amakuru

Nyuma yo kwinjira, abantu bumva buhoro buhoro. Kuri buri myaka 10 yimyaka, ikibazo cyo kutumva cyikubye kabiri, kandi bibiri bya gatatu byabantu bakuru bafite imyaka 60 bafite uburwayi bwo kutumva neza. Hariho isano hagati yo kutumva no kutumva neza, kugabanuka kwubwenge, guta umutwe, kongera amafaranga yo kwivuza, nizindi ngaruka mbi zubuzima.

Umuntu wese azagenda agira buhoro buhoro kubura imyaka yo kumva. Ubushobozi bwo kwumva bwabantu buterwa no kumenya niba ugutwi kwimbere (cochlea) gushobora guhuza neza amajwi mubimenyetso byubwonko (bigakorwa hanyuma bigasobanurwa mubisobanuro byubwonko bwubwonko). Impinduka zose z’indwara mu nzira kuva mu gutwi kugera mu bwonko zishobora kugira ingaruka mbi ku kumva, ariko gutakaza imyaka bijyanye no kutumva bifitanye isano na cochlea nimpamvu ikunze kugaragara.

Ikiranga imyaka ijyanye no kutumva ni ugutakaza buhoro buhoro utugingo ngengabuzima twumva imisatsi ishinzwe kwinjiza amajwi mu bimenyetso by'imitsi. Bitandukanye nizindi selile zo mumubiri, imisatsi yumva mumatwi yimbere ntishobora kubyara. Ingaruka ziterwa na etiologiya zitandukanye, utugingo ngengabuzima tuzatakara buhoro buhoro mubuzima bwumuntu. Ibintu byingenzi bishobora gutera ingaruka ziterwa no kutumva kwimyaka harimo gusaza, ibara ryuruhu rworoshye (nicyo kimenyetso cyerekana pigmentation ya cochlear kuko melanin igira ingaruka zo gukingira cochlea), ubugabo, hamwe n urusaku. Ibindi bishobora guteza ibyago harimo indwara ziterwa n'umutima-damura, nka diyabete, itabi na hypertension, bishobora gukomeretsa mikorobe-mitsi y'amaraso ya cochlear.

Kumva kwabantu bigenda bigabanuka buhoro buhoro uko bakuze, cyane cyane mugihe cyo kumva amajwi menshi. Umubare w'amatwi akomeye yo kutumva wiyongera uko imyaka igenda ishira, kandi kuri buri myaka 10 y'amavuko, ikibazo cyo kutumva cyikubye kabiri. Kubwibyo, bibiri bya gatatu byabantu bakuru bafite imyaka 60 bafite uburwayi bwo kutumva neza.

Icyorezo cya Epidemiologiya cyerekanye isano iri hagati yo kutumva no guhagarika itumanaho, kugabanuka kwubwenge, guta umutwe, kongera amafaranga yo kwivuza, nizindi ngaruka mbi zubuzima. Mu myaka icumi ishize, ubushakashatsi bwibanze cyane cyane ku ngaruka zo kutumva kwumva no kugabanuka kwubwenge no guta umutwe, hashingiwe kuri ibi bimenyetso, Komisiyo ya Lancet kuri Dementia yashoje mu 2020 ivuga ko kutumva mu myaka yo hagati no mu zabukuru ari byo bintu byinshi bishobora guhindura ingaruka ziterwa no guta umutwe, bingana na 8% by’indwara zose zo guta umutwe. Bikekwa ko uburyo nyamukuru uburyo bwo kutumva bwongera kugabanuka kwubwenge kandi ibyago byo guta umutwe ningaruka mbi zo kutumva no kutumva neza bidahagije kumitwaro yubwenge, ubwonko bwubwonko, no kwigunga.

Imyaka ijyanye no kunanirwa kwumva izagenda igaragara buhoro buhoro mumatwi yombi mugihe, nta bintu bitera ibintu bigaragara. Bizagira ingaruka kumvikana no kumvikanisha amajwi, kimwe nubunararibonye bwitumanaho rya buri munsi ryabantu. Abafite ikibazo cyo kutumva neza akenshi ntibatahura ko kumva kwabo kugabanuka ahubwo bakizera ko ibibazo byabo byo kutumva biterwa nimpamvu zituruka hanze nkimvugo idasobanutse n urusaku rwimbere. Abantu bafite ikibazo cyo kutumva cyane bazabona buhoro buhoro ibibazo byumvikana no kuvuga ahantu hatuje, mugihe kuvuga ahantu huzuye urusaku bazumva bananiwe kuko hakenewe imbaraga nyinshi zubwenge kugirango batunganyirize ibimenyetso byerekana imvugo. Mubisanzwe, abagize umuryango bumva neza ibibazo byumurwayi.

Iyo usuzumye ibibazo byo kumva k'umurwayi, ni ngombwa kumva ko imyumvire yumuntu yumva biterwa nibintu bine: ubwiza bwijwi ryinjira (nko guhuza ibimenyetso byamagambo mubyumba bifite urusaku rwinyuma cyangwa urusaku), uburyo bwa mehaniki yo kohereza amajwi binyuze mumatwi yo hagati kuri cochlea (ni ukuvuga kumva kwiyobora), cochlea ihindura ibimenyetso byijwi ryubwonko bwubwonko bwubwonko bwubwonko bwubwonko bwubwonko bwubwonko bwubwonko bwubwonko. ibimenyetso mubisobanuro (ni ukuvuga gutunganya amajwi yo hagati). Iyo umurwayi avumbuye ibibazo byo kumva, igitera gishobora kuba kimwe mubice bine byavuzwe haruguru, kandi mubihe byinshi, igice kirenze kimwe kimaze kugira ingaruka mbere yuko ikibazo cyo kumva kigaragara.

Intego yo gusuzuma ibanzirizasuzuma ni ugusuzuma niba umurwayi afite uburyo bworoshye bwo kuvura kunanirwa kwumva cyangwa ubundi buryo bwo kutumva bushobora gusaba ko hasuzumwa neza na otolaryngologue. Kunanirwa kwumva bishobora kuvurwa nabaganga bimiryango harimo itangazamakuru rya otitis na cerumen embolism, rishobora kugenwa hashingiwe ku mateka y’ubuvuzi (nko gutangira gukabije guherekejwe no kubabara ugutwi, no kuzura ugutwi guherekejwe no kwandura mu myanya y'ubuhumekero) cyangwa kwisuzumisha kwa otoscopi (nka embolisme yuzuye ya cerumen mu muyoboro w'ugutwi). Ibimenyetso biherekeje hamwe nibimenyetso byo kutumva bisaba ko hasuzumwa cyangwa kugirwa inama na otolaryngologue harimo gusohora ugutwi, otoskopi idasanzwe, guhora tinnitus, guhindagurika, guhindagurika kwumva cyangwa asimmetrie, cyangwa gutakaza gitunguranye nta mpamvu zibitera (nko gutwi hagati yo gutwi).

Gutungurwa kwumva gutunguranye ni kimwe mubitakaza kumva bisaba gusuzumwa byihutirwa na otolaryngologue (byaba byiza mugihe cyiminsi 3 itangiye), kuko kwisuzumisha hakiri kare no gukoresha glucocorticoid intervention bishobora kongera amahirwe yo gukira kwumva. Gutungurwa kwumva gutunguranye ni gake cyane, hamwe numwaka wanduye 1/10000, cyane cyane kubantu bakuze bafite imyaka 40 cyangwa irenga. Ugereranije no kutumva kimwe gusa guterwa nimpamvu ziyobora, abarwayi bafite ikibazo cyo kutumva kwumva gutunguranye bakunze kuvuga ko kutumva gukabije, kutagira ububabare mu gutwi kumwe, bikaviramo kutabasha kumva cyangwa kumva abandi bavuga.

Hano hari uburyo bwinshi bwo kuryama bwo gusuzuma kugirango utumva, harimo ibizamini byo kwongorerana no gupima urutoki. Nyamara, ibyiyumvo byihariye hamwe nuburyo bwihariye bwubu buryo bwo kwipimisha buratandukanye cyane, kandi imikorere yabyo irashobora kugarukira hashingiwe ku kuba abantu batumva neza imyaka. Ni ngombwa cyane cyane kumenya ko uko kumva bigenda bigabanuka buhoro buhoro mubuzima bwumuntu (Igicapo 1), hatitawe kubisubizo byapimwe, hashobora kwemezwa ko umurwayi afite urugero runaka rwo gutakaza kumva bitewe nimyaka yabo, ibimenyetso byerekana kubura kumva, kandi ntayindi mpamvu zubuvuzi.

Emeza kandi usuzume igihombo cyo kumva hanyuma wohereze amajwi. Mugihe cyo gusuzuma iburanisha, umuganga akoresha Calibrated audiometero mucyumba kitagira amajwi kugirango asuzume uko umurwayi yumva. Suzuma ubukana bw'ijwi ntarengwa (ni ukuvuga inzitizi yo kumva) umurwayi ashobora kumenya neza muri décibel iri hagati ya 125-8000 Hz. Urwego rwo hasi rwo kumva rwerekana kumva neza. Mu bana no mu rubyiruko rukuze, urwego rwo kwumva kuri radiyo zose ruba hafi ya 0 dB, ariko uko imyaka igenda yiyongera, kumva bigenda bigabanuka buhoro buhoro kandi amajwi akumva yiyongera buhoro buhoro, cyane cyane ku majwi menshi. Ishami ry'Umuryango w'Abibumbye ryita ku Buzima rishyira mu byiciro kumva ukurikije igipimo mpuzandengo cy’imyumvire y’umuntu ku majwi akomeye y’ijwi (500, 1000, 2000, na 4000 Hz), azwi ku izina rya kane ryumvikana neza [PTA4]. Abaganga b’amavuriro cyangwa abarwayi barashobora kumva ingaruka zurwego rwo kumva abarwayi kumikorere ningamba zikwiye zo kuyobora zishingiye kuri PTA4. Ibindi bizamini byakozwe mugihe cyibizamini byo kumva, nk'ibizamini byo kumva amagufwa no kumva ururimi, birashobora kandi gufasha kumenya niba igitera guta kumva bishobora kuba ari ugutumva neza cyangwa kutumva kwumva, kandi bigatanga ubuyobozi kuri gahunda ikwiye yo gusubiza mu buzima busanzwe kumva.

Intandaro nyamukuru yubuvuzi mugukemura ikibazo cyo kutumva kwijyanye nimyaka ni ukunoza uburyo bwo kuvuga no kumajwi yandi aho bumva (nk'umuziki n'amajwi) kugira ngo biteze imbere itumanaho ryiza, kwitabira ibikorwa bya buri munsi, n'umutekano. Kugeza ubu, nta buryo bwo gusubiza ibintu mu buryo bwo kubura imyaka. Imicungire y’iyi ndwara yibanda cyane cyane ku kurinda kumva, gufata ingamba zo gutumanaho kugira ngo hongerwe ireme ry’ibimenyetso byinjira byinjira (birenze urusaku rw’urusaku rw’imbere), no gukoresha ibyuma byumva no gutera cochlear hamwe n’ikoranabuhanga ryo kumva. Ikigereranyo cyo gukoresha ibikoresho byumva cyangwa cochlear yatewe mubagenerwabikorwa (bigenwa no kumva) biracyari hasi cyane.
Icyibandwaho mu ngamba zo kurinda kumva ni ukugabanya urusaku mu kwirinda amajwi cyangwa kugabanya amajwi y’isoko, kimwe no gukoresha ibikoresho birinda kumva (nka gutwi) nibiba ngombwa. Ingamba z'itumanaho zirimo gushishikariza abantu kugirana ibiganiro imbonankubone, kubagumana uburebure bw'amaboko mu biganiro, no kugabanya urusaku rw'imbere. Iyo ushyikirana imbona nkubone, uwumva ashobora kwakira ibimenyetso byumvikana neza kimwe no kureba mu maso h'umuvugizi no mu minwa, bifasha sisitemu yo hagati yo gutandukanya ibimenyetso byo kuvuga.
Imfashanyigisho zumva zikomeje kuba uburyo nyamukuru bwo gutabara kuvura imyaka yo kutumva. Imfashanyigisho zumva zirashobora kongera amajwi, kandi ibyuma byunvikana byunvikana birashobora kandi kunoza igipimo cyerekana-urusaku rwijwi ryifuzwa ukoresheje mikoro yerekana icyerekezo no gutunganya ibimenyetso bya digitale, ibyo bikaba ari ngombwa mugutezimbere itumanaho ahantu huzuye urusaku.
Imfashanyigisho zidafite imiti zikwiranye n’abantu bakuru bafite ikibazo cyo kutumva neza kandi giciriritse, Agaciro PTA4 muri rusange kari munsi ya 60 dB, kandi aba baturage bangana na 90% kugeza 95% by’abarwayi bose bafite ikibazo cyo kutumva. Ugereranije nibi, ibyuma byumva byanditse bifite amajwi menshi kandi birakwiriye kubantu bakuze bafite ikibazo cyo kutumva cyane, ariko birashobora kuboneka kubashinzwe kumva. Isoko rimaze gukura, ikiguzi cyibikoresho bifasha kumva byateganijwe kugereranywa nu matwi yo mu rwego rwo hejuru adafite insinga. Mugihe imikorere yimfashanyo yo kwumva ihinduka ikintu gisanzwe cyamatwi adafite insinga, ibyuma bifata amajwi birenze bishobora gutandukana nta gutwi gutwi.
Niba gutakaza kumva bikabije (agaciro ka PTA4 muri rusange ≥ 60 dB) kandi biracyagoye kumva abandi nyuma yo gukoresha ibyuma byumva, kubaga cochlear implant birashobora kwemerwa. Guterwa kwa Cochlear ni ibikoresho bya prostateque biologiya bifata amajwi kandi bikangura imitsi ya cochlear. Yatewe na otolaryngologue mugihe cyo kubaga hanze, bifata amasaha agera kuri 2. Nyuma yo guterwa, abarwayi bakeneye amezi 6-12 kugirango bamenyere kumva bagezweho binyuze mu gutera cochlear no kubona ko amashanyarazi aturuka ku mashanyarazi nk'ururimi n'amajwi bifite ireme.