\u0165a, chcem vedie\u0165, ako sa c\u00edti a znie. Tak\u017ee tret\u00ed alebo \u0161tvrt\u00fd de\u0148 v pr\u00e1ci som si zatla\u010dil elektr\u00f3du do ucha a otestoval meranie v samoexperimente: po\u010dul som pekn\u00fd s\u00ednusov\u00fd t\u00f3n v r\u00f4znych frekvenci\u00e1ch. Od tej chv\u00edle som bol presved\u010den\u00fd o meran\u00ed EAM.<\/p>\n

Pre moju spolo\u010dnos\u0165 sa v\u0161etko dramaticky zmenilo v roku 1994 zaveden\u00edm implanta\u010dn\u00e9ho syst\u00e9mu MED-EL-C40. Zrazu bolo mo\u017en\u00e9 aplikova\u0165 ve\u013emi r\u00fdchle k\u00f3dovacie strat\u00e9gie rozlo\u017een\u00e9 na mnoho kan\u00e1lov a tak mapova\u0165 ve\u013ek\u00e9 mno\u017estvo zvukov od z\u00e1kladne po \u0161pi\u010dku kochley ved\u013ea seba v \u010dase. Vysok\u00e9 zvuky boli v\u017edy stimulovan\u00e9 v spodnej \u010dasti slim\u00e1ka.\u00a0 In\u00fdmi slovami, MED-EL bola a je (!) prvou spolo\u010dnos\u0165ou na svete, ktorej sa podarilo stimulova\u0165 \u0161pi\u010dku slim\u00e1ka, po\u010dn\u00fac C40, a t\u00fdm generova\u0165 hlbok\u00e9 zvukov\u00e9 vnemy a\u017e do pribli\u017ene 100 Hz. (MED-EL optimalizoval elektr\u00f3dy tak\u00fdm sp\u00f4sobom, aby bolo mo\u017en\u00e9 dosiahnu\u0165 v\u0161etky fyziologicky aplikovan\u00e9 frekven\u010dn\u00e9 rozsahy v kochlei \u2013 a to pri zachovan\u00ed zvy\u0161kov\u00e9ho sluchu.)<\/p>\n

Pred zaveden\u00edm vy\u0161\u0161ie uveden\u00e9ho implant\u00e1tu C40 pacienti po\u010duli iba vysokofrekven\u010dn\u00e9 zvuky. To zodpovedalo skreslen\u00e9mu vn\u00edmaniu. Sluchov\u00e9 dojmy pripom\u00ednali hlas Mickey Mousa. Nedok\u00e1zal som sa s t\u00fdm zmieri\u0165. Preto moja ot\u00e1zka v\u0161etk\u00fdm pou\u017e\u00edvate\u013eom C40 v\u017edy znela: \"Ako po\u010dujete?\" S\u00fa\u010dasn\u00fd predseda CIA Karl-Heinz Fuchs je postlingv\u00e1lne hluch\u00fd. Z tohto d\u00f4vodu dok\u00e1\u017ee v\u00fdborne porovna\u0165 a pos\u00fadi\u0165 sluch pred hluchotou so sluchom po implant\u00e1cii. Bol prv\u00fdm pacientom, ktor\u00fd objasnil, takmer znerv\u00f3znen\u00fd: \"Ewald, neboj sa, po\u010dujem norm\u00e1lne. Tak n\u00edzke a vysok\u00e9 hlasy, hudba a prirodzen\u00e9 zvuky. \u2013 a teraz, pros\u00edm, presta\u0148te n\u00e1s otravova\u0165 touto ot\u00e1zkou o \"AKO\"!\"<\/p>\n

\"\"<\/p>\n

Ak oper\u00e1cia dopadne dobre a modern\u00e1 elektr\u00f3da od firmy MED-EL sa dostane do celej oblasti kochley \u2013 t.j. od vchodu a\u017e po \u0161pi\u010dku \u2013 potom sa nemus\u00edme ob\u00e1va\u0165 o prirodzenos\u0165 sluchu. Norm\u00e1lny sluch je pre pacienta zaru\u010den\u00fd.<\/p>\n

U\u017e v roku 1996 boli na oboch stran\u00e1ch implantovan\u00ed prv\u00ed nepo\u010duj\u00faci. V tom \u010dase som nielen o\u010dak\u00e1val, \u017ee budem robi\u0165 svoje vlastn\u00e9 experimenty, ale som tie\u017e ve\u013emi v\u010fa\u010dn\u00fd na\u0161im pou\u017e\u00edvate\u013eom, \u017ee boli v\u017edy ochotn\u00ed z\u00fa\u010dastni\u0165 sa \u0161irokej \u0161k\u00e1ly testov a \u0161t\u00fadi\u00ed. Op\u00e4\u0165 to bol Karl-Heinz Fuchs, kto mi po\u010das ve\u013emi dlhej jazdy autom bl\u00faznil o tom, ako dobre si m\u00f4\u017ee op\u00e4\u0165 vychutna\u0165 hudbu s bilater\u00e1lnou implant\u00e1ciou. Len som mu nechcel veri\u0165, tak som ho presved\u010dil, aby to podrobil sk\u00fa\u0161ke. Zap\u00edskal som mu nieko\u013eko piesn\u00ed a Karl-Heinz skuto\u010dne bezchybne zap\u00edskal mel\u00f3die a nakoniec ma presved\u010dil.<\/p>\n

Jednostrannou implant\u00e1ciou m\u00f4\u017eem zlep\u0161i\u0165 stav sluchu od absol\u00fatnej hluchoty a\u017e po porozumenie re\u010di v z\u00e1vislosti od pacienta a\u017e na sto percent. Pou\u017e\u00edvatelia kochle\u00e1rnych implant\u00e1tov musia sledova\u0165 konverz\u00e1ciu ove\u013ea viac pozornosti ako v pr\u00edpade os\u00f4b bez sluchov\u00e9ho postihnutia. Tento koncentrovanej\u0161\u00ed a nam\u00e1havej\u0161\u00ed sluch je pod\u013ea na\u0161ich z\u00e1kazn\u00edkov dramaticky u\u013eah\u010den\u00fd bilater\u00e1lnou starostlivos\u0165ou. Bilater\u00e1lna starostlivos\u0165 zni\u017euje nam\u00e1hanie sluchu; \u00a0Nam\u00e1hav\u00e9 zadr\u017eiavanie pozornosti u\u017e nie je potrebn\u00e9.<\/p>\n

V neposlednom rade \u0165a\u017e\u00edm z vlastn\u00fdch sk\u00fasenost\u00ed s hi-fi stereo syst\u00e9mami: v\u017edy som bol hudobn\u00fdm fan\u00fa\u0161ikom a m\u00f4j otec mal star\u00fd, obrovsk\u00fd magnetof\u00f3n. \u00a0To umo\u017enilo vytv\u00e1ranie stereof\u00f3nnych nahr\u00e1vok s dvoma mikrof\u00f3nmi. Ako t\u00edned\u017eer som s t\u00fdmto zariaden\u00edm str\u00e1vil ve\u013ea \u010dasu a vysk\u00fa\u0161al ve\u013ea vec\u00ed. \u0160peci\u00e1lnou vlastnos\u0165ou zariadenia bolo \"mono\" tla\u010didlo. Tak\u017ee m\u00f4\u017eete prepn\u00fa\u0165 sign\u00e1l STEREO na MONO jedn\u00fdm \u0165ahom. V\u00fdsledn\u00fd dojem z po\u010d\u00favania bol pre m\u0148a tak\u00fd formuj\u00faci, \u017ee ma tento fenom\u00e9n uchv\u00e1til nav\u017edy. V stereof\u00f3nnom nastaven\u00ed som mohol zavrie\u0165 o\u010di a vidie\u0165 orchester predo mnou. \u2013 A potom som stla\u010dil tla\u010didlo \"mono\" \u2013 zrazu sa svet okolo m\u0148a doslova scvrkol a dojem sa zredukoval na po\u010d\u00favaciu linku presne uprostred mojej hlavy. Toto uvedomenie bolo mimoriadne format\u00edvne.<\/p>\n

Stereof\u00f3nne po\u010d\u00favanie je najprirodzenej\u0161ia vec na svete pre po\u010duj\u00facich \u013eud\u00ed. V momente, ke\u010f niekto v na\u0161ich \u017eivotoch stla\u010dil tla\u010didlo \"mono\", dramaticky n\u00e1m unikla akustick\u00e1 trojrozmernos\u0165. A tvrd\u00edm, \u017ee ak by existovalo \"jednostrann\u00e9\" tla\u010didlo, ch\u00fdbalo by n\u00e1m ove\u013ea viac ako Mono. Mono zos\u00fala\u010fuje v\u0161etko po\u010d\u00favanie, ale jednostrann\u00e9mu po\u010d\u00favaniu ch\u00fdba takmer polovica sluchu \u2013 je to ako zapoji\u0165 iba jeden reproduktor do stereof\u00f3nneho syst\u00e9mu a druh\u00fd v\u00fdstup ponecha\u0165 nevyu\u017eit\u00fd.<\/p>\n

Prirodzen\u00fd sluch pre m\u0148a znamen\u00e1\u00a0 vn\u00edma\u0165 pr\u00edrodu s jej rozmanit\u00fdmi zvukmi. Najvy\u0161\u0161ou formou, ako to urobi\u0165, je priestorov\u00fd sluch.<\/p>\n

V spolo\u010dnosti MED-EL ver\u00edme, \u017ee kone\u010dn\u00fdm cie\u013eom ka\u017ed\u00e9ho sluchov\u00e9ho implant\u00e1tu mus\u00ed by\u0165 poskytn\u00fa\u0165 pou\u017e\u00edvate\u013eom \u010do najlep\u0161\u00ed sluch. Preto sme n\u00e1\u0161 v\u00fdvoj s\u00fastredili do troch k\u013e\u00fa\u010dov\u00fdch oblast\u00ed: Elektr\u00f3dy, ktor\u00e9 s\u00fa \u010do najdlh\u0161ie, s\u00fa predpokladom pre schopnos\u0165 stimulova\u0165 kochleu po celej jej d\u013a\u017eke. Ak sa to podar\u00ed, hovor\u00edme o Complete Cochlear Coverage, skr\u00e1tene CCC. Obzvl\u00e1\u0161\u0165 m\u00e4kk\u00e9, pru\u017en\u00e9 elektr\u00f3dy zabezpe\u010duj\u00fa atraumatick\u00e9 vlo\u017eenie do slim\u00e1ka, tak\u017ee tam je ovplyvnen\u00fdch \u010do najmenej \u0161trukt\u00far \u2013 naopak, v kombin\u00e1cii s vhodnou chirurgickou technol\u00f3giou je dokonca mo\u017en\u00e9 v mnoh\u00fdch pr\u00edpadoch zachova\u0165 ak\u00fdko\u013evek zvy\u0161kov\u00fd sluch. T\u00e1to vlastnos\u0165 sa naz\u00fdva Zachovanie \u0161trukt\u00fary alebo skr\u00e1tene SP. Strat\u00e9gia k\u00f3dovania ur\u010dite zohr\u00e1va rovnako d\u00f4le\u017eit\u00fa \u00falohu v prirodzenom sluchovom dojme. Pri k\u00f3dovan\u00ed jemnej \u0161trukt\u00fary (tie\u017e zn\u00e1mom ako jemn\u00fd sluch, skr\u00e1tene FH) sa jemn\u00e9 rozdiely v\u00fd\u0161ky zvukov\u00e9ho sign\u00e1lu, najm\u00e4 v n\u00edzkych t\u00f3noch, pren\u00e1\u0161aj\u00fa aj do neur\u00f3novej \u0161trukt\u00fary. Tieto tri aspekty \u2013 CCC, SP a FH \u2013 s\u00fa zhrnut\u00e9 pod pojmom triformancia. V neposlednom rade v\u0161ak prirodzen\u00fd sluch zah\u0155\u0148a aj po\u010dutie dvoma u\u0161ami. Pre na\u0161ich implantovan\u00fdch pou\u017e\u00edvate\u013eov to znamen\u00e1, \u017ee k trom \u010dastiam Triformance pridajme \u010fal\u0161\u00ed komponent \u2013 bilater\u00e1lnu starostlivos\u0165 o sluch.<\/p>\n

Pritom nasledujeme Einsteina \u2013 a vstupujeme do \u0161tvrtej dimenzie<\/em>.<\/p>\n

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

Od za\u010diatku mojej pr\u00e1ce v spolo\u010dnosti MED-EL som sa zaoberal ot\u00e1zkou: “Ako prirodzene po\u010duj\u00fa<\/p>\n","protected":false},"author":4,"featured_media":32823,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[418],"tags":[],"class_list":["post-32820","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-veda-sk"],"yoast_head":"\nAko po\u010dujete s kochle\u00e1rnym implant\u00e1tom? - Slovak<\/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\/sk\/ako-prirodzene-pocuju-pouzivatelia-sluchovych-implantatov\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ako po\u010dujete s kochle\u00e1rnym implant\u00e1tom? 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