Ingabe ingane yakho yenza umsindo ongacacile uma ikhuluma? Kungenzeka ukuthi kungenxa ye-Velopharyngeal Insufficiency (VPI)!

Wake wazizwa sengathi ingane yakho ikhuluma kabi lapho ikhuluma? Noma, ingabe yenza imisindo engavamile lapho isho izinhlamvu ezithile? Ngisho noma lezi zinto zibhekwa njengezivamile ebuntwaneni, ngezinye izikhathi kungase kube nesinye isizathu salokhu. Ezimweni ezinjalo, into okudingeka sikhathazeke ngayo yilesi simo esibizwa ngokuthi `(Velopharyngeal Insufficiency)`, esiphinde sibize ngokuthi `(VPI)` ngamafuphi. Ake sixoxe ngalokhu ngokuningiliziwe nanamuhla.

Kuyini `(Ukuntuleka Kwe-Velopharyngeal - VPI)`? Ake sikuqonde kalula!

Kalula nje, `(VPI)` kusho ukuthi imbobo ephakathi komlomo wethu kanye nomgodi wempumulo ayivaleki kahle. Cabanga nje, lapho sikhuluma noma sigwinya, le mbobo ivala kahle, futhi umoya kufanele uphume emlonyeni kuphela (ngemisindo eminingi). Kodwa kumuntu one-`(VPI)`, le mbobo ayivaleki kahle, ngakho omunye umoya okufanele uphume emlonyeni nawo uphuma ekhaleni. Yingakho izwi lizwakala sengathi livela ekhaleni, futhi amanye amagama kunzima ukuwaphimisela.

Lo mgodi ubizwa ngokwezokwelapha ngokuthi "i-velipharyngeal sphincter". Wakhiwa yilokhu okulandelayo:

• Ingxenye engenhla yomphimbo ngemuva kwekhala (i-Nasopharynx)
• Ingxenye ephakathi yomphimbo ngemuva komlomo (`(Oropharynx)`)

Lapho izingxenye zihlangana khona. Lo `(sphincter)` ungumsipha ofana nendandatho. Usebenza njengomnyango. Uma sikhuluma, uma sigwinya, uvala kahle. Ku-`(VPI)`, okwenzekayo ukuthi lo mnyango, okungukuthi, `(sphincter)`, awuvali kahle ngenxa yenkinga ethile yesakhiwo.

Cabanga ngale ndlela, njengoba nje imbobo encane epayipini lamanzi ingabangela ukuvuza kwamanzi, uma le mbobo ingavalwanga kahle, umoya ungavuza ekhaleni. Kwezinye izimo ezimbi kakhulu, ngisho nokudla nokuphuza kungaphuma ekhaleni.

Ubani onamathuba amaningi okuthuthukisa lesi simo `(VPI)`?

Lesi simo (VPI) sivame ukuthinta izingane kakhulu, ikakhulukazi ezimweni ezinjengalezi:

• Ukukhubazeka kolwelwesi oluzalwa nalo: Ezinye izingane zingase zizalwe nolwelwesi oluqhekekile (`(Cleft Palate)`). Noma, ulwelwesi lungase lube lufushane kunoluvamile (`(Abnormal short palate)`). Ngenxa yezizathu ezinjengalezi, umgodi esikhulume ngawo awukheki kahle.
• Ama-tonsils noma ama-adenoids akhulisiwe: Ama-tonsils ayizindlala ezinhlangothini zombili zomphimbo. Ama-Adenoid ayizindlala engxenyeni engenhla yomphimbo ngemuva kwekhala. Uma lezi ziba zinkulu kakhulu, zingavimba umgodi.
• Izimo zofuzo: I-VPI ingenzeka futhi nasezimeni ezithile zofuzo, njenge-Down syndrome noma i-Neurofibromatosis (isimo lapho izimila ezingezona umdlavuza zakheka khona ohlelweni lwezinzwa).
• Ubuthakathaka bemisipha obubangelwa izifo zesimiso sezinzwa: Isibonelo, esimweni esifana ne-"Cerebral Palsy" (i-Cerebral Palsy), imisipha yekhanda ingase ingasebenzi kahle.
• Isimila emlonyeni wabo:Isimila esisekhanda singase sibe imbangela yalokhu.

Ngaphezu kwalezi zinto, i-VPI ingenzeka futhi ngemva kokuhlinzwa okuthile noma ukwelashwa komdlavuza.

• Ukuhlinzwa kwe-Adenoid (ukuhlinzwa kokususa ama-adenoids)
• Ukuhlinzwa kokususa amathonsi (i-tonsillectomy)
• I-Uvulopalatopharyngoplasty (UPPP) iwukuhlinzwa kokwandisa indlela yokuphefumula ngokususa izicubu ezisele ngemuva komphimbo.
• Lesi simo singase sivele ngemva kwesikhathi esithile sokuthola ukwelashwa ngemisebe yomdlavuza womlomo noma wekhala nomphimbo.

Akuvamile kakhulu ukuthi abaculi abadlala izinsimbi zomculo zethusi noma zomoya wokhuni nabo bangakha uhlobo "lwe-stress VPI".

Yiziphi izimpawu zalesi simo `(VPI)`?

Uma usola ukuthi ingane yakho ine-VPI, qaphela lezi zimpawu:

• Izwi elizwakala njengekhala: Isici esiyinhloko ukuthi uma ukhuluma, kuzwakala sengathi kuvela ekhaleni lakho, njengokungathi umane uphethwe umkhuhlane.
• Ubunzima bokuphimisa amagama noma izinhlamvu ezithile: Ikakhulukazi lapho uphimisa izinhlamvu ezifana nokuthi "ப", "஬", "஗", "த", "஡" (`(p, b, g, t, d)`), kungase kungacaci. Isibonelo, uma uthi "஬ானா" kungase kuzwakale sengathi "மாமா", noma umsindo wokukhala ungase uzwakale esikhundleni salezo zinhlamvu.
• Imisindo engavamile ephuma ekhaleni lapho ukhuluma: Uma ukhuluma, ungase uzwe umsindo othi "shhh", noma umsindo wokuminyana ekhaleni.
• Akuvamile ukuthi kube noketshezi noma ukudla okuphuma ngekhala (`(regurgitation)`): Lesi yisimo esibucayi kancane. Singaphuma ekhaleni ngemva kokuphuza amanzi, ukuphuza ubisi, futhi ngezinye izikhathi ngisho nokudla ukudla.

Kuzwakala kanjani uma umuntu one-`(VPI)` ekhuluma?

Ukuze sichaze kabanzi, uma umuntu one-`(VPI)` ekhuluma, nazi izinto ezingenzeka:

• Uhlala nje endabeni lapha nalaphaya.
• Izwi alicacile futhi lizwakala sengathi liyangingiza.
• Umsindo womoya ovunguza ekhaleni, umsindo wokuhona nje, noma umsindo ofana nekhala uyavalwa.
• Kuzwakala sengathi ukhuluma ngekhala lakho esikhundleni somlomo wakho.

Odokotela basithola kanjani lesi simo `(VPI)`?

Uma usola ukuthi ingane yakho ine-VPI, kungcono ukubona udokotela wezingane noma uchwepheshe wezindlebe, impumulo, nomphimbo (uchwepheshe we-ENT). Udokotela cishe uzokwenza izivivinyo ezilandelayo:

• Ukuhlikihla: Ukuhlikihla kwenziwa ukuhlola noma yikuphi ukukhubazeka emlonyeni.
• Ukuhlolwa ngepayipi elincane ngekhamera (`(Fiberoptic nasoendoscope)`): Ipayipi elincane elinekhamera encane kanye nokukhanya kufakwa ngekhala ukuze kuhlolwe ukuthi `(sphincter)` engaphakathi komphimbo ivala kahle yini. Nakuba lokhu kungase kubonakale kungakhululekile kancane, akubuhlungu kakhulu enganeni.
• Ukuhlaziywa kwenkulumo (`(Ukuhlaziywa kwenkulumo)`):Lalela indlela ingane ekhuluma ngayo bese ubona ukuthi imisindo ethile ehlobene ne-`(VPI)` iyaphuma yini. Ungathola usizo kuchwepheshe wezokukhuluma ngalokhu.
• Ukuhlolwa okukhethekile kwe-X-ray (i-Videofluoroscopy): Kulokhu kuhlolwa, ingane inikwa uketshezi olubizwa nge-barium ukuze iluphuze, kanti izingxenye ezingaphakathi komphimbo zibukwa kuvidiyo ye-X-ray njengoba ingane igwinya futhi ikhuluma. Lokhu kusenza sibone ngokucacile ukuthi imbobo isebenza kahle yini nokuthi umoya uphuma kuphi.
• Ukubuka ngqo ulwanga ngenkathi ukhuluma nge-endoscope eguquguqukayo.

Yiziphi izindlela zokwelapha lesi simo `(VPI)`?

Ukwelashwa kokukhuluma kanye nokuhlinzwa kuvame ukusetshenziswa njengokwelashwa kwe-VPI.

• Ukwelashwa ngenkulumo: Lokhu kusiza ukushintsha indlela ingane ekhuluma ngayo nokunciphisa imisindo yamakhala. Ukwelashwa ngenkulumo kuvame ukudingeka ngaphambi nangemva kokuhlinzwa. Lokhu kungenxa yokuthi, noma ngabe ukuhlinzwa kulungisa iphutha lesakhiwo, ingane isajwayele ukukhuluma kabi, ngakho-ke ukwelashwa ngenkulumo kubalulekile ukushintsha leyo mikhuba.

• Ukuhlinzwa: Umgomo wokuhlinzwa ukuvala isikhala esiphakathi kwekhala nomlomo. Lokhu kwenziwa ngendlela engavimbeli indlela yokuphefumula. Uhlobo lokuhlinzwa olwenziwayo luncike ohlotsheni lwenkinga yesakhiwo. Udokotela ohlinzayo angenza izinto ezinjengalezi:
• Ukushintsha isimo solimi oluthambile.
• Ukwenza udonga lwe-pharyngeal lube lukhulu kancane futhi kunciphisa ibanga eliya emlonyeni othambile.
• Ukunweba, ukubumba kabusha, noma ukulungisa imisipha yesikhumba sekhanda.
• Kuthathwa i-flap yemisipha odongeni lwangemuva lomphimbo bese inamathiselwa ophahleni lomlomo. Lokhu kubizwa ngokuthi inqubo ye-pharyngeal flap.
• Ukusebenzisa imijovo yamafutha noma ezinye izinto zokugcwalisa ukuze kuvalwe isikhala ebunzini.

Abanye abantu banikezwa nedivayisi ekhethekile (`(yokufakelwa ngomlomo)`) efakwa emlonyeni. Lokhu kufana ne-`(i-retainer)` efakwa ngemva kokufakwa kwezintambo zamazinyo. Lokhu kwenzelwa ukusunduza uphahla lomlomo bese ulubamba endaweni yalo. Kodwa-ke, lokhu akukhululekile ukukugqoka. Ngakho-ke, kuvame ukunconywa kuphela kulabo abangakwazi ukuhlinzwa.

Ingabe zikhona izingozi ekuhlinzweni kwe-`(VPI)`?

Njenganoma yikuphi ukuhlinzwa, kunezinkinga ezithile ezingase zenzeke ngokuhlinzwa ukuze kulungiswe "(VPI)". Lokhu kufaka phakathi:

• Inkulumo ye-Hyponasal: Lokhu kusho ukuthi umsindo ojwayelekile wekhala okufanele uvele ekhaleni lapho ukhuluma uyalahleka , futhi izwi liyashintsha, njengokungathi umkhuhlane nje.
• Ukuvimba ukuhamba komoya ekhaleni.
• Ukuphefumula okuvimbelayo kokulala.
• Inkulumo ebuhlungu kakhulu yekhala: Lokhu kusho ukuthi umsindo uzwakala kakhulu kunasekhaleni.

Yingakho kubalulekile ukuthola lokhu kwelashwa ngaphansi kokuqondiswa kwethimba lezokwelapha elinolwazi.

Ingabe ingane yami ingavinjelwa ekutholeni (i-VPI)?

Eqinisweni, ayikho indlela ethile yokuvimbela ukwenzeka kwe-`(VPI)`. Nakuba ukugwema ukuhlinzwa okuhlobene nolwanga nomphimbo kunganciphisa ingozi ye-`(VPI)`, ezimweni eziningi lokhu kuhlinzwa kuyadingeka ngokwezokwelapha.

Yini okufanele uyilindele uma ingane yami inalesi simo?

Ukuhlinzwa kungayiqeda ngempumelelo i-VPI cishe kuma-85% ezimo. Kodwa-ke, abanye abantu bangase baqhubeke nokuba nezimpawu noma kungadingeka baphinde bahlinzwe.

Into ebaluleke kakhulu ukuthi ingane ene-`(VPI)` ivame ukujwayela indlela yokukhuluma engalungile, ngakho-ke ukwelashwa kokukhuluma kuyadingeka ngempela ukushintsha leyo mikhuba ngemva kokuhlinzwa.

Kufanele ngibuze nini udokotela wengane yami nge-VPI?

Uma ubona noma yimiphi imikhuba, imikhuba, noma imisindo engavamile enkulumweni yengane yakho, khuluma nodokotela wengane yakho ngakho. Ikakhulukazi uma kunomsindo ohlukile wekhala lapho ukhuluma, kungaba yicala le-VPI. Uma lesi simo selashwa ngokushesha, kulapho kungenzeka khona ukuvimbela imikhuba yokukhuluma yesikhathi eside okuzoba nzima ukuyiyeka kamuva.

Ukuntuleka Kwe-Velopharyngeal (VPI) yisimo lapho umgodi ophakathi komlomo wakho nekhala ungavaleki kahle. Lesi simo sibangela ukuthi umoya uphume ekhaleni lakho esikhundleni somlomo wakho uma ukhuluma. Uma ingane yakho inenkinga yokukhuluma futhi izwakala sengathi ikhala, qiniseka ukuthi ukhuluma nodokotela wezingane mayelana ne-VPI.

Isifinyezo (Umyalezo Wokuya Nawe Ekhaya)

• `(VPI)` yisimo esenzeka lapho `(i-velipharyngeal sphincter)` ehlukanisa umgodi womlomo kanye nomgodi wekhala ingavali kahle.
• Lokhu kungabangela umsindo wekhala lapho ukhuluma, futhi kungaba nzima ukuphimisela ezinye izinhlamvu .
• Ukukhubazeka komphimbo okuzalwa nawo, ama-tonsils/adenoids akhuphukile, izimo ezithile zofuzo, kanye nokuhlinzwa konke kungabangela i-VPI.
• Kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma unezimpawu.
• Ukwelashwa kokukhuluma kanye nokuhlinzwa yizona zindlela zokwelapha eziyinhloko ezisetshenziswayo.
• Ukwelashwa kusenesikhathi kanye nokwelashwa okufanele ngenkulumo kungasiza kakhulu ekusizeni ingane ukuthi ikhulume kahle.

Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukubuza udokotela. Khumbula, ukutholakala kusenesikhathi kanye nokwelashwa kungcono kakhulu.

I - VPI, ukungasebenzi kahle kwe-velpharyngeal, izwi, ukukhuluma ekhaleni, ubunzima bokukhuluma, ukuphazamiseka kwenkulumo, impilo yengane