He pōturi te tangi a tāu tamaiti ina kōrero ia? Tērā pea nā te ngoikore o te roro (VPI)!

Kua rongo koe i te ahua o te koretake o te reo o tāu tamaiti ina kōrero ia? He rerekē rānei ngā oro e puta ana i a ia ina kīia ētahi reta? Ahakoa he mea noa ēnei mea i te tamarikitanga, tera pea he take anō kei muri i tēnei. I roto i ēnei āhuatanga, me āwangawanga tātou mō tēnei āhuatanga e kiia nei ko te `(Velopharyngeal Insufficiency)`, e kiia nei hoki ko te `(VPI)`. Me kōrero tātou mō tēnei mea i roto i ngā taipitopito me ngā kōrero māmā i tēnei rā.

He aha te `(Velopharyngeal Insufficiency - VPI)`? Kia mārama tātou!

Ki te kī māmā noa, ko te tikanga o te `(VPI)` ko te kore e kati tika te pūaha i waenganui i te waha me te pūaha ihu. Whakaarohia, ina kōrero tātou, ina horomia rānei, ka kati tika tēnei pūaha, ā, ko te hau anake me puta mai i te waha (i roto i ngā oro maha). Engari i roto i te tangata whai `(VPI)`, kāore tēnei pūaha e kati tika, nō reira ko ētahi o te hau e tika ana kia puta mai i te waha ka puta mai anō hoki i te ihu. Koia te take e rite ana te reo ki te mea e puta mai ana i te ihu, ā, he uaua ki te whakapuaki i ētahi kupu.

Ko te ingoa hauora o tēnei pūaha ko te "velopharyngeal sphincter". Nā ō tātou:

• Te wāhanga o runga o te korokoro i muri i te ihu (Nasopharynx)
• Te wāhanga waenga o te korokoro i muri i te waha (`(Oropharynx)`)

Te wāhi e hono ai ngā wāhanga. He uaua tēnei `(sphincter)` he rite ki te mowhiti. He rite tana mahi ki te tatau. Ina kōrero tātou, ina horomi tātou, ka kati pūmau. I roto i te `(VPI)`, ko te mea ka tupu ko tēnei tatau, arā, te `(sphincter)`, kāore e kati tika nā tētahi raruraru hanganga.

Whakaarohia pēnei, pērā i te turuturu o te wai i roto i te pūwero wai, ki te kore e kati tika tēnei pūwero, ka "turuki" te hau i roto i te ihu. I ētahi wā kino rawa atu, ka puta mai te kai me te inu mā te ihu.

Ko wai te mea ka nui ake te tūponotanga ka pāngia e tēnei mate `(VPI)`?

Ko ngā tamariki te mea tino pāngia e tēnei mate (VPI), inā koa i roto i ēnei āhuatanga:

• Ngā hapa o te waha whānau: Tērā pea ka whānau mai ētahi pēpi me te waha ngatata (`(Cleft Palate)`). Tērā pea he poto ake te waha i te mea noa (`(Abnormally short palate)`). Mō ēnei take, kāore te whakatuwheratanga i kōrerotia ake nei e tika ana te hanga.
• Ngā tonsil kua nui haere, ngā adenoid rānei: Ko ngā tonsil he repe kei ia taha o te korokoro. Ko ngā adenoid he repe kei te pito o runga o te korokoro i muri i te ihu. Ina nui rawa ēnei, ka ārai i te whakatuwheratanga.
• Ngā āhuatanga ira: Ka puta hoki te VPI me ētahi āhuatanga ira, pērā i te Down syndrome, te Neurofibromatosis rānei (he āhuatanga e puta ai ngā pukupuku kore-matepukupuku i roto i te pūnaha io).
• Te ngoikore o ngā uaua nā ngā mate o te pūnaha io: Hei tauira, i roto i te āhuatanga pēnei i te "Cerebral Palsy", kāore pea ngā uaua o te upoko e mahi tika.
• Te pukupuku i roto i ō rātou waha:Tērā pea he pukupuku kei te tumuaki tetahi o ngā take o tēnei.

Haunga ēnei mea, ka puta anō hoki te VPI i muri i ētahi pokanga, i ētahi maimoatanga matepukupuku rānei.

• Adenoidectomy (pokanga hei tango i ngā adenoids)
• Te tango i ngā tonsil (te pokanga hei tango i ngā tonsil)
• Ko te Uvulopalatopharyngoplasty (UPPP) he pokanga hei whakawhānui i te ara manawa mā te tango i te kiko taikaha kei muri o te korokoro.
• Ka puta pea tēnei āhuatanga i muri i te whiwhinga o te rongoā irahiko mō ngā mate pukupuku o te waha, o te ihu me te korokoro rānei.

He tino onge, ka taea hoki e ngā kaiwaiata e whakatangi ana i ngā taonga puoro parahi, rakau rānei te whakawhanake i tētahi momo "stress VPI".

He aha ngā tohu o tēnei mate `(VPI)`?

Ki te whakapae koe kei a tāu tamaiti te VPI, tirohia ēnei tohu:

• He reo e tangi ana i te ihu: Ko te āhuatanga matua ko te tangi mai i tō ihu ina kōrero koe, me te mea he makariri koe.
• Te uaua ki te whakapuaki i ētahi kupu, i ētahi reta rānei: Ina koa ka whakapuakihia ngā reta pēnei i te "ப", "஬", "஗", "த", "஡" (`(p, b, g, t, d)`), kāore pea e mārama. Hei tauira, ina kīia "஬ானா" ka rite pea ki te "மாமா", ka rangona rānei he tangi whiowhio hei whakakapi mō aua reta.
• Ngā oro rerekē e puta mai ana i te ihu i te wā e kōrero ana: I a koe e kōrero ana, tera pea ka rangona he oro "shhh", he oro rānei e kōkō ana i te ihu.
• He onge te putanga mai o te wai, te kai rānei mā te ihu (`(regurgitation)`): He āhua kino ake tēnei. Ka puta mai i te ihu i muri i te inu wai, te inu miraka, ā, i ētahi wā ka kai kai.

He aha te tangi ina kōrero tetahi me te `(VPI)`?

Hei whakamārama ake, ina kōrero tetahi me te `(VPI)`, koinei ngā mea ka taea te tupu:

• He wā okioki noa iho i roto i te kōrero i konei, i reira.
• Kāore i te mārama te reo, me te mea nei he whatiwhati.
• Te haruru o te hau e pupuhi ana i te ihu, he tangi ngongoro noa iho, he tangi rānei me te mea kua purua te ihu.
• Me te mea kei te kōrero koe mā roto i tō ihu, kaua mā roto i tō waha.

Me pēhea te tātaritanga a ngā tākuta i te mate `(VPI)`?

Ki te whakapae koe he VPI tō tamaiti, he pai ake te toro atu ki tētahi tākuta tamariki, ki tētahi tohunga taringa, ihu, me te korokoro rānei (tohunga ENT). Tērā pea ka mahia e te tākuta ēnei whakamātautau e whai ake nei:

• Te Pāpātanga: Ka mahia te pāpātanga hei tirotiro i tetahi āhuatanga hē o te waha.
• Whakamātautau mā te whakamahi i tētahi ngongo angiangi me te kāmera (`(Fiberoptic nasoendoscope)`): Ka whakaurua he ngongo angiangi me tētahi kāmera iti me te mārama mā roto i te ihu hei tirotiro mēnā kei te kati tika te `(sphincter)` i roto i te korokoro. Ahakoa te āhua nei he ahua kore whakamarie tēnei, kāore i te tino mamae mō te tamaiti.
• Tātari kōrero (`(Tātari kōrero)`):Whakarongo ki te āhua o te kōrero a te tamaiti, tirohia mēnā kei te puta mai ngā oro e pā ana ki te `(VPI)`. Ka taea e koe te tiki āwhina mai i tētahi kaiwhakaora kōrero mō tēnei.
• He whakamātautau hihi-X motuhake (Videofluoroscopy): I tēnei whakamātautau, ka hoatu he wai e kīia nei ko te barium ki te tamaiti hei inu, ā, ka mātakihia ngā wāhanga o roto i te korokoro i runga i te ataata hihi-X i a te tamaiti e horomi ana, e kōrero ana. Mā tēnei ka taea e tātou te kite mārama mēnā kei te mahi tika te pūaha, me te wāhi e turuturu mai ana te hau.
• Mā te tirotiro tika i te waha i a koe e kōrero ana me te whakamahi i tētahi endoscope ngāwari.

He aha ngā maimoatanga mō te mate `(VPI)`?

Ko te whakaora kōrero me te pokanga te tikanga e whakamahia ana hei maimoatanga mō te VPI.

• Whakaora kōrero: Ka āwhina tēnei ki te whakarerekē i te āhua o te kōrero a te tamaiti, me te whakaiti i ngā oro o te ihu. He maha ngā wā ka hiahiatia te whakaora kōrero i mua atu, i muri mai hoki i te pokanga. Nā te mea, ahakoa kua whakatikahia te hapa hanganga e te pokanga, kei te taunga tonu te tamaiti ki te kōrero hē, nō reira he mea nui te whakaora kōrero hei whakarerekē i aua tikanga.

• Pokanga: Ko te whāinga o te pokanga he kati i te pūaha i waenganui i te ihu me te waha. Ka mahia tēnei i roto i tētahi huarahi e kore ai e aukati i te ara manawa. Ko te momo pokanga e mahia ana ka whakawhirinaki ki te āhua o te raruraru hanganga. Ka mahi pea te taote pokanga i ngā mea penei:
• Te whakarerekē i te āhua o te waha ngohengohe.
• Ka nui ake te pakitara o te korokoro, ka whakaiti hoki i te tawhiti ki te waha ngohengohe.
• Te totoro, te hanga anō, te whakatika rānei i ngā uaua o te tumuaki.
• Ka tangohia he pūwero uaua mai i te pakitara o muri o te korokoro ka whakapirihia ki te tuanui o te waha. Ka kiia tēnei he tikanga pūwero pharyngeal.
• Te whakamahi i ngā werohanga ngako, i ētahi atu whakakī rānei hei whakakī i te āputa i te rae.

Ka hoatu hoki ki ētahi tāngata he taputapu motuhake ("(waha prosthetic)") ka whakatakotoria ki roto i te waha. He rite tēnei ki te `(retainer)` ka whakatakotoria i muri i te whakaurunga o ngā waea niho. Ka mahia tēnei hei pana i te tuanui o te waha ki runga, hei pupuri hoki i a ia ki tōna tūranga. Heoi, he ahua kore whakamarie ēnei ki te mau. Nō reira, he maha ngā wā ka tūtohutia kia whakamahia anake mō te hunga kāore e taea te pokanga.

He mōrearea kei roto i ngā pokanga `(VPI)`?

Pērā i ngā pokanga katoa, tera pea ētahi raruraru ka puta mai i te pokanga hei whakatika i te ``(VPI)''. Kei roto i ēnei ko:

• Kōrero hyponasal: Ko te tikanga o tēnei ka ngaro te oro noa o te ihu e tika ana kia puta mai i te ihu i te wā e kōrero ana , ā, ka rerekē te reo, me te mea he makariri noa iho.
• Te aukati i te rere o te hau i te ihu.
• Te mate moe koretake (`(Te mate moe koretake)`).
• Te kino haere o te kōrero ihu nui: Ko te tikanga he nui ake te tangi o te ihu i te tikanga.

Koia te mea nui kia whiwhi koe i tēnei maimoatanga i raro i te arataki a tētahi tīma hauora mātau.

Ka taea e au te ārai i taku tamaiti kei pāngia e te (VPI)?

Ina hoki, kāore he tikanga motuhake hei ārai i te putanga mai o te `(VPI)`. Ahakoa ka taea e te karo i ngā pokanga e pā ana ki te waha me te korokoro te whakaiti i te mōrearea o te `(VPI)`, i roto i te nuinga o ngā wā he mea tika ēnei pokanga hauora.

He aha ngā mea hei tumanako atu mēnā kei taku tamaiti tēnei mate?

Ka taea e te pokanga te whakaora i te VPI i roto i te 85% o ngā take. Heoi, tera pea ka mau tonu ngā tohumate o ētahi tāngata, ka hiahia rānei kia pokangahia anō.

Ko te mea nui, he maha ngā wā kua taunga te tamaiti whai `(VPI)` ki tētahi momo kōrero hē, nō reira me tino hiahiatia te whakaora kōrero hei whakarerekē i aua whanonga i muri i te pokanga.

Āhea ahau me pātai atu ki te tākuta o taku tamaiti mō te VPI?

Ki te kite koe i ētahi tauira rerekē, i ngā tikanga, i ngā oro rerekē rānei i roto i te kōrero a tāu tamaiti, kōrero ki te tākuta o tāu tamaiti mō tēnā. Ina koa mēnā he tangi ihu mārama i te wā e kōrero ana, tera pea he take VPI. Ko te tere o te rongoā i tēnei mate, ko te tūponotanga ka ārai i ngā tikanga kōrero roa ka uaua ki te whakakore i muri mai.

Ko te Velopharyngeal Insufficiency (VPI) he āhuatanga e kore ai e kati tika te pūaha i waenganui i tō waha me tō ihu. Mā tēnei āhuatanga ka puta mai te hau i roto i tō ihu, kaua i tō waha, ina kōrero koe. Mena he uaua ki tāu tamaiti te kōrero, ā, he rite te tangi o te ihu ki te ihu, me kōrero koe ki tō tākuta tamariki mō te VPI.

Whakarāpopototanga (Karere hei tango ki te kāinga)

• Ko te `(VPI)` he mate e puta ana ina kore e kati tika te `(velopharyngeal sphincter)` e wehe ana i te waha me te ihu.
• Ka puta he tangi ihu i te wā e kōrero ana, ā, ka uaua pea te kī i ētahi reta .
• Ka taea e ngā hapa korokoro whānau, ngā tonsil/adenoid kua nui haere, ētahi āhuatanga ira, me te pokanga te take o te VPI.
• He mea nui kia rapu tohutohu hauora tonu atu mēnā ka puta ngā tohu.
• Ko te whakaora kōrero me te pokanga ngā maimoatanga matua e whakamahia ana.
• Mā te maimoatanga tere me te whakaora kōrero tika ka āwhina nui i te tamaiti kia mārama te kōrero.

Mena he pātai anō āu mō tēnei, kaua e mangere ki te pātai atu ki te tākuta. Kia maumahara, ko te kitenga wawe me te maimoatanga te mea pai rawa atu.

` VPI, ngoikore o te velopharyngeal, reo, kōrero ihu, uauatanga kōrero, mate kōrero, hauora tamaiti