Ingabe Udinga Ukuvivinya Ukuzwa?

by UKristin Hayes, uRN; Ibukezwe nguRichard N. Fogoros, MD

Ukusakaza Izimpawu Zokuzwa Ukulahlekelwa

Ukuzwa ukulahlekelwa kokubili kwezingane kanye nabantu abadala kungalimaza kakhulu indlela yokuphila. Abantu abadala abangaphezu kwezigidi ezingu-30 e-United States bavezwe emazingeni omsindo okuyingozi empilweni yakho. Uma ukuzwa kwakho kubonakalisiwe uma usukhulile, ungase ube engozini yokulahlekelwa amathuba okuthuthuka uma ungenayo ukulahlekelwa kwezindlebe zakho ukuphathwa. Abantu abadala abanokuzwa ukulalelwa okungaqondakali bavame ukwenza abantu abangaphansi kwabadala ngokuzwa okujwayelekile noma okulungisiwe.

Uma ungalahlekelwa ukulalelwa kwezindlebe, uyingxenye yabantu abangama-80 kwabangu-100 abathintekayo abangenzi lutho ngokuthuthukisa ukuzwa kwabo.

Izingane ezizwa ukulahlekelwa ezingaphathwa kahle kusengcupheni enkulu yokuphuza ukuthuthukiswa. Ngokwenza ukuzwa kwezingane zakho ezishayiwe zivivinywa, hhayi nje kuphela ongabasiza ukuba bagcine inqubekela phambili yabo yentuthuko, kodwa futhi balondoloze cishe amaRandi angu-400 000 ekwelapheni kamuva ekuphileni. Izindleko zokuhlola zilinganiselwe, kanti ezinye izivivinyo ezingenziwa nge-$ 8.

Ukulahleka kokuzwa okungekho kungathinta kabi izinto ezilandelayo zokuphila kwakho:

impilo yempilo
impilo engokomzwelo
impilo yengqondo
amakhono omphakathi
ubudlelwane nabangane, abalingani bomndeni nabasebenzi
ukuphumelela kwezemfundo kanye nomsebenzi

Ingabe Ngidinga Ukuzwa Ukuzwa?

Ezinganeni, ukuhlolwa okujwayelekile kokuzwa kokulahlekelwa kokuzwa kufanele kubuyekezwe udokotela wezingane. Ngokusho kwe- Bright Futures yi-American Academy of Pediatrics, kufanele ukuthi izingane zakho ezisanda kuzalwa zizwe zivivinywe ngemva kokuzalwa ngokuhlolwa kwe- otoacoustic emissions (OAE) , futhi uma kudingeka, ziqinisekiswe ngempumelelo yokuhlolwa kwe- brainstem ye-brainstration (BAER) ngaphakathi kwe-3 kuze kube yizinsuku ezingu-5 kuze kungakapheli izinyanga ezimbili.

Ngemuva kokuhlolwa kwengane yakho yokuzwa kwezingane, izici eziyingozi kufanele zihlolwe ngokuvakashelwa kokugcinwa kwezempilo njalo. Izingozi zengane yakho zihlanganisa:

ukukhathazeka komzali ngokulahlekelwa kokulalela
umlando womndeni wokulahlekelwa ukuzwa
i-unit unit yokunakekelwa enkulu ihlala ezinsukwini ezingaphezu kwezinsuku ezinhlanu njengengane
imithi ye-ototoxic iveza (eyaziwa ukuthi ingase ibangele ukulahlekelwa kwezindlebe)

izimo ezithile zezempilo ngeengozi eyaziwayo yokulahlekelwa ukuzwa
i-eustachian tube ukungasebenzi
i-otitis media ne-effusion

Uma ingane yakho inezici eziyingozi, izivivinyo zokulalela zizoqhutshwa njalo ukuze zithole ukulahleka kokuzwa ngokushesha ngangokunokwenzeka. Ngaphandle kwezinto eziyingozi ezingenhla, ingane yakho kufanele ibe nokuzwa kwayo ihlolwe nge-audiometry eminyakeni elandelayo:

once at 4, 5, 6, 8 and 10 years old
kanye phakathi kweminyaka yobudala engu-11 kuya ku-14
once phakathi kweminyaka engu-15 kuya ku-17
once phakathi kweminyaka engu-18 kuya ku-21

Uma ungabonakali izimpawu zokulahlekelwa kokuzwa ube ngumuntu omdala, usadinga ukuqapha, futhi udokotela wakho usazofuna izibonakaliso zokulahlekelwa kokuzwa ngesikhathi sokuhlolwa kwakho ngokomzimba ngokuthatha umlando wezempilo ophelele nangokuhlola izindlebe zakho. Zombili izingane ezindala nabaningi bangacabangela amaphuzu alandelayo ukuze basize ukuthi ukulahlekelwa kwezwi kufanele kukhulunywe nodokotela wakho:

Abanye abantu bakusho ukuthi ulalele i-TV kakhulu.
Unenkinga yokulandela izingxoxo nabantu abangaphezu koyedwa okhuluma ngesikhathi esifanayo.
Unenkinga yokuzwa ngomsindo omkhulu wangemuva.
Ucela abanye ukuba baphinde baphinde njalo.
Unenkinga yokuzwa abesifazane nabantwana kodwa hhayi amadoda.
Abanye abantu kubonakala sengathi bayakhungeza sonke isikhathi.

Ngokuvamile uzithola ungaqondi kahle abanye abantu abakushoyo.

Uma unomuzwa wokuthi noma iyiphi yalezi zitatimende kuyiqiniso, kufanele ucele udokotela wakho ukuba akusize ekulahlekeni kokuzwa. Udokotela oyinhloko yokwelapha angenza ukuhlola okuyisisekelo kokuzwa. Ukuhlolwa okuqhubekayo kwezinkinga zokuzwa kungathunyelwa kumuntu we-audiologist noma ochwepheshe be-ENT . Okulandelayo luhlu lwezivivinyo ezijwayelekile ongazenza ukuze uhlole izinga lakho lokulahlekelwa kokuzwa.

Ukuzwa Izivivinyo: Ukuhlolwa Kwezwi Okuhlekisayo

Isilinganiso sokuhlola ngokuphumelelayo ekunqumeni ukulahlekelwa kokulalelwa komunye oyedwa noma zombili izindlebe. Lokhu kuhlolwa kungenziwa kalula nganoma yimuphi udokotela ovamile futhi indlela enhle yokunquma ukuthi kufanele yini uhanjiswe ukuze uhlolwe ngokuqhubekayo.

Uma udokotela wakho enza lesi sivivinyo, bazokuma ngemuva kwakho ebangeni elingalo. Bazokwenza umlomo owodwa ngesikhashana bese uqala ukuxubha i-tragus yendlebe yakho (okuyi-flap yangaphandle ehamba phambili ngokuvula indlebe yakho) ukuze uvikele ukuzwa ohlangothini olulodwa. Udokotela wakho uzobe esehlabelela uchungechunge lwezinhlamvu nezinombolo bese uphinda uzibuyisele emuva ngaphambi kokuhlola enye indlebe.

Ukuzwa izivivinyo: Ukuhlolwa kwe-Weber no-Rinne

Ukuhlolwa okulula okuhlolwayo ukuthi udokotela wakho angenza ehhovisi yi-Weber and Rinne Test. Lena indlela enkulu yokuhlola ukusiza ukuthola ukuthi ukuhlolwa okwengeziwe kuyadingeka yini. Imishini kuphela edingekayo kule ndlela yokuhlola iyinfork yokulungisa. Akufanele kube khona ubuhlungu obuhambisana nalesi sivivinyo, noma ngabe uzozizwa ukudumaza endlebeni yakho ngesikhathi sokuhlolwa.

Ukuhlola kwe-Weber kwenziwa ngokushaya umshini wokugqoba onento eqinile ukuze uqale ukuthuthumela. Ukuphela komfoloko wokugcoba kuzobekwa endaweni ebhuloho ebunzini, ekhaleni noma emazinyo. Uma uzwa ngokujwayelekile, umsindo uzoba ngokuzwakalayo kokubili ezindlebeni zombili. Uma kuphakama ohlangothini olulodwa, udokotela wakho uzohlola ukuthi uluphi uhlobo lokulahlekelwa kokuzwa onalo:

Ukushaywa kwefometha umsindo kuzwakala kakhulu endlebeni yakho yokuzwa ukukhombisa ukulahleka kokuzwa kwezinzwa.
Ukumemeza umsindo wefologi ngokuzwakalayo ekulaleleni kwakho okuvelele kunakho konke kubonisa ukulahlekelwa ukuzwa kwe-conductive.

Uhlolo lwe-Rinne lwenziwa ngokushaya imfoloko yokugqoka entweni eqinile ukuze uqale ukudlidliza. Kodwa ngokungafani nokuhlolwa kwe-Weber, kunezingxenye ezimbili kulolu vivinyo. Udokotela wakho uzobe eseqedile umfoloko wokugcoba ohlelweni lwakho lwe-mastoid, okungemva kwengxenye ephansi yendlebe yakho ukuze uvivinye amathambo akho okuqhuba umsindo. Udokotela wakho uzobe esusa umfutho wokukhipha kude nomzimba wakho, kodwa eduze kwendlebe yakho, ukuze avivinye ukuqhuba umoya wakho. Impendulo ejwayelekile kuloluhlolo ukuthi kufanele uzwe umsindo (ukuqhutshwa emoyeni) okungaphezu kokuzwa umsindo (bone conduction). Ukusabela okungavamile kungase kubonise ukulahlekelwa kokuzwa okuqhutshwayo.

Ukuzwa Izivivinyo: iTympanometry

I-Tympanometry iyithuluzi elikhulu lokuhlola lapho lisetshenziselwa i-otoscope ye-pneumatic ye-fluid endlebeni engase ibangele ukulahlekelwa ukuzwa kwe-conductive. Ukuhlolwa kuphumela ku-tympanogram ebonisa ifomu lokutshala ukuthi udokotela wakho angalisebenzisa ukuze anqume ukuthi kungenzeka yini uketshezi ngemuva kwegubhu lakho indlebe. Ifomu le-wave libonisa udokotela wakho ukuthi umsindo ozwakalayo ungadluliselwa kanjani ngenduku yakho yezindlebe noma kungakanani ukugwema. I-wave engenzile ihambisana ne-otitis media.

Ukuzwa Izilingo: Ukukhishwa kwe-Otoacoustic

Ukuhlolwa kwe-Otoacoustic Emissions (OAE) ukuhlolwa okwenzelwe izingane. Njengoba imiphumela ayidingi impendulo kumuntu, lokhu kuhlolwa kungasiza futhi ekubambezelekeni kwentuthuko noma ezinye iziphazamiso ezenza kube nzima ukulandela imiyalelo. I-OAE yenza izinyathelo zokuphendula kwe- cochlea ukuze zizwakale futhi zingasiza ekuhloleni ukukhubazeka kwama-cochlear noma ukulahlekelwa kwezwi lokuziphatha.

Ukuzwa Izivivinyo: I-Audiometry Ehlanzekile Yomsindo (i-Audiogram)

I-audiogram iyindlela ejwayelekile yokuhlola. Ukuze wenze lesi sivivinyo, i-audiologist izobe uhlale endaweni yokuthula. Kunezingxenye ezimbili zalesi sivivinyo ukuze uvivinye kokubili ukuqhutshwa kwomoya kanye nokukhubazeka kwamathambo. Ama-headphones asetshenziselwa ukuhlola umoya oqhutshwayo, kuyilapho i-oscillator yethambo (idivayisi encane efana neforki yokugada) izobekwa ngemuva kwendlebe yakho phezu kwe-mastoid yakho ukuhlola okwenziwa kwe-bone. Idivayisi ngayinye izosebenzisa ama-frequencies ahlukene ukuze kunqunywe umkhawulo ophansi kakhulu (kuma-decibel) lapho ungazwa khona umsindo wamaphesenti angu-50 wesikhathi.

Ngemuva kwalokhu kuhlolwa kwenziwa, udokotela wakho uzosebenzisa izilinganiso ezitholakale esihlolweni ukuze anqume ukuthi uluphi uhlobo lokulahleka kokuzwa ozwayo. Uma ubuka i-audiogram yakho, uzobona igrafu ebonisa umugqa we-X no-O. I-X imelela imiphumela yakho yezindlebe ezisekhohlo, kanti i-O imele ukuzwa kwakho kusuka endlebeni yakho yangakwesokudla. I-axis ecacile yesigrafu imelela izinga eliphansi kunazo zonke (ku-decibels) ukuze uzwe umsindo. Ukufinyelela okulinganiselwe kubonisa i-pitch evivinywa. Lokhu kuzokuvumela udokotela wakho ukuba aqonde ukuthi imiphi imvamisa ozwa ukulahlekelwa nokuzwa ukuthi ukulahleka kwakho ukuzwa kube nzima kangakanani.

Ukuzwa Izivivinyo: Inkulumo ye-Audiometry

Ukukhuluma nge-audiometry kuyisivivinyo esikhulu ukuqinisekisa i-audiogram, futhi ubone ukuthi ngabe usizo lwezindlebe luyoba usizo noma cha. Kuyasiza futhi ekuboneni ukuthi umonakalo wokulalelwa kwenzeke kuphi. Esigabeni sokuqala sovivinyo, uhlolwe ngezinga eliphansi kunawo wonke lapho uphinda ubuyekeze uchungechunge lwamagama amabili e-syllable ngamaphesenti angu-50 ngokunemba. Umphumela, noma umngcele wokwamukelwa kwenkulumo (SRT) , kufanele ube ngokusondelene nemiphumela ye-audiometry ehlanzekile.

Ingxenye yesibili yokuhlolwa kwe-audiometry yokukhuluma yigama lokuhlukaniswa kwegama. Lokhu kuhlolwa kusebenzisa uhlu lwamagama angama-50 alinganiselwe lapho uzocelwa ukuba uphinde igama ngalinye. Uhlu lufundwa ezingeni lama-decibel angu-40 aphakeme kunombundu owenziwe engxenyeni yokuqala yokuhlolwa kwakho. Leli yingxenye yokuhlolwa engasiza udokotela wakho ukuba anqume ukuthi usizo lokuzwa luyoba usizo kuwe noma cha.

Lokhu kuhlolwa kungabaluleke kakhulu njengoba abantu abangama-80 abangama-100 abazwa ukulahlekelwa kwezindlebe bengagqoki usizo lokuzwa, kodwa bangazuza kulowo oyedwa. Njengoba kushiwo ngenhla, lokhu kungakuthinta wena ngokwezemfundo, emphakathini nasezingeni eliphezulu.

> Imithombo:

> I-American Academy of Pediatrics. (2017). Izincomo Zokunakekelwa Kwezempilo Kwezokuvikela. Kufinyelelwe ngo-Ephreli 25, 2017 kusuka ku-https: //www.aap.org/en-us/Documents/periodicity_schedule.pdf

> Haddad, J & Keesecker, S. (2016). UNelson Bookbook of Pediatrics. 20 ^th . Elsevier. 3071-3080.e1

> Ukuzwa Ukulahlekelwa Umhlangano weMelika. (nd). Ukuzwa Ukulahlekelwa Amaqiniso & Izibalo. http://www.hearingloss.org/sites/default/files/docs/HearingLoss_Facts_Statistics.pdf

> Kelly, uNR. (2017). Ukuhlola ukuhlolwa kwezingane nasebancane. Kufinyelelwe ngo-Ephreli 25, 2017 kusuka ku-http: //www.uptodate.com (Okubhaliselwe Kudingeka)

> Weber, PC. (2017). Ukuhlolwa kokulahlekelwa kokulalela kubantu abadala: Ukuhlolwa. Kufinyelelwe ngo-Ephreli 25, 2017 kusuka ku-http: //www.uptodate.com (Okubhaliselwe Kudingeka)