Cochlear implantation: nws yog dab tsi, leej twg yuav pab tau

Nyob rau hauv lub Lavxias teb sab Federation, raws li statistics, nyob txog 12 lab cov neeg uas sib txawv lub rooj sib hais puas. Hard ntawm lub rooj sib hais thiab cov neeg uas no: tsis hnov kev ib tug xov tooj ntawm cov teeb meem nyob rau hauv lub qub neej txhua hnub. Qhov no txwv lawv muaj peev xwm thiab kev koom tes nyob rau hauv pej xeem lub neej. Tshwj xeeb yog tej yam tsis zoo nyob rau hauv cov cwm pwm manifests nws tus kheej nyob rau hauv cov neeg uas yug los nrog rau tej lub rooj sib hais, thiab tom qab ntawd vim muaj ib co yam yog kiag li lag ntseg, los yog lub rooj sib hais poob sharply.

hnov no yog tsim rau cov lag ntseg tib neeg. Feem ntau cov neeg mob siv rau lawv, tab sis tej zaum lawv siv muab heev me ntsis cov nyhuv. Nyob rau hauv cov ntaub ntawv ntawm sensorineural tsis hnov cov neeg mob tej zaum yuav pab tau cochlear implant. Yuav kom to taub li cas nws ua hauj lwm, ua ntej saib yuav ua li cas lub pob ntseg ua hauj lwm thiab yog vim li cas peb hnov, raws li zoo raws li me ntsis hom tsis hnov lus.

Vim li cas peb hnov?

Suab yog ua los ntawm cov txheej thiab nruab nrab pob ntseg. Suab yoj co ua rau yus lub nruas ntsej. Ntxiv mus, nws hau no co mus rau ib tug saw ntawm hnov ossicles - ib tug rauj, thaiv thiab txoj hlua eeb nees.

Los ntawm cov stapes, uas yog nyob rau ntawm qhov kawg ntawm lub saw ntawm nruab nrab pob ntseg ossicles, deeg dhau mus rau hauv cov kab noj hniav ntawm cov inner pob ntseg. Nws muaj tus duab ntawm ib tug qwj thiab sau nrog kua. Nyob rau hauv no kab noj hniav muaj piav thoob hlo plaub hau hlwb uas hloov txhua yam deeg mus rau hauv paj impulses. Cov pulses yog xa mus rau lub hlwb los ntawm cov hnov paj, muaj cov tsim thiab xaav ntawm lub suab duab, peb hnov.

Yog vim li cas yog tsis hnov lus?

Hnov cov teeb meem tshwm sim, yog tias ua ib co taw tes nyob rau hauv lub tsim ntawm lub suab teeb tshwm sim. Yog li ntawd, yog hais tias irreversibly puas piav thoob hlo plaub hau hlwb ntawm lub inner pob ntseg raws li ib tug tshwm sim ntawm tej kev raug mob los yog muaj mob uas tsim tag nrho cov lag ntseg. Nws yuav ua tau postlingvalnoy yog hais tias tus me nyuam twb kawm tau hais tias lub sij hawm ntawm cov lag ntseg los yog prelingvalnoy - yog hais tias tus hais lus nws twb tsis tau mastered.

Hom ntawm lub rooj sib hais tsis

Tshwj xeeb tshaj yog tsis hnov lus muaj lawv tus kheej kev faib tawm, uas yog txiav txim nyob ntawm cov neeg, qhov chaw, thiab qhov pib ntawm lag ntseg.

Raws li cov neeg kawm ntawv ntawm lub rooj sib hais tsis raug muab faib mus rau hauv tag nrho cov lag ntseg thiab tsis hnov lus, yog hais tias muaj yog cov xaav ntawm lub suab, tab sis nws yog ib qhov nyuaj. Tsis hnov lus yog:

• sensorineural;
• conductive;
• mixed.

Sensorineural yog vim lub rooj sib hais cov teeb meem uas ua los ntawm kev ua txhaum nyob rau hauv lub puab pob ntseg los yog hnov paj conduction. Lub degree ntawm kev tsis taus mas nws txawv ntawm me me mus ua kom tiav lag ntseg.

Conductive tsis hnov tshwm sim vim cov teeb meem ces yuav tsum nyob rau hauv lwm los nruab nrab pob ntseg, vim uas conductivity suab deeg thiab tawg los distorted tau txais tsis nrhiav tau tus inner pob ntseg. Qhov no tej zaum yuav puas ntsoog nruas ntsej, sulfuric hau, thiab lwm yam

Nyob rau lub hnub nyoog ntawm pib ntawm cov teeb meem no yuav ua tau:

• yug;
• prelingvalnye;
• postlingvalnye.

Localization lag ntseg tej zaum yuav muab faib nyob rau hauv ib lub pob ntseg los yog ob qho tib si, ces, nws yog hu ua binaural tsis hnov lus.

Indications rau cochlear implantation

Cochlear implantation yog qhia nyob rau hauv cov nram no mob:

1. Nrog tob mog sensorineural lag ntseg.
2. Thaum uas tsis muaj xaav pib nyob rau hauv cov ntaub ntawv ntawm cov suab pab kiag li lawm nrog binaural lub rooj sib hais kev pab.
3. Nyob rau hauv lub qhaj ntawv ntawm kev hais lus xaav nyob rau hauv cov ntaub ntawv ntawm optimally xaiv lub rooj sib hais pab rau peb lub hlis, nrog ob sab sib dho no: sensorineural tsis hnov lus.
4. Nyob rau hauv lub qhaj ntawv ntawm kev txawj ntse teeb meem (mob ntawm kev puas hlwb kev ua si sib txawv ntawm cov ua cim).
5. Nyob rau hauv lub qhaj ntawv ntawm kev puas hlwb muaj teeb meem.
6. Nyob rau hauv lub qhaj ntawv ntawm ntau hom ntawm Somatic kab mob.

Contraindications thiab cov kev txwv

Qhov no hom ntawm cog yog tsis zoo nyob rau hauv cov ntaub ntawv ntawm lub rooj sib hais tsis uas tshwm sim raws li ib tug tshwm sim ntawm neuritis ntawm lub hnov paj los yog los ntshav nyob rau hauv lub sab nqaij daim tawv los yog qia lobe ntawm lub paj hlwb. Cochlear implantation nyob rau hauv cov neeg mob yuav tsis coj tus yam tau.

Nws ua rau tsis muaj kev nkag siab rau kev lub lag luam nyob rau hauv cov ntaub ntawv ntawm cochlear calcification (nag lossis daus ntawm calcium ntsev) los yog nws ossification (pob txha germination).

Cochlear implantation tsis ua kev zoo siab yog hais tias tus neeg mob nrog tsis hnov lus rau ib ntev lub sij hawm (xyoo) nyob rau hauv tsis silence. Nyob rau hauv cov ntaub ntawv no, lub lag luam tsis coj tus yam nyhuv vim lub fact tias heev tsis muaj stimulation ntawm cov hnov paj Atrophy twigs thiab tsis tau zoo tu qab tso.

Nyob rau hauv tas li ntawd, contraindications muaj xws li:

• O ntawm nruab nrab pob ntseg.
• Qhov kuaj pom ntawm ib tug perforation ntawm lub nruas ntsej.
• Kev nyab xeeb thiab ua hauj lwm zoo raws li txoj cai ntawm cov plaub hau hlwb, uas yog txiav txim los ntawm cov qauv ntawm cov otoacoustic emissions.
• Thaum prelingvalnoy lag ntseg - lub hnub nyoog ntawm cov me nyuam tshaj 6 xyoo.
• Thaum postlingvalnoy lag ntseg - Lag ntseg lub sij hawm ntev ntau hnov lus lub sij hawm.

Yuav ua li cas yog ib tug cochlear implant?

Lub system muaj ob qhov chaw uas yog interconnected los ntawm tej yam lub cev txoj kev tsis yog kev cob cog rua. Ib feem txuas nyob rau hauv lub txheej pob ntseg thiab muaj ib tug microphone thiab processor (nyob rau hauv niaj hnub qauv yog ua ke), raws li zoo raws li ib tug transmitter, uas yog txuas mus rau hauv daim tawv nqaij, ib yam li ib tus hlau nplaum. Ob txhais ib feem - lub puab thiab nruab nrab yog cov receiver. Nws yog tsau nyob rau hauv lub sab nqaij daim tawv pob txha. Ua tau, lub receiver yog teem thiab lub lag luam - implantation ntawm cochlear.

Yuav ua li cas yog qhov system ua hauj lwm?

Ib tug microphone mounted qab lub txheej pob ntseg, picks suab thiab xa lawv mus rau lub hais lus processor, nyob rau hauv tib lub qhov chaw. Lub processor tau txais lub suab yog encoded thiab hloov dua siab tshiab rau hauv hluav taws xob impulses. Lawv ntxiv los ntawm ib tug transmitter txuas rau ib daim tawv nqaij yog txhab khoom mus rau ib tug receiver nyob rau hauv lub sab nqaij daim tawv pob txha. Los ntawm muaj nyob rau lub electrode mus rau hauv lub cochlea lawv ua thiab ua raws li cov kauv ganglion ntawm lub hnov paj. Yog li tus neeg mob yog muaj peev xwm mus paub cov suab.

nqi ntawm

Tag nrho cov nqi ntawm ib tug cochlear implant, ib daim ntawv ntsuam xyuas los ntawm kev phais thiab postoperative kho txiav txim rau txhua tus neeg mob. Tus xov tooj uas yuav tsum tau kuaj nyob rau cov kev kho mob yav dhau los thiab tus neeg mob lub mob. Yog li ntawd, piv txwv li, rau cov neeg mob uas muaj keeb kwm uas tau muaj meningitis, tas muab magnetic resonance imaging, uas yuav txiav txim seb tus txheej xwm ntawm lub sab nqaij daim tawv pob txha. Lwm yam neeg mob xws xeem tej zaum yuav zam. Tsis tas li ntawd, tej zaum (tsis yog txhua txhua) yuav tsum tau sib tham geneticist los yog neurologist. Qhov no tag nrho cov muaj feem xyuam rau ntau npaum li cas nws yuav raug nqi cochlear kev cog hniav. Nws nqi yog kwv yees li ntawm cov kev txiav txim ntawm 1 lab 300 rubles. Tab sis rau cov pej xeem ntawm Lavxias teb sab Federation, lub lag luam no yuav ua tau rau dawb nyob rau hauv lub quota.

Tus nqi ntawm cov tsev kho mob thiab tsev kho mob nyob yog them nyias thiab nyob rau tus nqi ntawm lub tsev.

Tsim nyog kuaj thiab lag luam

1. Soj ntsuam ENT.
2. otonevrologa kev sib tham.
3. surdopedagogs kev sib tham.
4. Audiometry.
5. Impedancemetry.
6. Promontorialny xeem.
7. Otoacoustic emissions.
8. Hnov evoked potentials.
9. Xoo tomography nqaij daim tawv pob txha.
10. Standard kuaj ntsuam xyuas raws li rau kev phais (general tsom xam ntawm cov ntshav thiab zis kev ntsuam xyuas, cov ntshav qabzib, ntshav biochemical kev xeem).

Lub lag luam yuav siv sij hawm kwv yees li ntawm 1.5 lub sij hawm. Cov cog yog tsau nyob rau hauv lub cheeb tsam ntawm lub sab nqaij daim tawv pob txha qab lub pob ntseg, thiab tus electrodes yog nkag tau rau hauv lub cochlea. Ntxiv tuav ntaub qhwv thiab sutures raug muab tshem tawm nyob rau hauv 7-10 hnub.

Tig rau ntawm lub system yuav yuav 3-5 lub lis piam. Tus thawj hloov yuav tsum ua tsis ntxov tshaj ib lub hlis tom qab phais. Nws yog ib qho tseem ceeb heev rau nws maj mam muab, thiab tsis txhob ua rau tus neeg mob lub tsis zoo tus cwj pwm txawv ntawm rov qab los nws mus rau lub ntiaj teb no ntawm cov suab.

Qhov-theem cochlear kev cog hniav nyob rau hauv ob qho tib si pob ntseg ib zaug. Nyob rau hauv cov ntaub ntawv no, txhua sab muab ib tug nyias muaj nyias ib tug neeg sab nraud cochlear system. Daim ntawv ntsuam xyuas thiab kev ncaj ncees lub sij hawm yog tib yam li nyob rau hauv lub unilateral implantation.

kev ncaj ncees

Tom qab lub lag luam, "cochlear kev cog hniav" kev ncaj ncees yog ib qho tseem ceeb kauj ruam. Tom qab tus hais lus processor yog kev cob cog rua, nws yuav tsum tau kom teem thiab qhia tus neeg mob rau perceive suab thiab paub txog tej kev xav li hais tias nws yuav siv cov ntaub ntawv rau txoj kev loj hlob ntawm kev hais lus. Rehabilitation yuav siv sij hawm lub tseem ceeb tshaj plaws, tsis yooj yim thiab ntev ntev.

Undergo ib lub sij hawm ntawm kev ncaj ncees rau tus neeg mob yuav pab ib tug tag nrho pawg neeg ntawm cov kws txawj, uas muaj xws li otohirurgi, surdopedagogs, audiologists, psychologists. Cov chav kawm nyob rau hauv tshwj xeeb cov hom kev kawm thiab ntev-tuning kev sib kho, raws li tau zoo raws li kev sib tham ntawm tag nrho cov tub txawg. Nyob rau hauv lub neej yav tom ntej, lawv yuav tsum tau saib xyuas thoob plaws hauv lub neej ntawm tus neeg mob. Nyob rau hauv tas li ntawd, tus hais lus processor yuav tsis tseg yuav tsum tau reprogrammed.

Hnov. nqi

Rau cov neeg uas muaj ib tug tsis tshua muaj qib ntawm lub suab xaav tau tsim ntau pab kiag li lawm - hnov uas yuav pab tau kom hloov mus rau hauv kev sib raug ib puag ncig. BTE lub rooj sib hais pab yog, uas yog mounted qab lub pob ntseg, thiab nyob rau hauv-lub - lawv muab tso nyob rau hauv tus neeg mob lub pob ntseg kwg deg thiab yog ua rau txim. Tam sim no rau cov muag khoom yog thiab cov qauv.

Nyob rau hauv tas li ntawd, muaj ib tug CIC lub rooj sib hais pab. Lawv muaj nyob rau hauv lub pob ntseg kwg deg, heev me me luaj li cas thiab suab pom tsis tau lwm leej lwm tus. Tab sis xws li pab kiag li lawm yog contraindicated rau cov me nyuam nyob rau hauv 12 lub xyoos.

Tus nqi ntawm cov rooj sib hais pab nws txawv, tab sis nws yog tus me me. Qhov no enables ib tug loj tus naj npawb ntawm cov neeg mob siv kom hnov lus. Cov nqi heev pheej yig. Yog li ntawd, BTE qauv yuav tau muas los ntawm 4,5 mus rau 17 txhiab. Rubles. Nyob rau hauv-lub pab kiag li lawm yog kim kim.

Kev kho mob ntawm lub rooj sib hais tsis

Yog hais tias koj muaj ib tug tsis hnov lus, cov kev kho mob yog nyob ntawm seb yog vim li cas yog vim li cas nws tau summoned. Ntawm cov tau xaiv:

1. Kev tshem tawm ntawm cerumen - qhov no yog ua los ntawm txhais tau tias ntawm ntxuav, tej zaum siv ib tug tshwj xeeb lub cuab tam.
2. Kev siv cov hnov lus. Ntxiv BTE, ITE thiab glubokokanal'nykh, hnov tej zaum yuav siv tau, mounted nyob rau hauv ib tug eyeglass ncej los yog lub hnab tshos, raws li zoo raws li ib tug ceeb, thiab txawm nyob rau hauv daim ntawv ntawm cov tsej. Uas ib tug yuav nplua ib tug neeg mob, nrog ib tug ntsej.
3. Cochlear kev cog hniav - lawv hais nyob rau hauv no tsab xov xwm.

Kev tiv thaiv ntawm lub rooj sib hais tsis

Tsis hnov lus muaj peev xwm muab tau los ntawm ib tug kab mob, nws ua hauj lwm nyob rau hauv nrov kawm los yog ntev nyob rau hauv ib lub nrov qhov chaw. Hnov tej zaum yuav txo tau, thiab thaum muaj hnub nyoog hloov.

Yog hais tias lub chaw ua hauj lwm yog kev cob cog rua nrog ua pa nrov ntau lawm, nws yog pom zoo nyob rau hauv lub chaw ua hauj lwm siv headphones los yog lwm yam pab kiag li lawm los tiv thaiv tiv thaiv nrov nrov, xws li tshwj xeeb pob ntseg plugs.

Tu ncua yuav tsum tau soj ntsuam lub rooj sib hais tag nrho cov neeg uas txuam nrog heev nyob rau hauv ib lub nrov qhov chaw. Qhov no yuav pab txheeb xyuas tsis hnov lus thaum ntxov nyob rau hauv thiab lub sij hawm yuav txiav txim, li no tiv thaiv ntxiv tsis hnov lus thiab ntawm lub rooj sib hais poob los yog lag ntseg.

Tsis txhob nrov nrov heev nrov thaum lub sij hawm cov hnub caiv thiab tsis mloog heev nrov nrov suab paj nruag, los yog tsawg kawg ntawm lub sij hawm rau lub sij hawm mus rau noj so.