Ingabe izwi lakho linomsindo omkhulu? Lokhu kungaba ngenxa yokukhubazeka kwezwi.

Ngezinye izikhathi, lapho sivuka ekuseni, izwi lethu lizwakala lihlukile kancane, akunjalo? Noma lapho siqeda ukucula ingoma enhle, noma lapho simemeza futhi sikhuluma, izwi lethu liba lihosho kancane. Ngokuvamile, lezi zinto ziba ngcono ngosuku olulodwa noma ezimbili. Kodwa uma izwi lakho selihlukile noma lihoshoze amasonto, uma uzizwa ukhathele lapho ukhuluma, noma uma uzizwa sengathi uyaminyana lapho ugwinya ukudla nokuphuza, akuyona into okufanele ithathwe kalula. Namuhla, sizokhuluma ngesimo esisodwa esithile esingabangela izimpawu ezinjalo. Lokho ukukhubazeka kwe-vocal cord, noma njengoba sisho ngesiNgisi, isimo esibizwa ngokuthi 'i-Vocal Cord Paralysis'.

Kalula nje, kuyini ukungasebenzi kahle kwe-vocal cord?

Ukuze siqonde lokhu, ake siqale sibheke ukuthi ziyini lezi zintambo zezwi. Cabanga ukuthi ngaphakathi komphimbo wethu, ikakhulukazi ekuqaleni kwe-trachea, engxenyeni ebizwa ngokuthi i-larynx, kunezinsila ezimbili ezincane. Njengeminyango emibili esangweni. Lezi yizo esizibiza ngokuthi izintambo zezwi.

Kunemisebenzi eminingana yalokhu:

• Uma uphefumula: Lawa mabhande amabili ayahlukana, okwenza umoya ungene emaphashini.
• Uma ugwinya ukudla: Lokhu kuvala ngokuqinile futhi kuvikela ukudla ekungeneni komoya.
• Uma sikhuluma: Izwi lethu livela lapho la maqembu amabili ehlangana futhi enyakaza nomoya ovela emaphashini.

Manje usuyaqonda ukuthi lezi zintambo zezwi zibaluleke kangakanani? Ngakho-ke, ukungasebenzi kahle kwezintambo zezwi kusho ukuthi kukhona umonakalo othile ezinzwa ezilawula lezi zintambo zezwi, futhi lezi zintambo zemisipha azisebenzi kahle. Okusho ukuthi, lezi 'minyango yesango' azivuli futhi azivaleki kahle. Lokhu kungenza kube nzima ukukhuluma, ukugwinya, futhi ngezinye izikhathi ngisho nokuphefumula.

Kunezinhlobo ezimbili eziyinhloko zalesi simo.

Lokhu kungasebenzi kahle kwe-vocal cord kungahlukaniswa ngezinhlobo ezimbili eziyinhloko, kuye ngokuthi i-vocal cord eyodwa noma zombili azisebenzi kahle.

Ingabe nawe unalezi zimpawu?

Izimpawu zokungasebenzi kahle kwe-vocal cord zingahluka kuye ngokuthi kukhulu kangakanani kanye nendawo lapho i-vocal cord ingasebenzi kahle khona.

Lezi yizimpawu ezivamile:

• Izinguquko zezwi: ukuhosha, ubuthakathaka, umsindo wokuphefumula.
• Izinguquko ekuphakameni nasekuphakameni: Iphimbo kanye nokuphakama kwezwi kungashintsha.
• Ukuphelelwa umoya uma ukhuluma: Kuba nzima ukuphefumula ngisho nangemva kokukhuluma isikhashana, futhi uzizwa ukhathele.
• Ukuphefumula: Ukuphefumula kungase kwenzeke lapho uphefumula.
• Ubunzima bokugwinya (i-Dysphagia): Ukuzwa iqhubu emphinjeni lapho ugwinya ukudla noma isiphuzo.
• Ukuminyana: Ukuzizwa sengathi uhlala uminyana uma uphuza amanzi amancane noma udla ukudla.
• Ubunzima bokuhlanza umphimbo: Ukuzwa sengathi umphimbo unamathele emphinjeni, kodwa kunzima ukuwuhlanza.

Yiziphi izizathu zalesi simo?

Kunezizathu eziningi zokuthi kungani izinzwa ezilawula izintambo zezwi zingalimala. Ngezinye izikhathi, akukho sizathu esingatholakala.

Nazi ezinye zezizathu eziyinhloko:

• Ukuhlinzwa: Lezi zinzwa zingalimala, ikakhulukazi ngesikhathi sokuhlinzwa okubandakanya intamo, isifuba, kanye nekhanda (isibonelo, ukususwa kwe-thyroid). Ngezinye izikhathi zingalimala ngepayipi lokuphefumula elibekwa ngesikhathi sokuhlinzwa ngesikhathi sokuhlinzwa.
• Ukulimala: Ingozi enkulu entanyeni, ekhanda, noma esifubeni ingalimaza imizwa.
• Izifo ze-neurological: Izifo ezenza buthaka izinzwa, njengesifo sikaParkinson, i-multiple sclerosis (MS), noma isifo sohlangothi, zingathinta lezi zinzwa.
• Izimila: Izimila, kungakhathaliseki ukuthi ziyingozi noma azinabungozi, ezikhula elangeni noma ezindleleni zemizwa zingacindezela futhi zilimaze izinzwa.
• Ukutheleleka: Ezinye izifo ezibangelwa amagciwane, isibonelo, i-herpes, igciwane le-Epstein-Barr, kanye ne-COVID-19, zingabangela ukuvuvukala kanye nomonakalo ezinzwa.
• Izifo ezihlasela umzimba: Lesi simo singabangelwa nezifo lapho amasosha omzimba ehlasela khona imizwa, isibonelo, i-myasthenia gravis.
• Izinto ezinobuthi: Ukungenisa izinto ezinobuthi ezifana nomthofu, i-mercury, kanye ne-arsenic kungalimaza izicubu zemizwa. Uma usola ukuthi udle into enobuthi, shayela ngokushesha i-National Poison Information Center e-Colombo National Hospital ukuze uthole iseluleko.

Ngezinye izikhathi lesi simo singase senzeke ngisho nangemva komkhuhlane ovamile. Amacala lapho kungatholakali khona imbangela ecacile abizwa ngokuthi 'idiopathic'.

Udokotela ukuthola kanjani lokhu?

Uma unalezi zimpawu, kufanele nakanjani ubonane nodokotela we-ENT onguchwepheshe wezindlebe, impumulo kanye nomphimbo (udokotela ohlinzayo we-ENT). Udokotela uzoqala alalele ngokucophelela izimpawu zakho kanye nomlando wezokwelapha. Ngemva kwalokho, bangenza izivivinyo eziningana ukuqinisekisa ukuxilongwa.

• I-Laryngoscopy: Lokhu kuhilela ukufaka ipayipi elincane elinekhamera encane ngekhala lakho noma emlonyeni wakho ukuze ubheke ngqo izintambo zakho zezwi. Ungakhathazeki, uzonikezwa umuthi wokwenza kube nezinzwa uma kudingeka ngaphambi kokwenza lokhu. Lokhu kukuvumela ukuthi ubone ngokucacile ukuthi izintambo zakho zezwi ziyanyakaza noma cha.
• I-Videostroboscopy: Lokhu kufana ne-laryngoscopy, kodwa isebenzisa ikhamera ekhethekile ukubuka izintambo zezwi zinyakaza kancane njengoba ukhuluma.
• Izifundo zokuthatha izithombe: Kungenziwa i-CT scan noma i-MRI scan ukuze kuhlolwe amaqhubu ezindaweni ezifana nobuchopho, intamo kanye nesifuba.
• I-electromyography ye-Laryngeal (LEMG): Lokhu kulinganisa izimpawu zikagesi ezithunyelwa kusuka ezinzwa kuya emisipheni ye-larynx. Lokhu kungasiza ekunqumeni ukuthi izinzwa zonakele yini.
• Ukuhlolwa kwegazi: Ukuhlolwa kwegazi kungenziwa uma kusolwa ukuthi kukhona ukutheleleka noma isifo sokuzivikela komzimba.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kunqunywa ubukhulu besifo, izimpawu, kanye nembangela yaso.

Ukwelashwa Ngezwi

Lena yindlela yokwelapha eyinhloko. Isebenza kahle kakhulu, ikakhulukazi uma isimo singesibi kakhulu. Lapha, udokotela wezifo zolimi lokukhuluma uzokufundisa izivivinyo ezikhethekile zokuqinisa imisipha yakho yezwi nokulawula ukuphefumula kwakho ngenkathi ukhuluma.

Ukuhlinzwa kanye nezinye izindlela zokwelapha

Uma isimo sibi kakhulu noma singenakulawulwa ngokwelashwa ngezwi, kungase kudingeke ukuhlinzwa.

• Uma intambo eyodwa yezwi ingasebenzi (Unilateral Paralysis):
• Ukujova ngentambo yezwi: Kule nqubo, kufakwa i-filler ekhethekile ukugcwalisa isikhala esiphakathi kwentambo yezwi. Lokhu kwenza kube lula ukukhuluma nokugwinya.
• Ukuhlinzwa kohlaka lwe-laryngeal: Kulokhu, i-implant eyenziwe ngezinto ezifana ne-silicone ifakwa ku-larynx ngokuhlinzwa okuncane, isunduza i-vocal cord engasebenzi kahle phakathi. Lokhu kwenza kube lula ukuthi enye i-vocal cord ingene futhi ivaleke.
• Ukuvuselelwa kabusha: Lokhu kuhilela ukuthatha inzwa enempilo eya komunye umsipha entanyeni bese uyixhumanisa nenzwa emisipha yezwi engasebenzi kahle.

• Uma zombili izintambo zezwi zingasebenzi (Bilateral Paralysis):
• Njengoba inkinga enkulu kulokhu kuwubunzima bokuphefumula, into yokuqala okufanele uyenze ukudala indlela yokuphefumula. Into eyinhloko okufanele uyenze ngalokho ukuhlinzwa kwe-tracheostomy .
• Kulokhu kuhlinzwa, kwenziwa imbobo encane ngaphambili kwentamo bese kufakwa ipayipi ngqo epayipini lomoya. Lokhu kuvumela isiguli ukuthi siphefumule kalula.
• Ngaphezu kwalokho, imisebe ye-laser ingasetshenziswa ukususa ingxenye encane yangemuva kwezintambo zezwi ukuze kwandiswe indlela yokuphefumula.

Kufanele ubonane nodokotela ngokushesha nini?

Uma unezimpawu ezifana nokushintsha kwezwi lakho, ukushoshozela, noma ubunzima bokugwinya, ungakuzibi bese ubona udokotela. Uma uqala ukwelashwa ngokushesha, kulapho ungavimbela kangcono isimo ukuthi singabi sibi kakhulu.

Ubunzima bokuphefumula kungaba uphawu lokuthi izintambo zombili zezwi ziyahluleka. Futhi, uma ukudla noma isiphuzo kubhajwa futhi kungene emaphashini, kungabangela izifo ezinkulu njenge-aspiration pneumonia. Ngakho-ke qaphela kakhulu ngalezi zimpawu.