Ngaba umntwana wakho wenza isandi esingacacanga xa ethetha? Isenokuba ibangelwa yiVelopharyngeal Insufficiency (VPI)!

Ngaba wakha waziva ngathi umntwana wakho uva amazwi akhe xa ethetha? Okanye, ngaba benza izandi ezingaqhelekanga xa bethetha oonobumba abathile? Nangona ezi zinto zithathwa njengeziqhelekileyo ebuntwaneni, ngamanye amaxesha kunokubakho esinye isizathu emva koku. Kwiimeko ezinjalo, into ekufuneka siyixhalabele yile meko ibizwa ngokuba yi-`(Velopharyngeal Insufficiency)`, esiyibiza ngokuba yi-`(VPI)` ngamafutshane. Makhe sithethe ngale nto ngokweenkcukacha nangokulula namhlanje.

Yintoni `(Velopharyngeal Insufficiency - VPI)`? Masiyiqonde ngokulula!

Ngamafutshane, `(VPI)` ithetha ukuba umngxuma ophakathi komngxuma womlomo wethu kunye nomngxuma wempumlo awuvaleki kakuhle. Khawuthelekelele, xa sithetha okanye siginya, lo mngxuma uvaleka kakuhle, kwaye umoya kufuneka uphume emlonyeni kuphela (ngezandi ezininzi). Kodwa kumntu one `(VPI)`, lo mngxuma awuvaleki kakuhle, ngoko ke omnye umoya ofanele uphume emlonyeni nawo uphuma empumlweni. Yiyo loo nto ilizwi livakala ngathi liphuma empumlweni, kwaye amanye amagama kunzima ukuwabiza.

Esi sivalo sibizwa ngokwezonyango ngokuba yi-"velipharyngeal sphincter". Senziwe yi:

• Inxalenye ephezulu yomqala emva kwempumlo (iNasopharynx)
• Inxalenye ephakathi yomqala emva komlomo (`(Oropharynx)`)

Apho iindawo zidibana khona. Le `(sphincter)` sisihlunu esifana neringi. Isebenza njengocango. Xa sithetha, xa siginya, ivala ngokuqinileyo. Kwi `(VPI)`, okwenzekayo kukuba olu cango, oko kukuthi, `(sphincter)`, aluvaleki kakuhle ngenxa yengxaki ethile yesakhiwo.

Cinga ngale ndlela, kanye njengokuba umngxuma omncinci kumbhobho wamanzi unokubangela ukuba amanzi avuza, ukuba lo mngxuma awuvalwanga kakuhle, umoya "ungavuza" empumlweni. Kwezinye iimeko ezinzima, nokutya nokusela kunokuphuma ngempumlo.

Ngubani onokuba nethuba elingcono lokufumana le meko `(VPI)`?

Le meko (VPI) idla ngokubachaphazela kakhulu abantwana, ingakumbi kwiimeko ezifana nezi:

• Iziphene zepalate yokuzalwa: Abanye abantwana banokuzalwa benepalate eqhekekileyo (`(Cleft Palate)`). Okanye, ipalate isenokuba mfutshane kunesiqhelo (`(Absolutely short palate)`). Ngenxa yezizathu ezinje, umngxuma esiwukhankanyileyo awukheki kakuhle.
• Iitoni ezinkulu okanye ii-adenoids: Iitoni zii-glands ezikumacala omabini omqala. Ii-Adenoids zii-glands ezikwinxalenye ephezulu yomqala emva kwempumlo. Xa ezi zinkulu kakhulu, zinokuvala umngxuma.
• Iimeko zemfuza: I-VPI inokwenzeka nakwiimeko ezithile zemfuza, ezifana ne-Down syndrome okanye i-Neurofibromatosis (imeko apho izimila ezingezizo zomhlaza zenzeka kwinkqubo yemithambo-luvo).
• Ubuthathaka bemisipha ngenxa yezifo zenkqubo yemithambo-luvo: Umzekelo, kwimeko efana ne-"Cerebral Palsy"`, izihlunu zentloko zisenokungasebenzi kakuhle.
• Umhlaza emlonyeni wabo:Ithumba elisentlokweni yentloko nalo lisenokuba ngunobangela woku.

Ukongeza kwezi zinto, i-VPI inokwenzeka nasemva kotyando oluthile okanye unyango lomhlaza.

• I-Adenoidectomy (utyando lokususa ii-adenoids)
• Utyando lokususa iitoni (tonsils)
• I-Uvulopalatopharyngoplasty (UPPP) lutyando lokwandisa indlela yokungena komoya ngokususa izicubu ezigqithisileyo ngasemva komqala.
• Le meko inokwenzeka nakwixesha elithile emva kokufumana unyango lwemitha yomhlaza womlomo, impumlo nomqala.

Amaxesha amaninzi, iimvumi ezidlala izixhobo zomculo zebrass okanye zomoya womthi zinokuvelisa uhlobo "lwe-stress VPI".

Zithini iimpawu zale meko `(VPI)`?

Ukuba ukrokrela ukuba umntwana wakho une-VPI, khangela ezi mpawu:

• Ilizwi elivakala ngathi lempumlo: Uphawu oluphambili kukuba xa uthetha, kuvakala ngathi livela empumlweni yakho, ngokungathi unesifo somkhuhlane nje.
• Ubunzima bokubiza amagama okanye oonobumba abathile: Ingakumbi xa ubiza oonobumba abanjengo "ப", "஬", "஗", "த", "஡" (`(p, b, g, t, d)`), kusenokungacaci. Umzekelo, xa usithi "஬ானா" kusenokuvakala ngathi "மாமா", okanye isandi somlozi sinokuvakala endaweni yezo nobumba.
• Izandi ezingaqhelekanga eziphuma empumlweni xa uthetha: Xa uthetha, usenokuva isandi esithi "shhh", okanye isandi sokukrwitshwa empumlweni.
• Amaxesha amaninzi, ulwelo okanye ukutya kuvela ngempumlo (`(regurgitation)`): Le yimeko enzima kancinci. Ingaphuma empumlweni emva kokusela amanzi, ukusela ubisi, kwaye ngamanye amaxesha nokutya ukutya.

Ivakala njani xa umntu one-`(VPI)` ethetha?

Ukucacisa ngakumbi, xa umntu one-`(VPI)` ethetha, nazi izinto ezinokwenzeka:

• Unqumama nje ebalini apha naphaya.
• Ilizwi alicacanga kwaye livakala ngathi liyagungqa.
• Isandi somoya ovuthuzayo ngempumlo, isandi esilula sokurhona, okanye isandi esifana nempumlo siyavalwa.
• Kuvakala ngathi uthetha ngempumlo yakho endaweni yomlomo wakho.

Oogqirha bayixilonga njani imeko `(VPI)`?

Ukuba ukrokrela ukuba umntwana wakho une-VPI, kungcono ukubona ugqirha wabantwana okanye ingcali yendlebe, impumlo, nomqala (ingcali ye-ENT). Ugqirha usenokuqhuba olu vavanyo lulandelayo:

• Ukucofa: Ukucofa kwenziwa ukujonga naziphi na iingxaki enkalakahleni.
• Uvavanyo ngetyhubhu encinci enekhamera (`(Fiberoptic nasoendoscope)`): Ityhubhu encinci enekhamera encinci kunye nokukhanya kufakwa ngempumlo ukujonga ukuba `(sphincter)` engaphakathi emqaleni ivala kakuhle na. Nangona oku kunokubonakala kungakhululeki kancinci, akubuhlungu kakhulu kumntwana.
• Uhlalutyo lwentetho (`(Uhlalutyo lwentetho)`):Mamela indlela umntwana athetha ngayo uze ubone ukuba izandi ezithile ezinxulumene ne-`(VPI)` ziyaphuma na. Ungafumana uncedo kwingcali yezentetho ngale nto.
• Uvavanyo olukhethekileyo lwe-X-ray (iVideofluoroscopy): Kolu vavanyo, umntwana unikwa ulwelo olubizwa ngokuba yi-barium ukuba alusele, kwaye iindawo ezingaphakathi emqaleni zijongwa kwividiyo ye-X-ray njengoko umntwana eginya aze athethe. Oku kusenza sibone ngokucacileyo ukuba umngxuma usebenza kakuhle na kwaye umoya uphuma phi.
• Ukujongwa ngqo kwenkalakahla xa uthetha nge-endoscope eguquguqukayo.

Ziziphi iindlela zonyango zesifo `(VPI)`?

Unyango lokuthetha kunye notyando zihlala zisetyenziswa njengonyango lwe-VPI.

• Unyango lokuthetha: Oku kunceda ukutshintsha indlela umntwana athetha ngayo nokunciphisa izandi zeempumlo. Unyango lokuthetha ludla ngokufuneka ngaphambi nasemva kotyando. Oku kungenxa yokuba, nokuba utyando lulungisa isiphene sokwakheka komzimba, umntwana usaqhele ukuthetha ngendlela engafanelekanga, ngoko ke unyango lokuthetha lubalulekile ukutshintsha loo mikhwa.

• Utyando: Injongo yotyando kukuvala umngxuma ophakathi kwempumlo nomlomo. Oku kwenziwa ngendlela engathinteli indlela yomoya. Uhlobo lotyando olwenziweyo luxhomekeke kuhlobo lwengxaki yesakhiwo. Ugqirha angenza izinto ezinje:
• Ukutshintsha imo yenkalakahla ethambileyo.
• Ukwenza udonga lwepharyngeal lube lukhulu kancinci kwaye kunciphisa umgama oya kwinkalakahla ethambileyo.
• Ukuzolula, ukubumba ngokutsha, okanye ukulungisa izihlunu zentloko.
• Kuthathwa i-flap yemisipha eludongeni olungasemva lomphimbo ize incamathiselwe eluphahleni lomlomo. Oku kubizwa ngokuba yinkqubo ye-pharyngeal flap.
• Ukusebenzisa inaliti yamafutha okanye ezinye izinto zokugcwalisa ukuvala umsantsa ebunzini.

Abanye abantu banikwa isixhobo esikhethekileyo (`(i-oral prosthetic)`) esifakwa emlonyeni. Oku kufana ne-`(retainer)` efakwa emva kokuba kufakwe iintambo zamazinyo. Oku kwenzelwa ukutyhala uphahla lomlomo luze lubambeke endaweni yalo. Nangona kunjalo, ezi azikhululeki ukunxiba. Ke ngoko, zihlala zicetyiswa kuphela kwabo bangenako utyando.

Ngaba kukho naziphi na iingozi kutyando lwe-`(VPI)`?

Njengakwezinye iindlela zotyando, kukho iingxaki ezithile ezinokwenzeka xa utyando lulungiswa. Ezi ziquka:

• Intetho ye-Hyponasal: Oku kuthetha ukuba isandi esiqhelekileyo sempumlo esifanele siphume empumlweni xa uthetha siyalahleka , kwaye ilizwi liyatshintsha, ngokungathi ngumkhuhlane nje.
• Ukuvalwa komoya ophuma empumlweni.
• I-apnea yokulala (`(I-apnea yokulala ethintela ukungasebenzi kakuhle)`).
• Intetho ebuhlungu kakhulu yempumlo: Oku kuthetha ukuba isandi sivakala kakhulu kunangesiqhelo.

Yingakho kubalulekile ukufumana olu nyango phantsi kolwalathiso lweqela lezonyango elinamava.

Ndingamthintela umntwana wam ekubeni afumane (VPI)?

Enyanisweni, akukho ndlela ithile yokuthintela ukwenzeka kwe-`(VPI)`. Nangona ukuphepha utyando olunxulumene nenkalakahla nomqala kunokunciphisa umngcipheko we-`(VPI)`, kwiimeko ezininzi olu tyando luyimfuneko ngokwezonyango.

Yintoni endinokuyilindela ukuba umntwana wam unale meko?

Utyando lunokuyinyanga ngempumelelo i-VPI kwi-85% yamatyala. Nangona kunjalo, abanye abantu banokuqhubeka beneempawu okanye basenokufuna olunye utyando.

Eyona nto ibalulekileyo kukuba umntwana one-`(VPI)` udla ngokuqhelana nendlela yokuthetha engalunganga, ngoko ke unyango lokuthetha luyimfuneko ngokuqinisekileyo ukutshintsha loo mikhwa emva kotyando.

Ndingambuza nini ugqirha womntwana wam malunga ne-VPI?

Ukuba ubona naziphi na iipatheni ezingaqhelekanga, imikhwa, okanye izandi ezingaqhelekanga kwintetho yomntwana wakho, thetha nogqirha womntwana wakho ngayo loo nto. Ingakumbi ukuba kukho isandi esicacileyo sempumlo xa uthetha, isenokuba yimeko ye-VPI. Okukhona le meko inyangwa ngokukhawuleza, kokukhona kunokwenzeka ukuba kuthintelwe imikhwa yokuthetha ixesha elide eya kuba nzima ukuyiyeka kamva.

I-Velopharyngeal Insufficiency (VPI) yimeko apho umngxuma ophakathi komlomo wakho nempumlo ungavaleki kakuhle. Le meko ibangela ukuba umoya uphume empumlweni yakho endaweni yomlomo wakho xa uthetha. Ukuba umntwana wakho unengxaki yokuthetha kwaye uvakala ngathi uneempumlo, qiniseka ukuba uthetha nogqirha wezingane malunga ne-VPI.

Isishwankathelo (Umyalezo Wokuya Ekhaya)

• `(VPI)` yimeko eyenzeka xa `(velipharyngeal sphincter)` eyahlula umlomo kunye nomngxuma wempumlo ingavali kakuhle.
• Oku kunokubangela isandi sempumlo xa uthetha, kwaye kunokuba nzima ukubiza oonobumba abathile .
• Iziphene zomqala ezizalwa nazo, iitoni/adenoids ezandileyo, iimeko ezithile zemfuza, kunye notyando zonke zinokubangela i-VPI.
• Kubalulekile ukufuna iingcebiso zonyango ngokukhawuleza ukuba uneempawu.
• Unyango lokuthetha kunye notyando zezona ndlela ziphambili zonyango ezisetyenziswayo.
• Unyango olukhawulezileyo kunye nonyango olufanelekileyo lokuthetha lunokunceda kakhulu ekuncedeni umntwana ukuba athethe ngokucacileyo.

Ukuba unemibuzo engaphezulu malunga noku, ungathandabuzi ukubuza ugqirha. Khumbula, ukufumanisa kwangethuba kunye nonyango zezona zilungileyo.

I- VPI, ukungasebenzi kakuhle kwe-velorpharyngeal, ilizwi, ukuthetha impumlo, ubunzima bokuthetha, iingxaki zokuthetha, impilo yomntwana