{"id":46154,"date":"2022-03-21T08:27:04","date_gmt":"2022-03-21T08:27:04","guid":{"rendered":"https:\/\/blog.medel.com\/uncategorized-tr\/genisletilmis-adaylik-kriterleri-isitsel-beyin-sapi-implantlari\/"},"modified":"2023-03-15T14:34:51","modified_gmt":"2023-03-15T14:34:51","slug":"genisletilmis-adaylik-kriterleri-isitsel-beyin-sapi-implantlari","status":"publish","type":"post","link":"https:\/\/blog.medel.com\/tr\/teknoloji\/genisletilmis-adaylik-kriterleri-isitsel-beyin-sapi-implantlari\/","title":{"rendered":"Geni\u015fletilmi\u015f Adayl\u0131k Kriterleri: \u0130\u015fitsel Beyin Sap\u0131 \u0130mplantlar\u0131"},"content":{"rendered":"

Uzun y\u0131llar boyunca koklear implantlar sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 i\u00e7in \u00e7ok etkili bir tedavi y\u00f6ntemi olmu\u015ftur. \u00c7ok ileri derecede i\u015fitme kayb\u0131 olan hastalar bile i\u015fitsel olarak m\u00fckemmel sonu\u00e7lar alabilir. Koklear implantlar, kokleadaki i\u015flev g\u00f6rmeyen t\u00fcy h\u00fccrelerini atlayarak uyar\u0131mlar\u0131n i\u015fitme sinirine oradan da beynin i\u015fitme merkezlerine ula\u015fmas\u0131 i\u00e7in tasarlanm\u0131\u015ft\u0131r.<\/p>\n

Peki, tam olarak i\u015flev g\u00f6rmeyen i\u015fitme siniri olan hastalar \u00a0i\u00e7in ne yapabilirsiniz? Hastan\u0131n i\u015fitme siniri hipoplazisi veya ileri ossifiye kokleas\u0131 varsa ya da tamamen i\u015fitme siniri yoksa?<\/p>\n

Bu durum, n\u00f6ral i\u015fitme kayb\u0131 veya retrokoklear i\u015fitme kayb\u0131 olarak adland\u0131r\u0131l\u0131r. Neyse ki, bu adaylar\u0131n sese eri\u015fim sa\u011flamas\u0131 i\u00e7in bir tedavi se\u00e7ene\u011fi var.<\/p>\n

Bug\u00fcn, i\u015fitsel beyin sap\u0131 implant\u0131n\u0131n, beyne ses sinyallerini g\u00f6ndermek i\u00e7in i\u015fitme sinirini nas\u0131l atlad\u0131\u011f\u0131na bak\u0131yoruz. Daha da iyisi, i\u015fitsel beyin sap\u0131 implant\u0131n\u0131n n\u00f6ral i\u015fitme kayb\u0131 olan bebeklere (12 ayl\u0131k ve daha b\u00fcy\u00fck) ve k\u00fc\u00e7\u00fck \u00e7ocuklara kadar \u00e7ok daha geni\u015f yelpazedeki adaylara uygulanmas\u0131 art\u0131k onaylanm\u0131\u015ft\u0131r.1,2,3<\/sup><\/p>\n

\u0130\u015fitsel Beyin Sap\u0131 \u0130mplant\u0131 Nas\u0131l \u00c7al\u0131\u015f\u0131r?<\/h3>\n

Sisteme genel bir bak\u0131\u015f ile ba\u015flayal\u0131m. \u0130\u015fitsel beyin sap\u0131 implant\u0131 (ABI) yap\u0131 olarak koklear implantlar\u0131m\u0131za benzerdir. Koklear implant sistemi ile benzer \u015fekilde harici ses i\u015flemcisi sesleri alg\u0131lar ve kodlanm\u0131\u015f sinyalleri implanta g\u00f6nderir. Bunun yan\u0131 s\u0131ra, ABI koklear implanttan \u00e7ok farkl\u0131 bir elektrot dizisi kullan\u0131r.<\/p>\n

ABI elektrot dizisi, do\u011frudan beyin sap\u0131 koklear \u00e7ekirde\u011fine yerle\u015ftirilen 12 elektrotlu bir k\u00fcrektir. \u00a0Koklear \u00e7ekirdek, i\u015fitme siniri ve beyin aras\u0131ndaki n\u00f6ral yolda bir sonraki ad\u0131md\u0131r.\"\"<\/p>\n

MED-EL SYNCHRONY ABI sistemi ile mevcut herhangi bir MED-EL Koklear \u0130mplant ses i\u015flemcisi kullan\u0131labilir.<\/em><\/p>\n

\u0130\u015flev g\u00f6rmeyen i\u015fitme sinirini atlayarak beyne ses sinyallerinin g\u00f6nderilmesini sa\u011flar. Bu durum, ABI\u2019y\u0131 i\u015fitme siniri olmayan veya i\u015flev g\u00f6rmeyen adaylar veya tamamen kokleas\u0131 olmayan hastalar i\u00e7in uygun bir se\u00e7enek haline getirir. Her i\u015fitme siniri i\u00e7in bir koklear \u00e7ekirdek vard\u0131r. Bundan dolay\u0131 bilateral i\u015fitsel beyin sap\u0131 implant\u0131 uygulanabilmesi m\u00fcmk\u00fcnd\u00fcr.<\/p>\n

Ameliyat\u0131 daha karma\u015f\u0131k olmas\u0131na ra\u011fmen, hem \u00e7ocuklar hem de yeti\u015fkinler i\u00e7in g\u00fcvenli bir operasyon olarak kabul edilir. MED-EL i\u015fitsel beyin sap\u0131 implantlar\u0131 20 y\u0131ldan fazla s\u00fcredir uygulanmaktad\u0131r.\"\"<\/p>\n

MED-EL ABI elektrot dizisi, <\/em>ba\u011f\u0131ms\u0131z ak\u0131m kaynaklar\u0131na<\/em> sahip 12 ayr\u0131 elektrot konta\u011f\u0131na sahiptir.<\/em><\/p>\n

N\u00f6rofibromatozis Tip 2 Hastalar\u0131nda ABI<\/h3>\n

Yak\u0131n zamana kadar, i\u015fitsel beyin sap\u0131 implant\u0131 sadece N\u00f6rofibromatozis Tip 2 (NF2) olan hastalar i\u00e7in endikeydi. N\u00f6rofibromatozis Tip 2, sinir sistemi boyunca kanserli olmayan t\u00fcm\u00f6rlerin geli\u015fimi ile karakterize genetik bir hastal\u0131kt\u0131r. Bu vestib\u00fcler schwannomalar (akustik n\u00f6rinom olarak da bilinir) s\u0131kl\u0131kla i\u015fitme siniri \u00fczerinde olu\u015fur ve NF2 t\u00fcm\u00f6rlerinin cerrahi olarak \u00e7\u0131kar\u0131lmas\u0131 i\u015fitme sinirine zarar verebilir.1<\/sup><\/p>\n

N\u00f6rofibromatozis Tip 2 genellikle ergenlik ve gen\u00e7 eri\u015fkinlikte g\u00f6r\u00fcl\u00fcr. Bu nedenle daha \u00f6nce adayl\u0131k kriterleri; 15 ya\u015f ve \u00fcst\u00fc olan, bilateral i\u015flevsiz i\u015fitme siniri ile beraber seyreden NF2 hastalar\u0131 ile s\u0131n\u0131rl\u0131 idi.<\/p>\n

NF2 hastalar\u0131nda ABI i\u015fitme sonu\u00e7lar\u0131n\u0131n her hastada farkl\u0131 oldu\u011funu bilmek \u00f6nemlidir. Olumlu i\u015fitme sonu\u00e7lar\u0131, kar\u015f\u0131l\u0131kl\u0131 konu\u015fmalarda dudak okuma yard\u0131m\u0131 ile konu\u015fmalar\u0131 anlayabilmekten telefon ile konu\u015fabilmeye kadar de\u011fi\u015febilmektedir.1,5<\/sup><\/p>\n

Geni\u015fletilmi\u015f Adayl\u0131k Kriterleri: NF2 Hastal\u0131\u011f\u0131 Bulunmayan Adaylarda ABI<\/h3>\n

\u00a0<\/strong>Yak\u0131n zamanda, MED-EL ABI adayl\u0131\u011f\u0131 i\u00e7in daha geni\u015f kriterlere sahip CE onay\u0131 ald\u0131. Art\u0131k, MED-EL ABI, i\u015flevsel olmayan i\u015fitme siniri nedeni ile koklear implanttan fayda g\u00f6remeyen 12 ayl\u0131k ve daha b\u00fcy\u00fck hastalar i\u00e7in endikedir. Bu, hem konjenital hem de edinsel etiyolojilerin ABI ile tedavi edilebilece\u011fi anlam\u0131na gelir. Bunlar:<\/p>\n

    \n
  • \u0130\u015fitme siniri aplazisi<\/li>\n
  • \u0130\u015fitme siniri hipoplazisi<\/li>\n
  • Kafa travmas\u0131<\/li>\n
  • NF2 olmayan t\u00fcm\u00f6r<\/li>\n
  • \u015eiddetli koklear ossifikasyon<\/li>\n<\/ul>\n

    Bu \u00e7ok \u00f6nemlidir, \u00e7\u00fcnk\u00fc art\u0131k her ya\u015ftan aday\u0131n n\u00f6ral i\u015fitme kayb\u0131 tedavisine eri\u015fimi vard\u0131r. \u0130\u015fitsel beyin sap\u0131 implantlar\u0131 i\u00e7in geni\u015fletilmi\u015f adayl\u0131k kriterlerine bakal\u0131m.<\/p>\n

    \u00c7ocuklarda \u0130\u015fitsel Beyin Sap\u0131 \u0130mplant\u0131<\/h3>\n

    Ara\u015ft\u0131rmalar, k\u00fc\u00e7\u00fck \u00e7ocuklarda ABI uygulamas\u0131 \u00f6zellikle implantasyondan \u00f6nce i\u015fitmeye eri\u015fimi olan \u00e7ocuklarda umut verici sonu\u00e7lar g\u00f6stermi\u015ftir. Erken m\u00fcdahale beynin yeni n\u00f6ral girdiye ba\u015far\u0131l\u0131 bir \u015fekilde adapte olabilmesinde kilit rol oynar. Bunun yan\u0131nda, koklear implantlarda oldu\u011fu gibi, n\u00f6ral plastisite k\u00fc\u00e7\u00fck \u00e7ocuklarda daha g\u00fcvenilirdir.3,6<\/sup><\/p>\n

    \u0130\u015fitsel beyin sap\u0131 implantlar\u0131, yeterince erken implante edilen \u00e7ocuklarda a\u00e7\u0131k u\u00e7lu konu\u015fmalar\u0131 tan\u0131ma ve telefon konu\u015fmalar\u0131n\u0131 anlama yetene\u011fi de dahil olmak \u00fczere olumlu i\u015fitsel sonu\u00e7lar sa\u011flayabilir. Geli\u015fmelerin g\u00f6r\u00fclmesi zaman al\u0131r ve \u00f6zel rehabilitasyon gerektirir. Ancak \u00f6nemli faydalar elde edilebilir.<\/p>\n

    \u0130\u015fitme sinir fonksiyonu yetersiz olan \u00e7ocuklarda (\u00f6rn. koklear sinir hipoplazisi) ABI zaman i\u00e7erisinde \u00f6nemli \u00f6l\u00e7\u00fcde koklear implanttan daha iyi sonu\u00e7lar sa\u011flayabilir.3,6<\/sup><\/p>\n

      \n
    • Olumlu i\u015fitsel sonu\u00e7lar3,6<\/sup><\/li>\n
    • \u0130yile\u015fmi\u015f ya\u015fam kalitesi2<\/sup><\/li>\n
    • Bili\u015fsel faydalar3<\/sup><\/li>\n
    • G\u00fcvenli MRG kullan\u0131m\u01317<\/sup><\/li>\n
    • \u0130\u015fiten \u00e7ocuklar ile birlikte normal okula gitme imkan\u01313<\/sup><\/li>\n<\/ul>\n

      Yeti\u015fkinlerde \u0130\u015fitsel Beyin Sap\u0131 \u0130mplant\u0131<\/h3>\n

      Geni\u015fletilmi\u015f adayl\u0131k kriterleri, hem NF2 olan hem de NF2 olmayan yeti\u015fkin hastalar\u0131 da kapsar. NF2 olmayan n\u00f6ral i\u015fitme kayb\u0131, kaza sonucu olu\u015fan i\u015fitme sinir travmalar\u0131n\u0131 i\u00e7erebilir. Di\u011fer olas\u0131 nedenler aras\u0131nda otoskleroz veya menenjitten kaynaklanan bilateral koklear ossifikasyon say\u0131labilir.4<\/sup><\/p>\n

      Genellikle yeti\u015fkinlerde olumlu i\u015fitme sonu\u00e7lar\u0131 g\u00f6r\u00fclebilir. Ancak erken m\u00fcdahale burada da \u00f6nemlidir. Beynin i\u015fitme merkezlerine yak\u0131n zamanda sese eri\u015fim olmu\u015f ise, daha sa\u011flam bir i\u015fitme sistemi geli\u015febilir. Bunun sonucunda, ABI ile daha fazla ba\u015far\u0131ya ula\u015f\u0131labilir.1<\/sup><\/p>\n

      N\u00f6ral i\u015fitme kayb\u0131 olan yeti\u015fkinlerde, geni\u015fletilmi\u015f adayl\u0131k kriterleri art\u0131k bu ki\u015filere ABI\u2019dan daha fazla yararlanma f\u0131rsat\u0131 sunmaktad\u0131r.<\/p>\n

        \n
      • Geli\u015fmi\u015f dinleme kabiliyeti1,2,5<\/sup><\/li>\n
      • G\u00fcvenli MRG kullan\u0131m\u01317<\/sup><\/li>\n
      • \u0130yile\u015fmi\u015f ya\u015fam kalitesi<\/li>\n<\/ul>\n

         <\/p>\n

        Referanslar:<\/em><\/p>\n

          \n
        1. Behr, R., Colletti, V., Matthies, C., Morita, A., Nakatomi, H., Dominique, L., Darrouzet, V., Brill, S., Shehata-Dieler, W., Lorens, A., & Skarzynski, H. (2014). New outcomes with Auditory Brainstem Implants in NF2 Patients. Otol Neurotol.35(10): 1844\u20131851.
          \n<\/em><\/li>\n
        2. Lundin, K., Stillesj\u00f6, F., Nyberg, G., & Rask-Andersen. (2016). Self-reported benefit, sound perception, and quality-of-life in patients with auditory brainstem implants (ABIs). H. Acta Otolaryngol. 136(1):62\u201367.
          \n<\/em><\/li>\n
        3. Colletti, L., Shannon, R., & Colletti, V. (2014). The development of auditory perception in children following auditory brainstem implantation. Audiol Neurootol. 19(6): 386\u2013394.
          \n<\/em><\/li>\n
        4. Colletti, L., Shannon, R., Carner, M., Veronese, S., & Colletti, V. (2010) Complications in Auditory Brainstem Implant surgery in adults and children. Otol Neurotol. 31(4):558\u2013564
          \n<\/em><\/li>\n
        5. Behr, R., M\u00fcller, J., Shehata-Dieler, W., Schlake, H.P., Helms, J., Roosen, K., Klug, N., H\u00f6lper, B., Lorens, A. (2007) The high rate CIS Auditory Brainstem Implant for restoration of hearing in NF-2 patients. Skull Base. 17(2):91-107.
          \n<\/em><\/li>\n
        6. Lundin, K., Stillesj\u00f6, F., Nyberg, G., & Rask-Andersen. (2016). Experiences from Auditory Brainstem Implantation (ABIs) in four paediatric patients. Cochlear Implants Int. 17(2):109\u2013115.
          \n<\/em><\/li>\n
        7. Shew, M., Bertsch, J., Camarata, P., & Staecker, H. (2017). Magnetic Resonance Imaging in a Neurofibromatosis Type 2 patient with a novel MRI-compatible Auditory Brainstem Implant. J Neurol Surg Rep. 78(1):e12-e14.<\/em><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

          Uzun y\u0131llar boyunca koklear implantlar sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 i\u00e7in \u00e7ok etkili bir tedavi y\u00f6ntemi olmu\u015ftur. \u00c7ok ileri derecede i\u015fitme kayb\u0131 olan hastalar bile i\u015fitsel olarak m\u00fckemmel sonu\u00e7lar alabilir. Koklear implantlar, kokleadaki i\u015flev g\u00f6rmeyen t\u00fcy h\u00fccrelerini atlayarak uyar\u0131mlar\u0131n i\u015fitme sinirine oradan da beynin i\u015fitme merkezlerine ula\u015fmas\u0131 i\u00e7in tasarlanm\u0131\u015ft\u0131r.<\/p>\n","protected":false},"author":8,"featured_media":71935,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3238],"tags":[],"class_list":["post-46154","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-teknoloji"],"yoast_head":"\nGeni\u015fletilmi\u015f Adayl\u0131k Kriterleri: \u0130\u015fitsel Beyin Sap\u0131 \u0130mplantlar\u0131 - The MED-EL Blog<\/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:\/\/blog.medel.com\/tr\/teknoloji\/genisletilmis-adaylik-kriterleri-isitsel-beyin-sapi-implantlari\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Geni\u015fletilmi\u015f Adayl\u0131k Kriterleri: \u0130\u015fitsel Beyin Sap\u0131 \u0130mplantlar\u0131 - The MED-EL Blog\" \/>\n<meta property=\"og:description\" content=\"Uzun y\u0131llar boyunca koklear implantlar sens\u00f6rin\u00f6ral i\u015fitme kayb\u0131 i\u00e7in \u00e7ok etkili bir tedavi y\u00f6ntemi olmu\u015ftur. \u00c7ok ileri derecede i\u015fitme kayb\u0131 olan hastalar bile i\u015fitsel olarak m\u00fckemmel sonu\u00e7lar alabilir. 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