Nyob rau hauv Lavxias Federation, raws li kev txheeb cais, muaj kwv yees li 12 lab tus tib neeg uas muaj ntau yam tsis hnov lus. Tsis hnov lus thiab cov neeg uas tsis hnov lus tiav tau ntsib ntau yam teeb meem hauv lub neej niaj hnub. Qhov no txwv lawv txoj hauv kev thiab kev koom tes hauv pej xeem lub neej. Ib qho kev cuam tshuam tshwj xeeb ntawm tus cwj pwm yog tshwm sim hauv cov neeg uas yug los tsis hnov lus, thiab tom qab ntawd, vim qee qhov xwm txheej, ua lag ntseg tag, lossis lawv qhov hnov lus poob qis.
cov khoom pab hnov lus tau tsim los rau cov neeg tsis hnov lus. Cov neeg mob feem ntau siv lawv, tab sis qee zaum lawv cov kev siv ua rau muaj kev cuam tshuam me ntsis. Rau kev hnov lus tsis hnov lus, cochlear implants tuaj yeem pab tau. Yuav kom nkag siab tias nws ua haujlwm li cas, cia peb nkag siab ua ntej lub pob ntseg ua haujlwm li cas thiab vim li cas peb hnov, nrog rau luv luv tham txog hom kev hnov lus tsis hnov lus.
Vim li cas peb hnov?
Suab yog ua los ntawm pob ntseg sab nrauv thiab nruab nrab. Lub suab nthwv dej ua rau lub pob ntseg vibrate. Tom qab ntawd nws kis tau qhov kev vibration no mus rau cov saw hlau uas muaj lub suab ossicles - qhov no yog rauj, anvil thiab stirrup.
Los ntawm cov stirrup, uas nyob rau hauv qhov kawg ntawm cov saw ntawm cov pob txha ntawm nruab nrab pob ntseg, vibrations nkag mus rau hauv cov kab noj hniav ntawm lub pob ntseg. Nws yog zoo li ib tug qwj thiab puv nrog kua. Cov kab noj hniav no muaj cov plaub hau rhiab heev uas hloov cov tshuab kev co rau hauv cov hlab ntsha impulses. Cov impulses no nkag mus rau hauv lub hlwb los ntawm cov hlab ntsha auditory, qhov uas tsim thiab xaav ntawm lub suab duab uas peb hnov tshwm sim.
Vim li cas tsis hnov lus tshwm sim?
teeb meem hnov lus tshwm sim yog tias muaj kev cuam tshuam ntawm qee theem ntawm kev tsim suab. Yog li, yog hais tias cov plaub hau rhiab heev ntawm pob ntseg sab hauv yog irreversibly puas los ntawm ib yam ntawm cov kev raug mob los yog mob, ua tiav lag ntseg. Nws tuaj yeem yog postlingual, yog tus menyuam twb kawm hais lus los ntawm lub sijhawm lag ntseg txhim kho, lossis prelingual, yog nws tseem tsis tau paub hais lus.
Tom tsis hnov lus
Cov yam ntxwv ntawm kev hnov lus tsis hnov lus muaj lawv tus kheej kev faib tawm, uas yog txiav txim siab nyob ntawm qib, qhov chaw thiab lub sijhawm pib ntawm kev lag ntseg.
Raws li qib kev hnov lus tsis zoo, lawv tau muab faib ua lag ntseg thiab tsis hnov lus, yog tias qhov kev nkag siab ntawm lub suab tshwm sim, tab sis nws nyuaj. Tsis hnov lus tshwm sim:
- neurosensory;
- kev ua;
- mixed.
Sensorineural yog vim muaj teeb meem hnov lus uas tshwm sim los ntawm kev cuam tshuam ntawm pob ntseg sab hauv lossis kev ua ntawm cov hlab ntsha ntawm lub suab. Cov kev puas tsuaj no muaj txij li me me mus rau qhov lag ntseg.
Kev coj uaKev hnov tsis hnov lus tshwm sim vim muaj teeb meem tshwm sim nyob rau hauv lub pob ntseg sab nraud los yog nruab nrab, vim hais tias cov conductivity ntawm lub suab vibrations yog impaired thiab lawv distorted los yog tsis kis mus rau lub puab pob ntseg. Qhov no tuaj yeem yog pob ntseg puas, siv quav ciab, thiab lwm yam.
Raws li lub hnub nyoog pib, cov teeb meem no tuaj yeem yog:
- Nyob ib leeg;
- prelingual;
- postlingual.
Raws li qhov chaw nyob, lag ntseg tuaj yeem kis mus rau ib pob ntseg lossis ob qho tib si, ces qhov hnov lus zoo li no hu ua binaural.
Indications rau Cochlear Implantation
Cochlear implantation yog qhia hauv cov xwm txheej hauv qab no:
- Rau qhov sib sib zog nqus sensorineural ob tog lag ntseg.
- Ntawm qhov pib qis ntawm kev nkag siab nyob rau hauv rooj plaub ntawm kev siv cov khoom siv suab rau binaural hearing aids.
- Thaum tsis muaj kev nkag siab ntawm kev hais lus nyob rau hauv rooj plaub ntawm cov khoom siv kho qhov muag kom zoo rau peb lub hlis, nrog rau ob tog sib sib zog nqus hnov lus tsis hnov lus.
- Thaum tsis muaj teeb meem kev txawj ntse (kev puas siab puas ntsws ntawm ntau yam xwm txheej).
- Nyob tsis muaj teeb meem kev puas siab puas ntsws.
- Thaum tsis muaj ntau yam kab mob somatic.
Contraindications thiab txwv
Hom kev cog ntoo no tsis muaj txiaj ntsig yog tias hnov lus tsis zoo uas tau tshwm sim los ntawm qhov tshwm sim ntawm neuritis ntawm lub paj hlwb los yog hemorrhage nyob rau hauv lub cev los yog qia lobes ntawm lub hlwb. Cochlear implantation nyob rau hauv cov rooj plaub no yuav tsis coj cov kev xav tau.
Nws tsis muaj txiaj ntsig los ua haujlwm hauv rooj plaubcochlear calcification (calcium deposits) los yog cochlear ossification (pob txha loj hlob).
Cochlear implantation tsis muaj txiaj ntsig yog tias cov neeg mob hnov lus tsis hnov tsw tau nyob hauv qhov ntsiag to ntev (xyoo). Hauv qhov no, kev ua haujlwm yuav tsis coj cov txiaj ntsig xav tau vim yog qhov tsis muaj kev txhawb nqa ntev, cov ceg ntawm cov paj hlwb atrophy thiab tsis tuaj yeem rov qab los.
Ntxiv rau, contraindications yog:
- Cov txheej txheem mob ntawm pob ntseg nruab nrab.
- Kev pom ntawm perforated tympanic membrane.
- Kev nyab xeeb thiab kev ua haujlwm ntawm cov plaub hau, uas yog txiav txim los ntawm txoj kev ntawm otoacoustic emission.
- rau qhov lag ntseg ua ntej - tus me nyuam muaj hnub nyoog tshaj 6 xyoo.
- Nyob rau hauv kev lag ntseg tom qab, lub sijhawm lag ntseg uas kav ntev dua lub sijhawm hnov lus zoo.
cochlear implant yog dab tsi?
Lub kaw lus muaj ob ntu, uas tsis cuam tshuam los ntawm kev siv lub cev. Ib feem yog txuas tom qab lub pob ntseg sab nrauv thiab muaj lub microphone thiab lub processor (hauv cov qauv niaj hnub no lawv tau ua ke), nrog rau lub tshuab xa hluav taws xob uas txuas rau ntawm daim tawv nqaij zoo li cov hlau nplaum. Qhov thib ob yog sab hauv, thiab yog tus txais. Nws yog tsau nyob rau hauv lub cev nqaij daim tawv. Qhov tseeb, qhov haujlwm no muaj nyob rau hauv kev txhim kho lub receiver - cochlear implantation.
Lub kaw lus ua haujlwm li cas?
Ib lub microphone txuas rau pob ntseg sab nrauv khaws cov suab thiab xa mus rau cov neeg hais lus nyob rau ntawd. Cov suab tau txais yog encoded nyob rau hauv lub processorthiab hloov mus rau hauv hluav taws xob impulses. Tom qab ntawd lawv mus dhau ntawm lub tshuab xa hluav taws xob txuas rau ntawm daim tawv nqaij mus rau ib qho chaw txais nyob rau hauv cov pob txha ntawm lub cev. Los ntawm qhov ntawd, lawv nkag mus rau hauv cochlea los ntawm cov electrode thiab ua rau cov kauv ganglion ntawm lub paj hlwb. Ua li no, tus neeg mob tuaj yeem hnov suab.
Tus nqi
Tus nqi tag nrho ntawm kev cog cov cochlear, kuaj xyuas, phais thiab kho tom qab phais yog txiav txim siab tus kheej rau txhua tus neeg mob. Tus naj npawb ntawm kev kuaj mob yuav tsum tau nyob ntawm keeb kwm thiab kev mob ntawm tus neeg mob. Yog li, piv txwv li, rau cov neeg mob uas muaj keeb kwm ntawm meningitis, magnetic resonance imaging yog yuav tsum tau, uas yuav txiav txim seb tus mob ntawm lub cev nqaij daim tawv. Rau lwm tus neeg mob, xws li kev ntsuam xyuas yuav tsis ua. Tsis tas li ntawd, qee zaum (tsis yog tag nrho) kev sab laj ntawm tus kws kho caj ces lossis tus kws kho mob hlwb yog xav tau. Qhov no tag nrho cuam tshuam ntau npaum li cas tus cochlear cog yuav raug nqi. Nws tus nqi yog kwv yees li 1 lab 300 rubles. Tab sis rau cov pej xeem ntawm Lavxias teb sab Federation, xws li ib tug kev khiav hauj lwm yuav ua tau dawb xwb raws li quota.
Tus nqi pw hauv tsev kho mob thiab nyob hauv tsev kho mob yog them nyias thiab nyob ntawm tus nqi ntawm lub tsev kawm ntawv xaiv.
Kev kuaj mob thiab phais
- Kev kuaj tus kws kho mob ENT.
- Kev sab laj ntawm tus kws kho mob otoneurologist.
- Kev sib tham ntawm tus kws qhia lag ntseg.
- Audiometry.
- Impedancemetry.
- Promontory test.
- Otoacoustic emission.
- Auditory evoked muaj peev xwm.
- Computed tomography ntawm cov pob txha ntawm lub cev.
- Cov qauv kuaj sim, xws li kev cuam tshuam kev phais (kev kuaj ntshav thiab zis, ntshav qabzib, kuaj ntshav biochemical).
Kev ua haujlwm nws tus kheej yuav siv sijhawm li 1.5 teev. Kev cog hniav yog tsau rau hauv cov pob txha ntawm lub cev tom qab pob ntseg, thiab cov electrodes tau muab tso rau hauv cochlea. Tom qab ntawd, tsis pub dhau 7-10 hnub, hnav khaub ncaws thiab xaws xaws.
Koj tuaj yeem qhib qhov system tom qab 3-5 lub lis piam. Thawj qhov kev hloov pauv tuaj yeem ua tiav tsis pub dhau ib hlis tom qab kev ua haujlwm. Ntawm no nws yog ib qho tseem ceeb heev uas yuav tsum ua tib zoo thiab tsis txhob ua rau tus neeg mob tsis zoo thaum nws rov qab los rau lub ntiaj teb ntawm lub suab.
Simultaneous cochlear implantation yog ua tau ntawm ob lub pob ntseg ib zaug. Nyob rau hauv cov ntaub ntawv no, ib tug cais ywj siab cochlear system yog muab tso rau ntawm txhua sab. Kev tshuaj xyuas thiab lub sijhawm kho kom rov zoo yog tib yam li rau kev cog qoob loo ib leeg.
Rehab
Tom qab kev phais cochlear implantation, kev kho kom rov zoo yog qhov tseem ceeb. Thaum tus neeg hais lus txuas nrog, nws yuav tsum tau teeb tsa kom zoo thiab tus neeg mob yuav tsum raug cob qhia kom pom lub suab thiab paub txog cov kev xav no kom nws thiaj li siv tau cov ntaub ntawv tau txais los tsim kev hais lus. Rehabilitation yuav siv sij hawm qhov tseem ceeb tshaj plaws, nyuaj thiab ntev tshaj plaws.
Tag nrho cov kws tshaj lij, suav nrog otosurgeons, kws qhia lag ntseg, kws kho mob, kws kho hlwb, pab tus neeg mob mus txog lub sijhawm kho mob. Cov chav kawm muaj nyob rau ntawm cov txheej txheem tshwj xeeb thiab kev sib tham ntev, nrog rau kev sib tham ntawm txhua tus kws tshaj lij no. Yav tom ntej, lawvkev soj ntsuam yog tsim nyog thoob plaws hauv lub neej ntawm tus neeg mob. Tsis tas li ntawd, tus processor hais lus yuav tsum tau reprogrammed ib ntus.
khoom pab hnov lus. Nqe
Rau cov neeg uas muaj suab qis qis, ntau yam khoom siv tau tsim - cov khoom siv hnov lus uas tuaj yeem pab hloov pauv hauv ib puag ncig kev sib raug zoo. Cov khoom siv hnov ntxhiab yog qab pob ntseg, uas txuas tom qab lub auricle, thiab intra-pob ntseg - lawv nyob rau hauv tus neeg mob lub pob ntseg kwj dej thiab raug txiav txim. Cov qauv digital tseem tam sim no muag.
Tsis tas li ntawd, muaj cov cuab yeej siv pob ntseg sib sib zog nqus. Lawv nyob hauv lub kwj deg, me me thiab yuav luag pom tsis tau rau lwm tus. Tab sis cov khoom siv no yog contraindicated rau cov menyuam yaus hnub nyoog qis dua 12.
Tus nqi ntawm cov khoom siv hnov lus txawv tab sis kuj qis. Qhov no ua rau muaj coob tus neeg mob siv cov khoom siv hnov lus. Lawv cov nqi pheej yig heev. Yog li, cov qauv hauv qab pob ntseg tuaj yeem yuav los ntawm 4.5 txog 17 txhiab rubles. Cov khoom siv hauv pob ntseg tau kim dua me ntsis.
Kev kho tsis hnov lus
Yog tias hnov tsis hnov lus, kev kho mob yuav nyob ntawm qhov laj thawj. Cov kev xaiv muaj xws li:
- Kev tshem tawm cov phom phom - qhov no yog ua los ntawm kev ntxuav, qee zaum siv lub cuab yeej tshwj xeeb.
- Siv cov cuab yeej mloog. Ntxiv nrog rau lub pob ntseg hauv qab, pob ntseg hauv pob ntseg thiab qhov sib sib zog nqus-kwj dej, cov khoom siv hnov pob ntseg ua rau hauv lub thav duab ntawm lub tsom iav lossis hnab ris, nrog rau hauv daim ntawv ntawm lub taub hau thiabtxawm nyob rau hauv daim ntawv ntawm qhwv ntsej. Qhov twg yog qhov tsim nyog rau tus neeg mob tshwj xeeb, tus kws kho mob otolaryngologist yuav sab laj.
- Cochlear cog - tham hauv kab lus no.
Kev tiv thaiv tsis hnov lus
hnov tsis hnov lus tuaj yeem tshwm sim los ntawm kev mob, ua haujlwm hauv qhov chaw nrov nrov, lossis raug rau qhov chaw nrov nrov. Kev hnov lus kuj yuav txo qis vim muaj hnub nyoog hloov pauv.
Yog tias ua haujlwm nrov nrov, nws raug nquahu kom siv lub pob ntseg lossis lwm yam khoom siv los tiv thaiv lub suab nrov, xws li pob ntseg tshwj xeeb, ntawm qhov chaw ua haujlwm.
Tsis tu ncua xyuas lub rooj sib hais ntawm txhua tus neeg cuam tshuam nrog kev nyob ntev ntev hauv qhov chaw nrov. Qhov no yuav pab txheeb xyuas qhov tsis hnov lus thaum ntxov thiab ua haujlwm raws sijhawm, yog li tiv thaiv tsis hnov lus ntxiv thiab txhim kho tsis hnov lus lossis lag ntseg.
Koj yuav tsum tsis txhob muaj suab nrov heev thaum hnub so thiab tsis txhob mloog suab paj nruag nrov heev lossis tsawg kawg yog so ib ntus.
