Phoniatric outpatient clinic and cochlear implant center

The workplace is one of the oldest medical facilities focused on the treatment of communication disorders. It was originally called the Logopedic Institute. It was founded in 1945 by the doctor and speech therapist prof. MD PhDr. Miloš Sovák, DrSc. and became part of the Children's Faculty Hospital, later the Faculty Hospital in Motola. In the years 1964-1996, it was called the Phoniatric Department, its head was MUDr. Ivan Šupáček, CSc. In 1996, in accordance with the new workload, its name was expanded, it became the Phoniatrics Department and the Rehabilitation Center for Cochlear Implants in Children. The facility is part of the Ear, Nose and Throat Clinic of the 2nd Faculty of Medicine of the UK and the Motol FN. Its long-time leader, psychologist PhDr., had great merit in the development of the workplace. Eva Vymlátilová. Since March 1, 3, the department has been headed by MUDr. Petr Myška. In May 2016, the workplace moved to the FN Motol complex. From January 2019, 1, MUDr. Zdenka Aksenovová, Ph.D.

Head of department

MUDr. Zdenka Aksenovová, Ph.D., phone 22443 2698, zdenka.aksenovova@fnmotol.cz

Secretariat:

Eva Mazánková, phone 22443 2691, eva.mazankova@fnmotol.cz

District nurse:

Hana Ivasienková, phone 22443 2642, hana.ivasienkova@fnmotol.cz

Phoniatrician:

MUDr. Zdenka Aksenovová, Ph.D., phone 22443 2698,  zdenka.aksenovova@fnmotol.cz

Clinical psychologist:

PhDr. Eva Vymlátilová, phone 22443 2640, eva.vymlatilova@fnmotol.cz

Mgr. Kateřina Tučková, phone 22443 2640, katerina.tuckova@fnmotol.cz

Clinical speech therapist:

Mgr. Jitka Holmanová, phone 22443 2643, jitka.holmanova@fnmotol.cz

PaedDr. Kateřina Voříšková, phone 22443 2645, katerina.voriskova@fnmotol.cz 

Mgr. Zdena Jedličková, phone 22443 2644, zdena.jedlickova@fnmotol.cz 

Electrical engineers:

Ing. Lukáš Bauer, phone 22443 2694, lukas.bauer@fnmotol.cz

Ing. Miroslav Okluský, phone 22443 2694, miroslav.oklusky@fnmotol.cz

Ing. Stanislav Sedlák, ordering through a speech therapist

Ing. Martin Topol, ordering through a speech therapist

Audiology Nurse:

Zdeňka Levá, tel. 22443 2641, zdenka.leva@fnmotol.cz

Warning for patients !!!

Our workplace has moved to the Motol University Hospital. 

Due to the reorganization and relocation of our workplace to the premises of the children's polyclinic of the Motol University Hospital, the nature and spectrum of our work is changing.

We currently only care for pediatric patients under the age of 19.

We recommend that our existing adult patients (mainly hearing aid users) make an appointment at another phoniatrics workplace according to their place of residence, upon request we will provide an extract from the medical documentation - information from the secretary Mrs. Mazánková on tel. 22443 2691.

Comprehensive phoniatric, speech therapy and psychological care for our current patients with cochlear implants and BAHA hearing aids remains in full even after the age of 19.

Phoniatric outpatient clinic - children's polyclinic 3rd floor

MUDr. Zdenka Aksenova, Ph.D., prescribed Mon-Fri

It is necessary to order new patients recommendation and previous examination by a phoniatrician or ENT doctor from the place of residence. We only order through the reception on the phone number 22443 2691 on working days, preferably between 8:00-9:00 a.m. and then between 13:00 p.m. and 14:00 p.m.

Questions can be sent to e-mail - eva.mazankova@fnmotol.cz.

District nurse: Hana Ivasienková,  tel. 22443 2642

Audiology Nurse: Zdenka Leva, tel. 22443 2641

Clinic of a clinical psychologist - children's polyclinic 3rd floor

PhDr. Eva Vymlátilová, prescribed Tue-Wed, tel. 22443 2640

M.Sc. Katerina Tučková, ordinates Mon, Thu, Fri, tel. 22443 2640

Clinical speech therapist - pediatric polyclinic 4th floor

M.Sc. Jitka Holmanová, prescribed Mon-Wed, tel. 22443 2643

PaedDr. Kateřina Voříšková, prescribed Mon-Fri, tel. 22443 2645

M.Sc. Zdena Jedličková, prescribed Mon-Fri, tel. 22443 2644

Workplace of clinical engineers

Ing. Miroslav Oklusky, ordering through a speech therapist

Ing. Lukas Bauer, ordering through a speech therapist

Ing. Stanislav Sedlak, ordering through a speech therapist

Ing. Martin Topol, ordering through a speech therapist

Workplace of a social worker

Eliška Hlavackova, Dis. order by calling 22443 1173 or 722 983 734

The multidisciplinary team is dedicated to children with speech, voice and hearing impairments. It specializes in the selection of pediatric cochlear implant candidates, provides comprehensive care for these patients and performs long-term rehabilitation of cochlear implant users. The Phoniatric Department and the Cochlear Implantation Rehabilitation Center provides its patients with the following care:

• phoniatric - diagnosis and therapy of communication disorders, allocation of hearing aids including individual ear molds, recommendation of compensatory aids
• speech therapy - rehabilitation of all communication disorders, especially pedagogical counseling
• psychological - diagnostics, psychotherapy, psychagogy, counseling 
• social - advice regarding social benefits and other benefits
• programming of speech processors of cochlear implants - individual adaptation of speech processors, which enables auditory perception for children with a cochlear implant

Due to the reorganization and relocation of our workplace to the premises of the children's polyclinic of the Motol University Hospital, the nature and spectrum of our work is changing.

We currently only care for pediatric patients under the age of 19.

We recommend our existing adult patients (especially hearing aid users) to order another phoniatric workplace according to their place of residence, on request we will provide an extract from the medical documentation - information from the secretary Mrs. Mazánková on tel. 22443 2691.

Comprehensive phoniatric, speech therapy and psychological care for our current patients with cochlear implants and BAHA hearing aids remains in full even after the age of 19.

Procedure for ordering patients to the phoniatric outpatient clinic of the Department of Ear, Nose and Throat 2, Faculty of Medicine, Charles University and University Hospital Motol.

The phoniatric outpatient clinic and the outpatient department of the Cochlear Implant Center are part of the Department of Ear, Nose and Throat 2, Faculty of Medicine, Charles University and University Hospital Motol. The main task of the outpatient clinic is to care for a hearing-impaired child, from the diagnosis of a hearing defect through compensation with hearing aids to an indication for cochlear implantation, including subsequent care for users of hearing aids and cochlear implants.

This outpatient clinic also operates as a superconsulting workplace for patients with speech and voice defects from all over the Czech Republic.

To order new patients (except for suspected hearing impairment in children under 3 years of age), it is necessary to have a recommendation and a previous examination by a phoniatrician or ENT doctor from the place of residence. We only order on the phone number 22443 2691 on working days, preferably between 8:00-9:00 a.m. and then between 13:00 p.m. and 14:00 p.m.

Questions can be sent to e-mail - eva.mazankova@fnmotol.cz.

Patients who go to the phoniatrician for a check-up (Dr. Aksenovová) print out a serial number upon arrival on the 3rd floor and report to the reception.

The patient after cochlear implantation they can in in acute cases outside office hours (weekends, holidays, etc.) seek help on phone number 22443 2633.

Phoniatrician, psychologists and audiology departments - building of the children's polyclinic 3rd floor

Speech therapist surgery - building of the children's polyclinic 4rd floor

Setting up sound processors and adult CI users - bed part 8th floor, 8A

Frequently Asked Questions

How is hearing examined?

Hearing examination methods are divided into subjective, which require patient cooperation (and therefore cannot be used in young children) and objective, where patient cooperation is not necessary. Subjective methods include the classic hearing test with loud speech and whispers and audiometric examination. Objective methods are based on sensing the responses of different levels of the brain to a sound stimulus. These include, for example, BERA, CERA, SSEP. These examinations are usually performed under natural or drug-induced sleep, or under general anesthesia.

At what age can a child's hearing be examined?

The child's hearing can be examined several days after birth using objective audiometric methods. At our workplace, we are staffed and equipped to examine hearing in newborns, small and large children, as well as adult patients.

Is hearing examination using objective methods reliable?

In the group of children, which we examined using objective methods and later also using a standard audiometric examination, it was shown that the hearing thresholds measured by objective methods correspond to the hearing thresholds that the children gave us during audiometry.

Caution should be exercised in premature infants or patients with neurological disabilities who have a slower maturation of the auditory pathways and therefore objective audiometry may in some cases show slightly worse hearing results than is actually the case. For this reason, it is necessary to repeat the examination in controversial cases, use more methods and mainly monitor the overall development of the child and his response to sounds.

What are the risk factors for congenital hearing loss?

Congenital hearing loss can arise from genetic causes (a child inherits a predisposition to hearing impairment from its parents, while the parents can hear well, they can only be carriers of bad genetic information) or negative environmental influences affect the developing embryo (i.e. illness of the mother - e.g. .diabetes, cytomegalovirus, rubella or drugs that a pregnant woman takes - ATB, cytostatics, etc.).

What conditions must a child meet in order to receive a cochlear implant?

The cochlear implant candidate must meet audiological, speech therapy and psychological criteria. His hearing loss must be so great that even the most powerful hearing aids are not enough to compensate. The child must have the prerequisites to develop spoken language and must be willing and able to cooperate at least partially in rehabilitation. Parents must agree to the operation and be sufficiently instructed and have realistic ideas about their child's abilities and the benefits of the cochlear implant, and must be willing to cooperate in subsequent long-term rehabilitation care. The overall health of the child and the possible presence of other disabilities are also monitored (the child must be able to undergo surgery under general anesthesia; we currently operate on children with combined disabilities, eg deafblind, with cerebral palsy, autism, mental retardation, etc.).

How is the operation - cochlear implantation performed?

The operation is performed under general anesthesia and lasts about 2-3 hours. The surgical procedure commonly used in the world's implantation centers is uniform in the main points and differs only in some details.

First, an incision is made near the ear and a bed is created for the implant body in the bone behind the ear. The electrode bundle is then inserted into the cochlea. The auditory nerve responses are measured during surgery. Finally, the implant is fixed in position and the individual layers are sutured. The wound is covered with a bandage and the child is transported to the postoperative ward. About a week after the procedure, the stitches are removed and the child is released for home treatment.

Are unilateral or even bilateral cochlear implants performed in the Czech Republic?

In the past, unilateral cochlear implantation was the standard procedure. We are currently also performing bilateral implants. You can get more information at our workplace.

Can a user of one cochlear implant wear a hearing aid on the other ear?

In some cases, the hearing aid in the other ear may allow directional hearing or improve speech comprehension in a noisy environment. The benefit of the hearing aid is individual, depending on the size of the hearing residue on the unopened ear and the previous experience of the hearing aid user. Check with your doctor at CKID about the possibility of using a cochlear implant in one ear and a hearing aid in the other ear at the same time.

How long after the operation does the child start to hear?

After the surgical wound has healed (ie about 4-6 weeks after implantation), the first programming of the sound processor is performed in our department. This means that the child gets the outer parts of the implant and the first adjustment is made. From this point on, the child may begin to perceive sounds. First they learn to hear sounds, then to recognize and distinguish, and only in the next phase do they learn to listen to and understand speech. Parents usually observe the first progress in understanding speech several weeks to months after implantation. It depends on the age and abilities of the child and also on how the parents work with the child.

Can a child with a cochlear implant play sports?

A child with an implant can play sports and exercise in physical education classes at school.

However, the user of the cochlear implant should not perform activities and sports in which there is an increased risk of head injury (blow to the head, fall on the head) and the internal part of the device may be damaged. In particular, we do not recommend contact sports (boxing, wrestling), team sports (colliding with a teammate) or activities associated with jumps, rebounds, strikes and impacts on the ground.

Sports activities should always be assessed individually, taking into account the nature of the sport, the operating conditions and the abilities of the particular CI user. When playing sports, it is necessary to take extra care, follow safety rules, use protective equipment (helmets, etc.). Account must also be taken of the fact that a CI user may have difficulty with directional hearing and speech comprehension in noise and acoustically unfavorable conditions (gyms, sports halls). When operating water sports, it is necessary to store the external parts of the CI and ensure their safe storage (protect from water, damage, loss).

The decision to run a particular sport is fully within the competence of the user.

In addition to the standard equipment of the phoniatric, speech therapy and psychological outpatient clinic, the workplace is equipped with equipment for VRA (Visual Reinforcement Audiometry) examination, devices for otoacoustic emissions and hearing examination using SSEP (Steady State Evocated Potentials), psychological tests used to diagnose the hearing impaired.

The department cooperates with the IPVZ on postgraduate teaching of doctors, speech therapists and psychologists. The internship of students of special pedagogy from the Faculty of Education of Charles University takes place here. In cooperation with the ENT clinic, seminars and internships are organized for professionals who take care of cochlear implant users in their place of residence.

The staff deals intensively with the issue of cochlear implants in children, publishes in professional journals and lectures on their experiences at domestic and foreign congresses.

The department provides complementary care for implanted children in their place of residence, usually in Special Education Centers at schools for the hearing impaired.