{"id":23860,"date":"2015-12-23T11:00:34","date_gmt":"2015-12-23T10:00:34","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=23860"},"modified":"2015-12-23T18:13:03","modified_gmt":"2015-12-23T17:13:03","slug":"sluch-je-jediny-smysl-ktery-umime-nahradit","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=23860","title":{"rendered":"Sluch je jedin\u00fd smysl, kter\u00fd um\u00edme nahradit"},"content":{"rendered":"

Dvacet let pom\u00e1h\u00e1 brn\u011bnsk\u00fd foniatr Tom\u00e1\u0161 Talach pacient\u016fm s po\u0161kozen\u00fdm sluchem. „Lid\u00e9 probl\u00e9my skr\u00fdvaj\u00ed a boj\u00ed se o\u0161kliv\u00e9ho sluchadla,“ \u0159\u00edk\u00e1.<\/strong>
\n
\nilustra\u010dn\u00ed foto: Kateweb \/ Flickr.com<\/p>\n

Sluch, hlas, \u0159e\u010d. To v\u0161e l\u00e9\u010d\u00ed foniatr. V \u010cesku jich je asi sto dvacet. Podle p\u0159edsedy foniatrick\u00e9 sekce l\u00e9ka\u0159sk\u00e9 spole\u010dnosti Tom\u00e1\u0161e Talacha by se o foniatrii m\u011blo mluvit jako o oboru, jen\u017e se v\u011bnuje poruch\u00e1m komunikace jako celku. „Sluch, hlas i \u0159e\u010d jsou neodd\u011bliteln\u011b propojeny a ovliv\u0148uj\u00ed emoce, my\u0161len\u00ed a v podstat\u011b celou lidskou osobnost,“ vysv\u011btluje.<\/p>\n

– Jak je na tom „\u010desk\u00fd“ sluch?<\/p>\n

Ofici\u00e1ln\u00ed statistika u n\u00e1s neexistuje. Vych\u00e1z\u00edme-li z \u00fadaj\u016f N\u011bmecka, Francie a Velk\u00e9 Brit\u00e1nie, trp\u00ed poruchou sluchu ka\u017ed\u00fd des\u00e1t\u00fd \u010dlov\u011bk. Z tohoto milionu nedosl\u00fdchav\u00fdch \u010cech\u016f se bohu\u017eel k vy\u0161et\u0159en\u00ed odhodl\u00e1 jen \u010d\u00e1st. Mnoz\u00ed si pot\u00ed\u017ee odm\u00edtaj\u00ed p\u0159iznat, nebo je skr\u00fdvaj\u00ed. Dnes jsme p\u0159itom v osobn\u00edm \u017eivot\u011b i v pr\u00e1ci pln\u011b z\u00e1visl\u00ed na schopnosti spr\u00e1vn\u011b komunikovat.<\/p>\n

– Nar\u016fst\u00e1 po\u010det nemocn\u00fdch?<\/p>\n

Zcela ur\u010dit\u011b. Souvis\u00ed to zejm\u00e9na se st\u00e1rnut\u00edm populace. V N\u011bmecku trp\u00ed nedosl\u00fdchavost\u00ed o t\u0159i procenta lid\u00ed v\u00edc ne\u017e ve Francii, proto\u017ee maj\u00ed v\u00edc senior\u016f. Na\u0161e zem\u011b se demograficky N\u011bmecku velmi podob\u00e1. A nejde jen o seniory. Mnoho lid\u00ed sluch ne\u00fam\u011brn\u011b zat\u011b\u017euje hlukem a pova\u017euje to za norm\u00e1ln\u00ed. T\u0159eba na ka\u017ed\u00e9m p\u0159ehr\u00e1va\u010di hudby si m\u016f\u017eete zapnout omezen\u00ed hlasitosti na bezpe\u010dnou mez. Ale skoro nikdo to nevyu\u017e\u00edv\u00e1.<\/p>\n

– V bl\u00edzk\u00e9 dob\u011b by mohli schv\u00e1lit novelu z\u00e1kona o ve\u0159ejn\u00e9m zdravotn\u00edm poji\u0161t\u011bn\u00ed. Zm\u011bn\u00ed n\u011bjak zp\u016fsob l\u00e9\u010dby?<\/p>\n

Dosud plat\u00ed, \u017ee pacienti nad 18 let maj\u00ed ze zdravotn\u00edho poji\u0161t\u011bn\u00ed \u00fahradu pouze na jedno sluchadlo. Sluch je ale p\u00e1rov\u00fd org\u00e1n. U br\u00fdl\u00ed v\u00e1s tak\u00e9 nenapadne po\u0159\u00eddit si jen jedno skl\u00ed\u010dko. V N\u011bmecku pou\u017e\u00edv\u00e1 sluchadla oboustrann\u011b 60 procent u\u017eivatel\u016f, v USA dokonce t\u0159i \u010dtvrtiny. U n\u00e1s m\u00e1 bohu\u017eel v\u011bt\u0161ina lid\u00ed sluchadlo pouze na jednom uchu. N\u00e1vrh novely p\u0159edpokl\u00e1d\u00e1 pro dosp\u011bl\u00e9 pacienty p\u0159\u00edsp\u011bvek i na druh\u00e9. Dal\u0161\u00edm zlep\u0161en\u00edm je hrazen\u00ed l\u00e9\u010dby sluchadlem i pro leh\u010d\u00ed vady sluchu ne\u017e dosud.<\/p>\n

– Co se m\u016f\u017ee st\u00e1t, kdy\u017e m\u00e1 \u010dlov\u011bk sluchadlo jen na jednom uchu?<\/p>\n

Zdrav\u00e9 a norm\u00e1ln\u011b sly\u0161\u00edc\u00ed d\u00edt\u011b se nerod\u00ed s funguj\u00edc\u00ed schopnost\u00ed prostorov\u00e9ho sly\u0161en\u00ed. Trv\u00e1 \u0159adu m\u011bs\u00edc\u016f, ne\u017e se tuto d\u016fle\u017eitou \u010dinnost mozek nau\u010d\u00ed. B\u011bhem \u017eivota v\u0161e funguje podv\u011bdom\u011b, prakticky okam\u017eit\u011b jsme schopni ur\u010dit zdroj zvuku a spr\u00e1vn\u011b vn\u00edmat okoln\u00ed prostor. Podm\u00ednkou je v\u0161ak symetrick\u00e9 sly\u0161en\u00ed. Nedosl\u00fdchavost nej\u010dast\u011bji postihuje ob\u011b u\u0161i, a kdy\u017e zlep\u0161\u00edte sly\u0161en\u00ed pouze na jedn\u00e9 stran\u011b, pak \u010dlov\u011bk nedok\u00e1\u017ee sluchem poznat, odkud na n\u011bj vol\u00e1te nebo ze kter\u00e9 strany se bl\u00ed\u017e\u00ed auto k p\u0159echodu. Dv\u011b sluchadla poskytuj\u00ed prostorov\u00e9 sly\u0161en\u00ed a z\u00e1sadn\u011b zvy\u0161uj\u00ed schopnost rozum\u011bt \u0159e\u010di v hlu\u010dn\u00e9m prost\u0159ed\u00ed. Rozd\u00edl m\u016f\u017ee \u010dinit a\u017e patn\u00e1ct procent, t\u00e9m\u011b\u0159 ka\u017ed\u00e9 p\u00e1t\u00e9 slovo. Pokud je pacient ponech\u00e1n dlouho bez mo\u017enosti sly\u0161et na ob\u011b u\u0161i, mozek si p\u0159ivykne. Navr\u00e1cen\u00ed prostorov\u00e9ho sly\u0161en\u00ed je pak slo\u017eit\u00e9 a bez z\u00e1ruky pln\u00e9 obnovy funkce.<\/p>\n

– Tak\u017ee v p\u0159\u00edpad\u011b pot\u00ed\u017e\u00ed nen\u00ed na co \u010dekat.<\/p>\n

Rozhodn\u011b. Nedosl\u00fdchavost obvykle za\u010d\u00edn\u00e1 pozvolna a jen na n\u011bkter\u00fdch frekvenc\u00edch. Takov\u00fd \u010dlov\u011bk nesly\u0161\u00ed jen m\u00e9n\u011b hlasit\u011b, ale p\u0159edev\u0161\u00edm jinak. Mozek m\u00e1 schopnost p\u0159ivykat a po \u010dase si na toto patologick\u00e9 sly\u0161en\u00ed pacient zvykne. Nev\u011bdomky si pom\u00e1h\u00e1 pohledem na \u00fasta lid\u00ed a sna\u017e\u00ed se v\u00fdznam slov dom\u00fd\u0161let. Vyh\u00fdb\u00e1 se prost\u0159ed\u00ed, kde je sluch zapot\u0159eb\u00ed, a\u017e se \u00fapln\u011b izoluje. \u010c\u00edm d\u00e9le pacient setrv\u00e1 v nel\u00e9\u010den\u00e9 nedosl\u00fdchavosti, t\u00edm v\u00edce jej opou\u0161t\u00ed i schopnost \u0159e\u010d zpracovat. A t\u00edm obt\u00ed\u017en\u011bji si pak mus\u00ed zvykat na navr\u00e1cen\u00e9 norm\u00e1ln\u00ed sly\u0161en\u00ed. P\u0159i pocitu zhor\u0161en\u00ed by lid\u00e9 m\u011bli l\u00e9ka\u0159e vyhledat co nejd\u0159\u00edve. A nemus\u00ed m\u00edt obavu z o\u0161kliv\u00e9ho sluchadla. Dnes m\u00e1me k dispozici \u0159e\u0161en\u00ed, kter\u00e1 jsou tak\u0159ka neviditeln\u00e1.<\/p>\n

– Jedn\u00edm z nich jsou i kochle\u00e1rn\u00ed implant\u00e1ty. Spolu s Romem Kost\u0159icou jste je pom\u00e1hali zav\u00e1d\u011bt v Brn\u011b.<\/p>\n

Centrum kochle\u00e1rn\u00edch implantac\u00ed ve Fakultn\u00ed nemocnici u sv. Anny v Brn\u011b vzniklo hlavn\u011b d\u00edky \u00fasil\u00ed profesora Kost\u0159ici, j\u00e1 jsem jen pom\u00e1hal. Kochle\u00e1rn\u00edm implantac\u00edm, p\u0159i nich\u017e se implant\u00e1t chirurgicky vlo\u017e\u00ed do vnit\u0159n\u00edho ucha a nahrad\u00ed jeho po\u0161kozenou funkci, se do t\u00e9 doby v\u011bnovali pouze v pra\u017esk\u00e9m Motole. Dnes u\u017e m\u00e1me p\u0159es \u0161edes\u00e1t \u00fasp\u011b\u0161n\u011b l\u00e9\u010den\u00fdch pacient\u016f a centrum st\u00e1le roste. Stal se z n\u011bj spole\u010dn\u00fd projekt obou brn\u011bnsk\u00fdch fakultn\u00edch nemocnic, kter\u00fd sd\u00edl\u00ed \u0161pi\u010dkov\u00e9 odborn\u00edky a z\u00e1zem\u00ed. A neomezujeme se jen na kochle\u00e1rn\u00ed implant\u00e1ty. Na\u0161e centrum jako jedin\u00e9 pou\u017e\u00edv\u00e1 pln\u011b implantovan\u00e1 sluchadla pro kostn\u00ed veden\u00ed.<\/p>\n

– Lze sluch tr\u00e9novat?<\/p>\n

U zdrav\u00e9ho sluchu to nen\u00ed pot\u0159eba. Jak \u010dlov\u011bk st\u00e1rne, m\u016f\u017ee tr\u00e9novat kognitivn\u00ed funkce \u2013 pam\u011b\u0165, pozornost, schopnost pochopen\u00ed informac\u00ed. Sluch se t\u00edm sice nezm\u011bn\u00ed, ale a\u017e nastane pot\u0159eba l\u00e9\u010dby, bude m\u00edt lep\u0161\u00ed v\u00fdsledky. Jin\u00e1 je situace u pacient\u016f s po\u0161kozen\u00fdm sluchem. Tam jsou tr\u00e9nink a rehabilitace nezbytn\u00e9. Nesta\u010d\u00ed toti\u017e sluch jen napravit.<\/p>\n

– Co t\u00edm mysl\u00edte?<\/p>\n

A\u0165 poruchu sluchu l\u00e9\u010d\u00edme sluchadlem, operac\u00ed, nebo implant\u00e1tem, c\u00edlem nen\u00ed jen zes\u00edlit a zm\u011bnit pacientovo vn\u00edm\u00e1n\u00ed okoln\u00edch zvuk\u016f. Zvukov\u00e9 podn\u011bty pro n\u011bj maj\u00ed jinou podobu a on se je mus\u00ed znovu nau\u010dit. Mus\u00edme mu pomoci v jeho pam\u011bti p\u0159epsat star\u00e9 z\u00e1znamy o \u0161patn\u00e9m zp\u016fsobu sly\u0161en\u00ed t\u011bmi nov\u00fdmi. \u0158\u00edk\u00e1 se tomu reedukace sluchu a je to pr\u00e1ce pro foniatra a logopeda.<\/p>\n

– Je mo\u017en\u00e9 pot\u00ed\u017e\u00edm p\u0159edch\u00e1zet?<\/p>\n

Vyh\u00fdbat se rizik\u016fm, kter\u00e1 sluch po\u0161kozuj\u00ed. Nejrizikov\u011bj\u0161\u00ed je hluk. D\u00e1le n\u011bkter\u00e1 antibiotika, chinin, dehydratace, dlouhodob\u011b v\u011bt\u0161\u00ed d\u00e1vky aspirinu, stres.<\/p>\n

– Sluch se tedy podce\u0148uje?<\/p>\n

Spisovatelka Helen Kellerov\u00e1, kter\u00e1 se narodila hluch\u00e1 i slep\u00e1, napsala, \u017ee slepota odd\u011bluje \u010dlov\u011bka od v\u011bc\u00ed a hluchota od lid\u00ed. Nevidom\u00fd pacient m\u00e1 velmi t\u011b\u017ek\u00e9 posti\u017een\u00ed, st\u00e1le v\u0161ak m\u016f\u017ee komunikovat s okol\u00edm. Nen\u00ed s\u00e1m. Pokud hluch\u00fd pacient nem\u00e1 mo\u017enost sly\u0161en\u00ed nahradit odez\u00edr\u00e1n\u00edm nebo implant\u00e1tem, je zcela izolov\u00e1n od soci\u00e1ln\u00edho kontaktu a kvalita jeho \u017eivota je hor\u0161\u00ed.<\/p>\n

– Pro d\u011bti to mus\u00ed b\u00fdt velmi t\u011b\u017ek\u00e9, kdy\u017e nesly\u0161\u00ed. Jak je l\u00e9\u010d\u00edte?<\/p>\n

Sna\u017e\u00edme se jim vr\u00e1tit sluch v co nejmlad\u0161\u00edm v\u011bku. D\u011btsk\u00fd mozek m\u00e1 do ur\u010dit\u00e9ho v\u011bku unik\u00e1tn\u00ed dovednost u\u010dit se syst\u00e9m lidsk\u00e9 \u0159e\u010di. Tato schopnost se v\u0161ak okolo p\u00e1t\u00e9ho roku ztrat\u00ed. Na\u0161\u00ed snahou je obnovit sluch co nejd\u0159\u00edve, aby se \u0159e\u010d stihla vytvo\u0159it spr\u00e1vn\u011b.<\/p>\n

– P\u0159esto se objevuj\u00ed p\u0159\u00edpady, kdy rodi\u010de s po\u0161kozen\u00fdm sluchem necht\u011bj\u00ed, aby se d\u00edt\u011b z hluchoty vyl\u00e9\u010dilo.<\/p>\n

Sluchov\u011b posti\u017een\u00ed u\u017eivatel\u00e9 znakov\u00e9ho jazyka se pova\u017euj\u00ed za jazykovou a kulturn\u00ed men\u0161inu. Nesly\u0161\u00edc\u00ed rodi\u010de n\u011bkdy kochle\u00e1rn\u00ed implantaci odm\u00edtnou a d\u00edt\u011b vychov\u00e1vaj\u00ed jen znakovou \u0159e\u010d\u00ed. V\u011bt\u0161inou maj\u00ed strach, \u017ee jim odejde. Z etick\u00e9ho hlediska mus\u00edme respektovat pr\u00e1va rodi\u010d\u016f, na\u0161\u00ed \u00falohou je poskytnout jim v\u0161echny informace a l\u00e9\u010dbu nab\u00eddnout. P\u0159esto ve mn\u011b p\u0159eva\u017euje touha spravovat to, co bych spravit mohl. A\u017e se d\u00edt\u011b bude pt\u00e1t, pro\u010d z\u016fstalo hluch\u00e9, vysv\u011btlen\u00ed z\u016fstane na rodi\u010d\u00edch. Sluch je dnes toti\u017e jedin\u00fd smysl, kter\u00fd dok\u00e1\u017eeme zcela nahradit.<\/p>\n

– Nen\u00ed v p\u0159\u00edpad\u011b \u00fasp\u011b\u0161n\u00e9 implantace naru\u0161en pozn\u00e1vac\u00ed v\u00fdvoj d\u00edt\u011bte?<\/p>\n

Kochle\u00e1rn\u00ed implantace je a\u017e na konci cesty. Po vy\u0161et\u0159en\u00ed d\u00edt\u011b pou\u017e\u00edv\u00e1 kvalitn\u00ed sluchadla, a teprve pokud nemaj\u00ed p\u0159\u00ednos, je na m\u00edst\u011b chirurgick\u00fd z\u00e1krok. Implant\u00e1t je pouze prost\u0159edek, kter\u00fd umo\u017e\u0148uje vn\u00edmat zvuky a \u0159e\u010d. V\u00fdsledek p\u0159in\u00e1\u0161\u00ed a\u017e rehabilitace pacienta, o kter\u00e9ho se v\u017edy star\u00e1 skupina odborn\u00edk\u016f. Hlavn\u00ed pr\u00e1ci v\u0161ak odvedou rodi\u010de p\u0159i ka\u017edodenn\u00edm cvi\u010den\u00ed \u0159e\u010di a sluchu. Mamink\u00e1m implantovan\u00fdch d\u011bt\u00ed by se m\u011bly ud\u011blovat medaile za state\u010dnost. V\u0161ichni se st\u00e1v\u00e1me \u010dleny jednoho t\u00fdmu. Vlo\u017een\u00e9 \u00fasil\u00ed se stokr\u00e1t vr\u00e1t\u00ed, kdy\u017e vid\u00edte, jak p\u016fvodn\u011b hluch\u00e9 d\u00edt\u011b za\u010dne objevovat sv\u011bt zvuk\u016f a mluvit.<\/p>\n

– \u0158\u00edkal jste, \u017ee sluch, hlas i \u0159e\u010d ovliv\u0148uj\u00ed lidskou osobnost. Jak to mysl\u00edte?<\/p>\n

Tyto funkce jsou z\u00e1kladn\u00edmi kameny jazyka, bez kter\u00e9ho bychom doslova nebyli ni\u010d\u00edm. V\u011bt\u0161inu doby, po kterou existuje druh homo sapiens, jsme sd\u00edleli Zemi s jin\u00fdmi lidsk\u00fdmi druhy. Teprve p\u0159ed 70 tis\u00edci lety se u na\u0161ich p\u0159edk\u016f objevila schopnost pou\u017e\u00edvat abstraktn\u00ed pojmy. \u0158\u00edk\u00e1me tomu kognitivn\u00ed revoluce. Jazyk mohl n\u00e1hle pojmenovat vz\u00e1jemn\u00e9 vztahy v tlup\u011b, pocity a spole\u010dn\u00e9 z\u00e1jmy. Bez toho by nebyla mo\u017en\u00e1 spolupr\u00e1ce velk\u00fdch skupin a vznik civilizace. Pr\u00e1v\u011b jazyk rozhodl, \u017ee na\u0161i p\u0159edkov\u00e9 usp\u011bli v konkurenci ostatn\u00edch lidsk\u00fdch druh\u016f. Schopnosti myslet v abstraktn\u00edch pojmech a mluvit v nich se d\u00e1l posilovaly a m\u011bnily jedna druhou. D\u011bje se to st\u00e1le. \u010clov\u011bk by se s\u00e1m na sebe nem\u011bl d\u00edvat jako na n\u011bco nem\u011bnn\u00e9ho. V\u0161echno okolo n\u00e1s se vyv\u00edj\u00ed a my tak\u00e9.<\/p>\n

—<\/p>\n

Foniatr Tom\u00e1\u0161 Talach (45) je absolventem L\u00e9ka\u0159sk\u00e9 fakulty Masarykovy univerzity v Brn\u011b. Pracuje jako vedouc\u00ed foniatrick\u00e9ho a audiologick\u00e9ho odd\u011blen\u00ed Kliniky otorinolaryngologie a chirurgie hlavy a krku ve Fakultn\u00ed nemocnici u sv. Anny v Brn\u011b, kde se pod\u00edlel na zalo\u017een\u00ed Centra kochle\u00e1rn\u00edch implantac\u00ed.<\/p>\n

Jan David
\nMlad\u00e1 fronta Dnes<\/p>\n","protected":false},"excerpt":{"rendered":"

Dvacet let pom\u00e1h\u00e1 brn\u011bnsk\u00fd foniatr Tom\u00e1\u0161 Talach pacient\u016fm s po\u0161kozen\u00fdm sluchem. „Lid\u00e9 probl\u00e9my skr\u00fdvaj\u00ed a boj\u00ed se o\u0161kliv\u00e9ho sluchadla,“ \u0159\u00edk\u00e1.<\/p>\n<\/div>","protected":false},"author":1,"featured_media":16054,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[],"class_list":["post-23860","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rozhovory","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/23860","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=23860"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/23860\/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=23860"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23860"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23860"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}