{"id":28127,"date":"2024-10-24T08:00:53","date_gmt":"2024-10-24T06:00:53","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=28127"},"modified":"2025-04-16T12:15:07","modified_gmt":"2025-04-16T12:15:07","slug":"tingulli-i-implanteve-kokleare-as-mickey-mouse-dhe-as-zeri-automatik","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/sq\/tingulli-i-implanteve-kokleare-as-mickey-mouse-dhe-as-zeri-automatik\/","title":{"rendered":"Tingulli i implanteve kokleare: as si mickey mouse as si z\u00ebri automatik"},"content":{"rendered":"

\u00c7\u2019far\u00eb tingulli do t\u00eb prodhoj\u00eb implanti im koklear?<\/h1><\/div>

Q\u00eb nga implantimi i par\u00eb koklear kryer n\u00eb vitin 1977, \u00ebsht\u00eb zhvilluar teknologjia e implanteve kokleare \u2013 dhe me t\u00eb, t\u00eb kuptuarit e t\u00eb folurit dhe cil\u00ebsia e tingullit me nj\u00eb implant koklear. Studimet e tanishme simulojn\u00eb tingullin e implanteve kokleare.<\/strong><\/p>\n<\/div>

<\/span><\/div><\/div><\/div><\/div><\/div>

Ekspert\u00ebt e din\u00eb nga p\u00ebrvoja praktike se pjesa m\u00eb e madhe e kandidat\u00ebve p\u00ebr implante kokleare kan\u00eb dy pyetje kryesore: e para \u00ebsht\u00eb, \u201cSa mir\u00eb do t\u00eb d\u00ebgjoj?\u201d dhe e dyta \u201cSi do t\u00eb prodhohet tingulli?\u201d [1]<\/a> Ti p\u00ebrgjigjesh pyetjes p\u00ebr kuptueshm\u00ebrin\u00eb e t\u00eb folurit nuk \u00ebsht\u00eb e thjesht\u00eb. Jan\u00eb t\u00eb shumt\u00eb faktor\u00ebt e ndikimit q\u00eb luajn\u00eb nj\u00eb rol. Megjithat\u00eb, ne mund t\u00eb vler\u00ebsojm\u00eb t\u00eb pakt\u00ebn kuptueshm\u00ebrin\u00eb e t\u00eb folurit dhe m\u00eb pas ta shprehim at\u00eb n\u00eb vlera numerike. Ne mund t\u00eb p\u00ebrshkruajm\u00eb vet\u00ebm tingullin pak a shum\u00eb me fjal\u00eb t\u00eb bukura ose duke e krahasuar me imazhet e tingujve t\u00eb njohura. Psikologu i njohur p\u00ebr zhvillimin Michael F. Dorman, profesor i merituar n\u00eb Shkencat e Gjuh\u00ebsis\u00eb, D\u00ebgjimit dhe t\u00eb Folurit, i ka trajtuar k\u00ebto \u00e7\u00ebshtje sfiduese nga nj\u00eb prespektiv\u00eb shkencore p\u00ebr disa dekada. N\u00eb fillim ka studiuar ndikimin e faktor\u00ebve t\u00eb ndrysh\u00ebm teknik\u00eb tek t\u00eb kuptuarit e t\u00eb folurit me implantet kokleare n\u00eb grupe k\u00ebrkimore t\u00eb ndryshme. Ai shpjegon mund\u00ebsit\u00eb q\u00eb ai po p\u00ebrdor tani p\u00ebr t\u00eb studiuar tingullin e implanteve kokleare: \u201cPacient\u00ebt me implante kokleare t\u00eb cil\u00ebt jan\u00eb t\u00eb shurdh\u00ebr n\u00eb nj\u00ebr\u00ebn an\u00eb t\u00eb veshit kan\u00eb hapur nj\u00eb dritare p\u00ebr studiuesit p\u00ebr t\u2019iu p\u00ebrgjigjur pyetjes q\u00eb kan\u00eb pothuajse t\u00eb gjith\u00eb kandidat\u00ebt p\u00ebr implante kokleare: \u201c\u00c7\u2019far\u00eb tingulli do t\u00eb prodhoj\u00eb implantit tim koklear?\u201d[2]<\/a><\/p>\n

Rezultatet e studimeve t\u00eb tij m\u00eb t\u00eb fundme [3]<\/a> [4]<\/a>jan\u00eb inkurajuese: pr\u00eb p\u00ebrdoruesit e implanteve kokleare me elektroda t\u00eb shkurt\u00ebr, implanti koklear prodhon nj\u00eb tingull m\u00eb akut n\u00eb krahasim me d\u00ebgjimin natyral. Megjithat\u00eb, p\u00ebr disa p\u00ebrdorues t\u00eb implanteve kokleare me elektroda t\u00eb gjat\u00eb, implanti koklear prodhon nj\u00eb tingull pothuajse ose plot\u00ebsisht t\u00eb nj\u00ebjt\u00eb me d\u00ebgjimin natyral, nd\u00ebrsa t\u00eb tjer\u00ebt e perceptojn\u00eb tingullin e implantit koklear si pak a shum\u00eb t\u00eb mbytur, ndonj\u00ebher\u00eb edhe m\u00eb pak t\u00eb qart\u00eb se d\u00ebgjimin natyral n\u00eb veshin tjet\u00ebr.[5]<\/a><\/p>\n

\u201cN\u00eb k\u00ebrkim p\u00ebr nj\u00eb Mickey House\u201d \u2013 p\u00ebrshkruaj ose krahaso imazhet e tingujve<\/h2>\n

Nj\u00eb nga pioner\u00ebt e k\u00ebtyre studimeve krahasuese ishte Sandra Prentiss me koleg\u00ebt e saj shkenc\u00ebtar\u00eb n\u00eb Shtetet e Bashkuara t\u00eb Amerik\u00ebs. Ata bashk\u00ebpunuan me nj\u00eb p\u00ebrdorues t\u00eb implantit kokelar n\u00eb t\u00eb cil\u00ebn elektroda e implantit koklear mbulonte pothuajse t\u00eb dy rrotullimet e kokleas ku d\u00ebgjimi i mbetur u ruajt pothuajse i pandryshuar n\u00eb t\u00eb gjitha tonalitetet pas implantimit. Dhjet\u00eb vite m\u00eb par\u00eb, si pjes\u00eb e nj\u00eb rast studimi, grupi shkencor i ka k\u00ebrkuar k\u00ebtij p\u00ebrdoruesi t\u00eb krahasoj\u00eb perceptimin e tonalitetit me implantin koklear me at\u00eb t\u00eb d\u00ebgjimit natyral t\u00eb mbetur n\u00eb t\u00eb nj\u00ebjtin vesh. Rezultatet konfirmuan caktimin e tonit personal n\u00eb pika specifike t\u00eb kokleas dhe k\u00ebshtu r\u00ebnd\u00ebsin\u00eb e\u00a0elektrodave t\u00eb gjat\u00eb.<\/a>\u00a0P\u00ebr tingujt me intensitet t\u00eb ul\u00ebt, u tregua gjithashtu efekti i zgjidhjes s\u00eb p\u00ebrkohsh\u00ebm n\u00eb perceptimin e tonit duke konfirmuar k\u00ebshtu efektivitetin e t\u00eb ashtuquajtur\u00ebs\u00a0kodifikim i p\u00ebrkryer i struktur\u00ebs.<\/a>\u00a0Si rrjedhoj\u00eb, ky rast studimor nuk jep asnj\u00eb informacion n\u00eb lidhje me imazhin e tingullit.<\/p>\n

\"\"

Weller dhe koleg\u00ebt e tij treguan se: P\u00ebrdoruesit e implanteve kokleare elektrodat e t\u00eb cil\u00ebve u vendos\u00ebn m\u00eb shum\u00eb se 360 grad\u00eb kan\u00eb t\u00eb kuptuarin e t\u00eb folurit m\u00eb t\u00eb mir\u00eb, nd\u00ebrsa p\u00ebrdoruesit me elektrodat e vendosura m\u00eb pak se 360 grad\u00eb shfaq\u00ebn ndjesh\u00ebm t\u00eb kuptuarin e t\u00eb folurit m\u00eb t\u00eb dob\u00ebt. \u00a9adaptiert von Weller et al. 2023<\/p><\/div>\n

M\u00eb pas kjo \u00e7\u00ebshtje u trajtua nga shkenc\u00ebtari amerikan Michael F. Dorman s\u00eb bashku me t\u00eb tjer\u00eb shkenc\u00ebtar\u00eb, koleg\u00eb t\u00eb tij n\u00eb studime t\u00eb ndryshme n\u00eb bashk\u00ebpunim me p\u00ebrdorues t\u00eb implanteve kokleare me d\u00ebgjim normal dhe natyral n\u00eb nj\u00ebrin an\u00eb t\u00eb veshit.\u00a0Implantet kokleare tek pacient\u00ebt e shurdh\u00ebr n\u00eb nj\u00ebrin an\u00eb t\u00eb veshit\u00a0u kryhen p\u00ebr her\u00eb t\u00eb par\u00eb n\u00eb vitin 2003 n\u00eb kuad\u00ebr t\u00eb nj\u00eb studimi europian dhe sot jan\u00eb nj\u00eb pro\u00e7edur\u00eb n\u00eb shum\u00eb shtete p\u00ebrfshir\u00eb Austrin\u00eb\u00a0<\/a> [6]<\/a>. N\u00eb fillim, disa ekspert\u00eb dyshonin se ndjesia e tingullit e krijuar n\u00eb m\u00ebnyr\u00eb artificiale nga implanti koklear ishte n\u00eb p\u00ebrputhje me ndjesin\u00eb e tingullit natyral n\u00eb an\u00ebn tjet\u00ebr t\u00eb veshit. Megjithat\u00eb, Dorman dhe koleg\u00ebt e tij u k\u00ebrkuan k\u00ebtyreve p\u00ebrdoruesve me implante kokleare t\u00eb krahasojn\u00eb me sakt\u00ebsi tingullin q\u00eb vjen nga implanti koklear me d\u00ebgjimin natyral nga ana tjet\u00ebr e veshit. Ata p\u00ebrdoren disa fjali t\u00eb shkurtra si nj\u00eb sinjal akustik. K\u00ebto jan\u00eb punuar m\u00eb pas teknikisht p\u00ebr veshin q\u00eb d\u00ebgjon normalisht deri sa pjes\u00ebmarr\u00ebsit n\u00eb studim nuk e p\u00ebrshkruanin tingullin e nj\u00ebjt\u00eb me at\u00eb t\u00eb pap\u00ebrpunuar t\u00eb implantit koklear. N\u00eb hyrjen e nj\u00eb prej botimeve t\u00eb p\u00ebrfunduara, shkenc\u00ebtar\u00ebt shkruajn\u00eb se ata kishin parashikuar tingujt e Mickey House-it ose robotit nga imitimet e tingullit t\u00eb zhvilluara n\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb. K\u00ebto jan\u00eb imazhe q\u00eb disa i p\u00ebrdorin akoma sot p\u00ebr t\u00eb p\u00ebrshkruar tingullin e nj\u00eb implanti koklear kur kandidat\u00ebt apo t\u00eb interesuarit k\u00ebrkojn\u00eb informacione rreth k\u00ebsaj. Megjithat\u00eb, tingulli i implanteve moderne kokleare \u00ebsht\u00eb me sa duket shum\u00eb m\u00eb natyral sesa supozohej m\u00eb par\u00eb! Sipas Dorman-it, sinjali i t\u00eb folurit e stimulimit t\u00eb tingujve ishte kryesisht pak i ngjirur. [7]<\/a> [8]<\/a>. Disa pjes\u00ebmarr\u00ebs n\u00eb k\u00ebt\u00eb studim e vler\u00ebsuan madje tingullin e implantit koklear plot\u00ebsisht t\u00eb nj\u00ebjt\u00eb me tingullin natyral tek veshi tjet\u00ebr- ky ishte ve\u00e7an\u00ebrisht rasti p\u00ebr disa p\u00ebrdorues t\u00eb implanteve MED-EL me elektroda t\u00eb gjat\u00eb.<\/p>\n

Simulimi tregon: Implantet moderne kokleare prodhojn\u00eb tingull natyral!<\/h2>\n

Shkenc\u00ebtar\u00ebt kan\u00eb zhvilluar simulime t\u00eb ndryshme p\u00ebr t\u00eb b\u00ebr\u00eb m\u00eb t\u00eb kuptuesh\u00ebm efektet e parametrave teknik. Megjithat\u00eb, kjo gjithmon\u00eb \u00ebsht\u00eb trajtuar vet\u00ebm si \u00e7\u00ebshtje krahasimi: elektrodat e gjat\u00eb apo t\u00eb shkurt\u00ebr, pak a shum\u00eb banda t\u00eb frekuenc\u00ebs me ose pa informacione mbi struktur\u00ebn e rafinuar. B\u00ebhet fjal\u00eb p\u00ebr informacion t\u00eb r\u00ebnd\u00ebsish\u00ebme jo vet\u00ebm p\u00ebr grupet e zhvillimit: Kandidat\u00ebt p\u00ebr implantet kokleare mund t\u00eb p\u00ebrdorin k\u00ebto simulime p\u00ebr t\u00eb vendosur se cilat karakteristika t\u00eb implantit koklear ata mund tu kushtojn\u00eb v\u00ebm\u00ebndje t\u00eb ve\u00e7ant\u00eb. Megjithat\u00eb, k\u00ebto simulime nuk mund t\u00eb japin nj\u00eb ndjesi t\u00eb tingullit aktual t\u00eb nj\u00eb implanti koklear! Simulimet e reja nga eksperti i implanteve kokleare Michael F. Dorman dhe koleg\u00ebve t\u00eb tij synojn\u00eb t\u00eb b\u00ebjn\u00eb pik\u00ebrisht k\u00ebt\u00eb. N\u00eb shpjegimet e tyre, ata n\u00ebnvizojn\u00eb<\/p>\n

\"\"

Nd\u00ebrsa grupet e elektrodave MED-EL FLEX 24 p\u00ebrdoren n\u00eb sistemet EAS p\u00ebr personat q\u00eb mund t\u00eb d\u00ebgjojn\u00eb akoma tingujt e ul\u00ebt me d\u00ebgjimin e tyre natyral, elektrodat m\u00eb t\u00eb gjat\u00eb t\u00eb disa furnizuesve jan\u00eb akoma m\u00eb t\u00eb shkurt\u00ebr p\u00ebr kandidat\u00ebt me humbje t\u00eb thelluar d\u00ebgjimi. [11]<\/a><\/p><\/div>se ndjesia e tingullit natyral nuk mund t\u00eb barazohet thjesht me t\u00eb kuptuarit optimal e t\u00eb folurit.
\nEdhe me teknologjin\u00eb aktuale tek implantet kokleare, p\u00ebrshtatja me implantin koklear \u00ebsht\u00eb akoma i nevojsh\u00ebm. Rehabilitimi i d\u00ebgjimit garanton nj\u00eb p\u00ebrdorim optimal t\u00eb implanteve kokleare. Pro\u00e7esi i d\u00ebgjimit tek truri mund t\u00eb p\u00ebrshtatet m\u00eb pak se tingulli optimal i nj\u00eb implanti koklear por kjo shpesh k\u00ebrkon disa vite [9]<\/a> e cila \u00ebsht\u00eb nj\u00eb tjet\u00ebr p\u00ebrfundim i k\u00ebrkimit t\u00eb Dorman-it. Megjithat\u00eb, rezultatet e studimit jan\u00eb mbres\u00eblen\u00ebse: sot, kandidat\u00ebt e implanteve kokleare mund t\u00eb presin nj\u00eb cil\u00ebsi t\u00eb tingullit pothuajse natyrale me nj\u00eb elektrod\u00eb tek implanti me gjat\u00ebsi t\u00eb rregulluar.<\/p>\n<\/div>

Gjat\u00ebsia e elektrod\u00ebs: si karakteristikat teknike ndikojn\u00eb tek tingulli<\/strong><\/p>\n

Shkenc\u00ebtar\u00ebt nxituan t\u00eb zhvillonin shembuj t\u00eb tingujve p\u00ebr t\u00eb ndihmuar personat me d\u00ebgjim normal p\u00ebr t\u00eb kuptuar ndikimin e \u00e7do karakteristik\u00eb teknike t\u00eb implanteve kokleare, ve\u00e7an\u00ebrisht ndikimin e gjat\u00ebsis\u00eb s\u00eb elektrodave. Veshi i mes\u00ebm i njeriut p\u00ebrdor \u201ckodifikimin e vendit\u201d: tone t\u00eb ndryshme u caktohen vendeve specifike tek koklea. Me nj\u00eb implant koklear, jan\u00eb t\u00eb d\u00ebgjueshme pik\u00ebrisht nj\u00eb gam\u00eb e tingujve q\u00eb ekuivalenti i t\u00eb cilit arrin elektrod\u00ebn e implantit koklear brenda kokleas. Prandaj, \u00ebsht\u00eb ve\u00e7an\u00ebrisht e r\u00ebnd\u00ebsishme q\u00eb gjat\u00ebsia e elektrod\u00ebs t\u00eb p\u00ebrputhet sa m\u00eb af\u00ebr e mundur me gjat\u00ebsin\u00eb e kokleas. P\u00ebr kandidat\u00ebt e implanteve kokleare ose p\u00ebrdoruesve me nj\u00eb koklea tipike, fabrika austriake MED-EL \u00ebsht\u00eb e vetmja q\u00eb ofron elektroda q\u00eb jan\u00eb mjaft t\u00eb gjata deri n\u00eb (32 milimetra) p\u00ebr t\u00eb arritur n\u00eb m\u00ebnyr\u00eb t\u00eb barabart\u00eb pikat p\u00ebr tone t\u00eb larta dhe ul\u00ebta. P\u00ebr shembull, nj\u00eb elektrod\u00eb e gjat\u00eb vet\u00ebm 24 milimetra nuk arrin m\u00eb shum\u00eb se tre notat muzikore e gam\u00ebs s\u00eb frekuenc\u00ebs t\u00eb nj\u00eb koklea tipike t\u00eb parritshme!<\/p>\n

P\u00ebr ti b\u00ebr\u00eb t\u00eb d\u00ebgjueshme t\u00eb gjith\u00eb tingujt, prodhuesit e implanteve kokleare p\u00ebrdorin truke t\u00eb quajtura \u201czhvendosja e frekuenc\u00ebs\u201d dhe \u201cngjeshja e frekuenc\u00ebs\u201d. Me zhvendosjen e frekuenc\u00ebs, tingulli me nj\u00eb frekuenc\u00eb prej 70 hertz stimulohet ku d\u00ebgjohej fillimsht 590 hertz. N\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb, gjith\u00e7ka ting\u00ebllon m\u00eb me tonalitet t\u00eb lart\u00eb dhe kjo \u00ebsht\u00eb e njohur si efekti Mickey Mouse-it. Me kompresimin e frekuenc\u00ebs shtes\u00eb, 7 notat muzikore t\u00eb tingullit t\u00eb d\u00ebgjuesh\u00ebm shprehen n\u00eb 4. N\u00ebse ky efekt luhet n\u00eb nj\u00eb piano, jo vet\u00ebm q\u00eb do t\u00eb ting\u00ebllonte n\u00eb m\u00ebnyr\u00eb t\u00eb pak\u00ebndshme por edhe shum\u00eb i stonuar- k\u00ebshtu, duhet t\u00eb supozojm\u00eb se kjo \u00ebsht\u00eb gjithashtu efekt i arritur me implant koklear. P\u00ebr m\u00eb tep\u00ebr, nj\u00eb elektrod\u00eb m\u00eb e shkurt\u00ebr jo vet\u00ebm q\u00eb ndikon tek tingulli por d\u00ebmton gjithashtu t\u00eb kuptuarit e t\u00eb folurit. Shum\u00eb shkenc\u00ebtar\u00eb e kan\u00eb treguar k\u00ebt\u00eb, s\u00eb fundmi nga Tobias Weller dhe koleg\u00ebt e tij tek Spitali Universitar i Hanoverit.<\/p>\n

Ata thon\u00eb se \u201cp\u00ebrfitimi\u201d i nj\u00eb implanti koklear \u00ebsht\u00eb m\u00eb i lart\u00eb me nj\u00eb k\u00ebnd futje (e elektrod\u00ebs) prej 540-630 grad\u00ebsh sesa me nj\u00eb k\u00ebnd futje m\u00eb t\u00eb vog\u00ebl se 360 grad\u00eb, megjith\u00ebse nuk ka ulje t\u00eb ndjeshme pas 630 grad\u00ebsh.\" [10]<\/a><\/p>\n<\/div><\/div><\/div><\/div>

\n

[1]<\/a> Dorman MF, Natale SC, Baxter L, et al. Approximations to the Voice of a Cochlear Implant: Explorations With Single-Sided Deaf Listeners. Trends in Hearing. 2020;24. doi:10.1177\/2331216520920079
\n[2]<\/a> Zeitler DM, Dorman MF, Cochlear Implantation for Single-Sided Deafness: A New Treatment Paradigm. J Neurol Surg B Skull Base 2019; 80(02): 178-186. doi: 10.1055\/s-0038-1677482
\n[3]<\/a> Dorman MF, Natale SC, Butts AM, Zeitler DM, Carlson ML. The sound quality of cochlear implants: Studies with singlesided deaf patients. Otol Neurotol. 2017 Sep;38(8):e268-e273. doi: 10.1097\/MAO.0000000000001449.
\n[4]<\/a> Dorman MF, Natale SC, Zeitler DM, Baxter L, Noble JH. Looking for Mickey Mouse\u2122 But Finding a Munchkin: The Perceptual Effects of Frequency Upshifts for Single-Sided Deaf, Cochlear Implant Patients. J Speech Lang Hear Res. 2019 Sep 20;62(9):3493-3499. doi: 10.1044\/2019_JSLHR-H-18-0389. Epub 2019 Aug 15.
\n[5]<\/a> Dorman MF, 2020
\n[6]<\/a> Prentiss S, Staecker H, Wolford B. Ipsilateral acoustic electric pitch matching: a case study of cochlear implantation in an up-sloping hearing loss with preserved hearing across multiple frequencies. Cochlear Implants Int. 2014;15(3):161-165. doi:10.1179\/1754762814Y.0000000066
\n[7]<\/a> Dorman MF 2020
\n[8]<\/a> Dorman MF 2019
\n[9]<\/a> Dorman MF, Natale SC, Noble JH and Zeitler DM (2022) Upward Shifts in the Internal Representation of Frequency Can Persist Over a 3-Year Period for Cochlear Implant Patients Fit With a Relatively Short Electrode Array. Front. Hum. Neurosci. 16:863891. doi: 10.3389\/fnhum.2022.863891
\n[10]<\/a> \u201e9 Gr\u00fcnde f\u00fcr die Relevanz der CI-Elektrode\u201c, https:\/\/blog.medel.pro\/de\/chirurgie\/relevanz-der-ci-elektrode\/
\n[11]<\/a> Quellen: Elektroden-Einf\u00fchrwinkel laut Studien siehe blog.medel.pro; Flex34 approximiert.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

\u00c7\u2019far\u00eb tingulli do t\u00eb prodhoj\u00eb implanti im koklear? Q\u00eb nga implantimi i par\u00eb<\/p>\n","protected":false},"author":4,"featured_media":31618,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[418],"tags":[],"class_list":["post-28127","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-shkenca"],"yoast_head":"\nAlbanian<\/title>\n<meta name=\"description\" content=\"Q\u00eb nga implantimi i par\u00eb koklear kryer n\u00eb vitin 1977, \u00ebsht\u00eb zhvilluar teknologjia e implanteve kokleare - dhe me t\u00eb, t\u00eb kuptuarit e t\u00eb folurit dhe cil\u00ebsia e tingullit me nj\u00eb implant koklear. 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