{"id":23719,"date":"2017-04-02T05:26:45","date_gmt":"2017-04-02T03:26:45","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=23719"},"modified":"2017-04-03T16:56:59","modified_gmt":"2017-04-03T14:56:59","slug":"implantat-v-usnim-hlemyzdi","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=23719","title":{"rendered":"Implant\u00e1t v u\u0161n\u00edm hlem\u00fd\u017edi"},"content":{"rendered":"

Babi\u010dka nedosl\u00fdch\u00e1 a l\u00e9ka\u0159 j\u00ed p\u0159edep\u00ed\u0161e sluchadlo. Jen\u017ee babi\u010dka po\u0159\u00e1d nesly\u0161\u00ed a chce siln\u011bj\u0161\u00ed apar\u00e1tek. P\u0159itom u\u017e je t\u0159eba na t\u00e9 hranici, kde sluchadlo nepom\u00e1h\u00e1 a na \u0159adu by m\u011bla p\u0159ij\u00edt operace, \u0159\u00edk\u00e1 specialista na u\u0161n\u00ed choroby Ji\u0159\u00ed Sk\u0159ivan. V \u010cR \u017eije p\u016fl milionu sluchov\u011b posti\u017een\u00fdch, z toho je skoro osm tis\u00edc zcela nesly\u0161\u00edc\u00edch.<\/strong> <\/p>\n

– LN Stoup\u00e1 po\u010det lid\u00ed s vadami sluchu, t\u0159eba i v z\u00e1vislost na hlu\u010dnosti kolem n\u00e1s, pou\u017e\u00edv\u00e1n\u00ed mobil\u016f, sluch\u00e1tek a podobn\u011b?<\/p>\n

Po\u010det posti\u017een\u00fdch nestoup\u00e1, ale zlep\u0161uje se diagnostika, tak\u017ee pacienti se dostanou rychleji k \u0159e\u0161en\u00ed probl\u00e9mu, a\u0165 u\u017e chirurgick\u00e9mu nebo protetick\u00e9mu, tedy pomoc\u00ed n\u00e1hrady, nap\u0159\u00edklad sluchadla.<\/p>\n

– LN Jedn\u00edm z takov\u00fdch \u0159e\u0161en\u00ed jsou i tzv. kochle\u00e1rn\u00ed implant\u00e1ty, kter\u00e9 se voperuj\u00ed do vnit\u0159n\u00edho ucha. Komu pom\u00e1haj\u00ed?<\/p>\n

Lidem nedosl\u00fdchav\u00fdm m\u016f\u017ee pomoci jak sluchadlo, tak chirurgick\u00e9 metody, je\u017e se za\u010d\u00ednaj\u00ed pou\u017e\u00edvat. \u00dapln\u011b nesly\u0161\u00edc\u00edm u\u017e ani sebesiln\u011bj\u0161\u00ed sluchadlo nepom\u016f\u017ee, pro n\u011b je jedin\u00fdm \u0159e\u0161en\u00edm kochle\u00e1rn\u00ed implant\u00e1t. Ro\u010dn\u011b ho u n\u00e1s dostane asi pades\u00e1t, \u0161edes\u00e1t lid\u00ed.<\/p>\n

– LN Pro jakou v\u011bkovou skupinu jsou kochle\u00e1rn\u00ed implant\u00e1ty vhodn\u00e9?<\/p>\n

V\u011bk nerozhoduje, operujeme mal\u00e9 d\u011bti i seniory. D\u011bti s vadami sluchu se ale l\u00e9pe a rychleji diagnostikuj\u00ed. Rodi\u010d si z\u00e1hy v prvn\u00edm roce \u017eivota v\u0161imne, \u017ee d\u00edt\u011b nereaguje na zvuky a za\u010dne to \u0159e\u0161it. U dosp\u011bl\u00fdch jde o tzv. progreduj\u00edc\u00ed poruchu sluchu, kdy se nedosl\u00fdchavost neust\u00e1le zhor\u0161uje. Oni doufaj\u00ed, \u017ee jim pom\u016f\u017ee siln\u011bj\u0161\u00ed sluchadlo, p\u0159itom u\u017e jsou na t\u00e9 hranici, kde sluchadlo nepom\u00e1h\u00e1 a na \u0159adu by m\u011bla p\u0159ij\u00edt operace. N\u011bkte\u0159\u00ed dosp\u011bl\u00ed pacienti, hlavn\u011b ve vy\u0161\u0161\u00edm v\u011bku, se v\u0161ak operac\u00ed boj\u00ed.<\/p>\n

– LN Jak\u00fd je rozd\u00edl mezi sluchadlem a implant\u00e1tem?<\/p>\n

Sluchadlo funguje akusticky, zesiluje zvuk a p\u0159en\u00e1\u0161\u00ed ho do ucha. Implant\u00e1t zven\u010d\u00ed vypad\u00e1 podob\u011b \u2013 apar\u00e1t za uchem. Upravuje v\u0161ak p\u0159ij\u00edman\u00fd zvuk do elektrick\u00e9ho sign\u00e1lu a p\u0159en\u00e1\u0161\u00ed ho dovnit\u0159 do implantovan\u00e9 \u010d\u00e1sti, je\u017e stimuluje nervov\u00e1 zakon\u010den\u00ed ve vnit\u0159n\u00edm uchu.<\/p>\n

– LN Nakolik m\u016f\u017ee tato operace pacient\u016fm pomoci?<\/p>\n

P\u0159ed operac\u00ed se pe\u010dliv\u011b zji\u0161\u0165uje vhodnost operace pomoc\u00ed \u0159ady test\u016f \u2013 m\u011b\u0159en\u00ed \u00farovn\u011b sluchu, magnetick\u00e9 rezonance mozku a sp\u00e1nkov\u00fdch kost\u00ed… Pokud d\u00edt\u011b spl\u0148uje dan\u00e1 krit\u00e9ria a je vybaveno implant\u00e1tem brzy, bude u\u017eitek z operace opravdu velik\u00fd. Naopak u dosp\u011bl\u00e9ho pacienta nikdy nem\u016f\u017eeme dop\u0159edu \u0159\u00edct, jak\u00fd v\u00fdsledek operace bude m\u00edt.<\/p>\n

– LN Pro jak\u00fd typ pacienta nen\u00ed operace vhodn\u00e1?<\/p>\n

Jedin\u00e1 skupina, kterou neoperujeme a ona o to ani nestoj\u00ed, jsou dosp\u011bl\u00ed, kte\u0159\u00ed se u\u017e narodili jako nesly\u0161\u00edc\u00ed, pou\u017e\u00edvaj\u00ed znakovou \u0159e\u010d a vizu\u00e1ln\u00ed komunikaci. Ti se u\u017e nikdy nenau\u010d\u00ed mluvit, implant\u00e1t by tedy p\u0159inesl minim\u00e1ln\u00ed u\u017eitek.<\/p>\n

– LN Pro\u010d se pacienti po operaci mus\u00ed „nau\u010dit sly\u0161et“?<\/p>\n

Sly\u0161\u00ed jinak ne\u017emy. Ti, kte\u0159\u00ed p\u0159i\u0161li o sluch d\u016fsledkem nap\u0159\u00edklad \u00farazu nebo toxick\u00e9 l\u00e1tky, \u0159\u00edkaj\u00ed, \u017ee vjem p\u0159es kochle\u00e1rn\u00ed implant\u00e1t je n\u011bco \u00fapln\u011b jin\u00e9ho. Elektrick\u00e1 stimulace sluchov\u00e9ho nervu m\u00e1 jin\u00e9 charakteristiky ne\u017e stimulace akustick\u00e1 a oni si na to mus\u00ed zvyknout. Oproti tomu d\u011btem, kter\u00e9 nikdy norm\u00e1ln\u011b nesly\u0161ely, p\u0159ijde elektrick\u00e1 stimulace norm\u00e1ln\u00ed.<\/p>\n

– LN Jak se \u010dlov\u011bk u\u010d\u00ed sly\u0161et?<\/p>\n

Logopedov\u00e9 a foniat\u0159i vystavuj\u00ed operovan\u00e9 d\u011bti r\u016fzn\u00fdm zvukov\u00fdm podn\u011bt\u016fm, ze za\u010d\u00e1tku t\u0159eba jen jednoduch\u00fdm slabik\u00e1m, a zji\u0161\u0165uj\u00ed, jak na to d\u011bti reaguj\u00ed, jestli to opakuj\u00ed. Vypad\u00e1 to podobn\u011b jako u jejich norm\u00e1ln\u011b sly\u0161\u00edc\u00edch vrstevn\u00edk\u016f, kte\u0159\u00ed se tak\u00e9 teprve u\u010d\u00ed reagovat na zvuky, a vede to a\u017e k osvojen\u00ed \u0159e\u010di. Dosp\u011bl\u00fdm se nejprve pou\u0161t\u011bj\u00ed slova a v\u011bty a zji\u0161\u0165uje se, jak jim rozum\u00ed, a hlavn\u011b se s implant\u00e1tem s\u017e\u00edvaj\u00ed v denn\u00ed praxi.<\/p>\n

– LN Jak\u00e1 omezen\u00ed pro nositele implant\u00e1t p\u0159edstavuje?<\/p>\n

Implant\u00e1ty mohou aktivovat detektory kov\u016f na leti\u0161t\u00edch nebo v obchodech. Obzvl\u00e1\u0161t\u011b d\u016fle\u017eit\u00e9 je informovat o nich p\u0159ed vy\u0161et\u0159en\u00edm magnetickou rezonanc\u00ed, v n\u011bkter\u00fdch p\u0159\u00edpadech se mus\u00ed drobn\u00fdm opera\u010dn\u00edm z\u00e1krokem vyjmout. P\u0159i koup\u00e1n\u00ed si pacienti bu\u010f tu vn\u011bj\u0161\u00ed, sn\u00edmatelnou \u010d\u00e1st implant\u00e1tu sundaj\u00ed, ale pak nic nesly\u0161\u00ed, nebo si zakoup\u00ed speci\u00e1ln\u00ed obaly, kter\u00e9 procesor chr\u00e1n\u00ed p\u0159ed vodou. N\u011bkter\u00e9 typy jsou dokonce v\u016f\u010di vod\u011b odoln\u00e9, tak\u017ee se d\u00e1 s nimi plavat i pod vodou.<\/p>\n

– LN Jakou m\u00e1 implant\u00e1t \u017eivotnost?<\/p>\n

M\u011bl by vydr\u017eet cel\u00fd \u017eivot.<\/p>\n

– LN P\u0159edpokl\u00e1d\u00e1m, \u017ee ani po operaci nesly\u0161\u00ed pacient stejn\u011b dob\u0159e jako zdrav\u00fd \u010dlov\u011bk.<\/p>\n

V tichu sly\u0161\u00ed implantovan\u00ed lid\u00e9 ide\u00e1ln\u011b, v hlu\u010dn\u00e9m prost\u0159ed\u00ed, t\u0159eba na ru\u0161n\u00e9 ulici, ale podstatn\u011b h\u016f\u0159e ne\u017e zdrav\u00fd jedinec. Vad\u00ed i situace, kdy mluv\u00ed v\u00edce osob najednou, tedy na sch\u016fz\u00edch, v restauraci, pak mus\u00ed pacienti v\u011bnovat hodn\u011b \u00fasil\u00ed tomu, aby se zam\u011b\u0159ili na toho, kdo na n\u011b mluv\u00ed, a co jim \u0159\u00edk\u00e1. Kvalita sluchu po implantaci m\u016f\u017ee b\u00fdt pom\u011brn\u011b velik\u00fdm probl\u00e9mem a teprve budouc\u00ed v\u00fdvoj m\u016f\u017ee p\u0159in\u00e9st takov\u00e9 implant\u00e1ty, s nimi\u017e operovan\u00ed pacienti usly\u0161\u00ed stejn\u011b kvalitn\u011b jako zdrav\u00ed lid\u00e9.<\/p>\n

– LN Na co se zam\u011b\u0159uje v\u00fdvoj nov\u00e9 generace implant\u00e1t\u016f?<\/p>\n

St\u00e1le se zdokonaluj\u00ed zp\u016fsoby, jimi\u017e implant\u00e1t dr\u00e1\u017ed\u00ed sluchov\u00fd nerv, zdokonaluj\u00ed se algoritmy vedouc\u00ed k potla\u010den\u00ed hluku a \u0161umu. D\u00e1le se budou implant\u00e1ty zmen\u0161ovat a budou pln\u011b, v\u010detn\u011b baterie a mikrofonu, voperov\u00e1ny do lidsk\u00e9ho t\u011bla. Pak na prvn\u00ed pohled ani nepozn\u00e1te, \u017ee jej \u010dlov\u011bk m\u00e1. A ur\u010dit\u011b se roz\u0161\u00ed\u0159\u00ed indikace operace i na pacienty, kte\u0159\u00ed maj\u00ed i jen \u010d\u00e1ste\u010dnou poruchu sluchu, t\u0159eba nesly\u0161\u00ed zvuky jen v ur\u010dit\u00e9 frekvenci.<\/p>\n

– LN Propl\u00e1cej\u00ed zdravotn\u00ed poji\u0161\u0165ovny n\u00e1klady na tuto operaci?<\/p>\n

Poji\u0161\u0165ovny pln\u011b hrad\u00ed implant\u00e1t, operaci i n\u00e1slednou rehabilitaci. Implant\u00e1t stoj\u00ed od 530 do 630 tis\u00edc korun. V posledn\u00ed dob\u011b p\u0159edev\u0161\u00edm mal\u00e9 zdravotn\u00ed poji\u0161\u0165ovny vyv\u00edjej\u00ed tlaky na to, aby byl hrazen jen ten nejlevn\u011bj\u0161\u00ed implant\u00e1t, kter\u00fd nen\u00ed nejlep\u0161\u00ed. Vn\u00edm\u00e1m jako velik\u00fd nedostatek, \u017ee si pacienti nemohou na zdravotn\u00ed p\u00e9\u010di p\u0159ipl\u00e1cet.<\/p>\n

—<\/p>\n

N\u011bmecko 3000
\nRakousko 250
\nPolsko 700
\nMa\u010farsko 150
\n\u010cR 70
\nSlovensko 30<\/p>\n

Po\u010det kochle\u00e1rn\u00edch implant\u00e1t\u016f voperovan\u00fdch v roce 2013<\/p>\n

P\u0159ibli\u017en\u00fd po\u010det implantac\u00ed na 1 milion obyvatel<\/p>\n

celkem ve sv\u011bt\u011b 50 000 implantac\u00ed<\/p>\n

Kochle\u00e1rn\u00ed implant\u00e1t<\/p>\n

\u010c\u00e1st um\u00edst\u011bn\u00e1 za u\u0161n\u00edm boltcemmikrofonem zachycuje okoln\u00ed zvuky, m\u011bn\u00ed je na elektrick\u00e9 sign\u00e1ly a p\u0159en\u00e1\u0161\u00ed je p\u0159es implantovan\u00e9 za\u0159\u00edzen\u00ed do vnit\u0159n\u00edho ucha (kochlea je ozna\u010den\u00ed \u010d\u00e1sti vnit\u0159n\u00edho ucha zvan\u00e9 hlem\u00fd\u017e\u010f).<\/p>\n

MUDr. Ji\u0159\u00ed Sk\u0159ivan, CSc.<\/p>\n

(1958) Po studiu na Fakult\u011b v\u0161eobecn\u00e9ho l\u00e9ka\u0159stv\u00ed Univerzity Karlovy v Praze nastoupil na Kliniku ORL 1. l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy, kde byl z\u00e1stupcem p\u0159ednosty pro v\u00fdzkum. Od roku 2014 je p\u0159ednostou Kliniky u\u0161n\u00ed, nosn\u00ed a kr\u010dn\u00ed v pra\u017esk\u00e9 Fakultn\u00ed nemocnici Motol.<\/p>\n

Lidov\u00e9 noviny<\/p>\n","protected":false},"excerpt":{"rendered":"

Babi\u010dka nedosl\u00fdch\u00e1 a l\u00e9ka\u0159 j\u00ed p\u0159edep\u00ed\u0161e sluchadlo. Jen\u017ee babi\u010dka po\u0159\u00e1d nesly\u0161\u00ed a chce siln\u011bj\u0161\u00ed apar\u00e1tek. P\u0159itom u\u017e je t\u0159eba na t\u00e9 hranici, kde sluchadlo nepom\u00e1h\u00e1 […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":16054,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-23719","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/23719","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23719"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/23719\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/16054"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23719"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23719"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23719"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}