Riba:
- Ikon haɗa nau'ikan nau'ikan tympanogram (A, B, C) da binciken reflex acoustic tare da ilimin lissafin kunni na tsakiya da kuma tabbatar da daftarin hankali na wucin gadi tare da binciken asibiti.
- Ikon ba da hankali na wucin gadi sakamakon ma'auni a cikin mahallin da samar da daftarin fassarar farko da aka haɗa tare da audiogram
- Ikon rarrabe iyakokin bincike na gwaje-gwajen immittance da jajayen tutoci masu buƙatar neman magani (ENT)
Audiogram ya nuna "nawa" ji ke faruwa; Amma don fahimtar inda rashin jin ya faru, ya zama dole a san yadda kunnen tsakiya ke aiki. Gwaje-gwajen immittance (gwajin da ke auna juriya da watsawa ta tsakiya zuwa makamashin sauti) sun cika wannan gibin. A cikin wannan rukunin, za mu rufe gwaje-gwajen immittance guda biyu na gama gari - tympanometry da acoustic reflex - kuma mu nuna muku yadda ake amfani da AI cikin aminci don fassara su. Babban ka'ida ba ta canzawa: AI yana samar da daftarin fassarar; Tympanogram kadai ba ya yin ganewar asali, an haɗa shi tare da jarrabawar asibiti da tarihin, yanke shawara ya kasance ga ƙwararren.
Menene tympanometry kuma menene yake aunawa?
Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwararren Ƙwaƙwalwa na Ƙaƙwalwa na Ƙaƙwalwa na Ƙaƙwalwa ) da tsarin kunne na tsakiya ke amsawa ga sauti yayin da yake canza matsa lamba a cikin tashar kunne ta hanyar sarrafawa. Sakamakon ya bayyana a matsayin mai lankwasa (tympanogram) da matsayi na tsaka-tsakin, tsayinsa da girman canal ana kimantawa. A al'adance, an gano manyan nau'ikan iri uku:
Nau'in A: Ƙarfin yana cikin yankin matsa lamba na al'ada da tsayin daka. Kunnen tsakiya yawanci yana aiki akai-akai. There are subtypes: As (shallow crest — may suggest conditions such as stiffness/otosclerosis), Ad (extremely deep crest — may suggest ossicular chain laxity or highly mobile eardrum).
Nau'in B: Lebur, lanƙwasa kololuwa. Fassara tare da ƙarar canal: layi mai laushi tare da ƙarar al'ada yana nuna ruwa ko rashin motsi a cikin kunnen tsakiya (misali otitis media tare da effusion); lebur mai lankwasa tare da babban girma yana nuna raɗaɗin eardrum ko buɗaɗɗen samun iska; Madaidaicin lanƙwasa tare da ƙaramin ƙara yana nuna toshewar bincike ko toshewar tashoshi.
Nau'in C: Kololuwar ya koma yankin matsa lamba mara kyau. Yana nuna ƙananan matsa lamba na kunne (misali eustachian tube dysfunction).
Hankali: Lanƙwan "Nau'in B" iri ɗaya yana nufin abubuwa daban-daban dangane da ƙarar tashar. Idan ba ku ba da ƙarar tashar zuwa hankali na wucin gadi ba, fassarar za ta zama cikakke kuma mai ɓatarwa. Kada a taɓa karanta nau'in tympanogram dabam da ƙara.
acoustic reflex
Acoustic reflex shine takushewar tsokar tsattsauran ra'ayi a tsakiyar kunne lokacin da aka shigar da isasshiyar sauti mai ƙarfi a cikin kunne. Wannan reflex yana ba da bayani game da amincin wasu sassa na hanyar saurare da reflex arc. Kasancewa, rashi da kofa na reflex suna da mahimmanci; Misali, rashin reflex a wasu alamu na iya ba da shawarar matsalar nau'in gudanarwa ko wani yanayi. Duk da haka, fassarorin reflex acoustic suna da rikitarwa kuma ba sa samar da ganewar asali kadai; Ana kimanta shi tare da audiogram, tympanometry da binciken asibiti.
Haɗa gwaje-gwaje
Ƙarfin a cikin ilimin jiwuwa ba a cikin gwaji ɗaya ba, amma a cikin daidaituwar gwaje-gwajen da juna. Teburin da ke ƙasa yana taƙaita alamu na yau da kullun; Duk da haka, waɗannan jagorori ne kuma ana kimanta kowane shari'a ɗaya ɗaya.
tympanogram
Yiwuwar yanayin kunnen tsakiya
Neman rakiyar akai-akai
Mataki na gaba
Nau'in A
kunnen tsakiya na al'ada
Za a iya samun siffa ta hankali
Haɗa tare da audiogram
Nau'in B (girma na al'ada)
ruwa/rashin motsi
Kewayon nau'in watsawa
Otoscopy + ENT kimantawa
Nau'in B (high girma)
Ramin membrane/bude bututu
Mai canzawa
Otoscopy + ENT
Nau'in C
mummunan matsa lamba
Bangaren watsa haske
Bi-biye / A cewar ENT
Mataki-mataki: goyon bayan sharhin immittance tare da basirar wucin gadi
- Ba da duk abubuwan haɗin gwiwa. Samar da nau'in tympanogram wanda ba'a san sunansa ba, matsa lamba mafi girma, ƙarar canal da binciken sautin murya.
- Haɗa tare da audiogram. Ƙara taƙaitaccen audiogram na majiyyaci iri ɗaya don AI zai iya zana daidaito.
- Iyakance rawar. Ka ce, "Kada ku yi ganewar asali; daga binciken da na ba ku za ku iya zana yiwuwar yanayin kunnen tsakiya, kada ku yi amfani da madaidaicin harshe."
- Nemi jajayen tutoci. Yi alamu waɗanda ƙila za su buƙaci mizani na ENT (misali Nau'in B guda ɗaya, tuhuma na huɗaɗɗen membrane) da aka yiwa alama daban.
- Tabbatar da gwajin asibiti. Kar a yarda da tympanogram kadai a sakamakon ba tare da binciken otoscopy ba, tarihi da jarrabawa.
- Matsar zuwa amincewar gwani/likita. Bayar da kimantawar ENT a cikin lamuran da ke buƙatar jagorar likita.
Rauni mai ƙarfi / Ƙarfi mai ƙarfi
Rawanin faɗakarwa:
Tympanogram ya dawo a kwance, menene majinyacin yake da shi?
Babu ƙarar canal, babu reflex acoustic, babu mahallin audiogram; Ya nemi a tantance ma'anar "me ke faruwa?" An tilasta AI don yin tsinkaya tare da bayanan da ba su cika ba.
Ƙarfi mai ƙarfi:
Matsayinku: Immittance comment daftarin mataimakin. Yin ganewar asali; Yi amfani da yaren "mai yiwuwa", rubuta bayanan da suka ɓace [babu bayanai]. Kunnen dama: tympanogram Type B, ƙarar canal tsakanin kewayon al'ada, babu kololuwa. Acoustic reflex: ba a gano ba. Takaitaccen Audiogram: ratar iska-kashi yana nan, tafiyar da kashi yana kusa da al'ada. Aiki: rubuta ko waɗannan binciken sun yi daidai da juna kuma su zana yiwuwar yanayin kunnen tsakiya; Yi alama inda za'a iya buƙatar mizanin ENT. Bayyana cewa yanke shawara ya rage ga ƙwararren/likita.
Ƙarfin faɗakarwa yana ba da duk abubuwan sinadaran, yana ɗaure shi da odiyo, ya hana madaidaicin harshe, kuma yana neman wurin neman magani.
uku mini lokuta
Case 1 - Daidaitaccen tsari. A cikin yaro mai shekaru 6, kunnen dama shine Nau'in B (ƙara na al'ada), ratar iska-kashi shine 30 dB, kuma ƙaddamar da kashi na al'ada ne. Masanin yana ciyar da binciken ga AI; YZ ya fayyace "daidai tare da nau'in nau'in sarrafawa da kuma yiwuwar ruwa na kunne na tsakiya; an ba da shawarar otoscopy da ENT." Ana ganin zubar da jini a kan otoscopy, ana kiran yaron zuwa ENT. Gwaje-gwajen sun tabbatar da juna, suna hanzarta rubuta rubutun AI.
Case 2 - Girman tarko. Kwararre yana ganin nau'in B amma ya tambayi AI ba tare da ba da ƙarar tashar ba. AI ta ce "mai yiwuwa ruwan tsakiyar kunne." Masanin ya lura cewa girman tashar yana da girma; A wannan lokacin teburin yana juyawa zuwa cikin ramin eardrum ko buɗaɗɗen bututu. Masanin yana ƙara ƙarar zuwa faɗakarwa kuma yana gyara daftarin. Darasi: tympanogram ba tare da ƙara ba shine rabin bayani.
Case 3 - Tutar ja. Baligi mara lafiya yana da Nau'in B na gefe da kuma wani ɓangaren jijiya da ba a bayyana ba a cikin wannan kunnen. Kwararrun yana duba daftarin tare da tace "jajen tuta". YZ yana tunatar da cewa binciken asymmetrical na iya buƙatar ƙarin kimantawar likita. Kwararren yana mayar da mara lafiya zuwa ENT; AI ya zama tunatarwa, yanke shawara ya kasance tare da gwani.
Samfuran gaggawar da za a iya kwafi
IMMITENCE HADIN KARIN TEMPLATE kimanta wannan taƙaitaccen nau'in tympanogram + ƙarar canal + acoustic reflex + audiogram tare. Shin binciken ya yi daidai da juna? Rubuta zane na yiwuwar yanayin kunnen tsakiya ta amfani da yare "mai yiwuwa". Bayanai: [bincike]
TEMPLATE KYAUTA KYAUTA KYAUTA tympanogram da na bayar shine Nau'in B. Girman Canal: [darajar]. Menene ma'anar ma'anoni masu santsi tare da wannan ƙarar? Kar a yi sharhi ba tare da ba da ƙara ba. Ba da sakamakon a matsayin jerin, yanke shawara ya kasance ga gwani.
JAN TUTAR SAMUN SAUKI Shin akwai wani tsari a cikin wannan immittance + binciken audiogram wanda zai iya buƙatar neman ENT/likita (misali asymmetry na gefe, wanda ake zargi da ɓarna membrane, ganowar da ba a bayyana ba)? Yi alama kuma rubuta dalilin da yasa kuke ba da shawarar turawa. Bayanai: [bincike]
AUDIOGRAM-IMMITENCE TEMPLATE CLOSS-IMMITENCE Idan audiogram yana nuna nau'in nau'in sarrafawa, shin ma'aunin bugun ya yi daidai da shi? Idan sabani, wanne maimaita gwaji/matakin asibiti aka bada shawarar? Bayanai: [takaice audiogram + tympanogram]
Kuskuren gama gari
- Ketare ƙarar tashar. Fassarar Nau'in B mai zaman kanta ba tare da ƙara ba; hadawa ramin membrane da ruwa.
- Kuskure tympanogram kadai don ganewar asali. Bayyana sakamako ba tare da otoscopy ba, tarihi da audiogram.
- Ƙarfafa fassarar sautin reflex. Yin tabbataccen ganewar asali daga ganowa guda ɗaya.
- Bacewar jan tuta. Samun nasara akan binciken asymmetric na ɗaya ba tare da buƙatar jagorar likita ba.
- Yin watsi da rikici tsakanin gwaje-gwaje. Tsallake maimaitawa/kimanin asibiti idan audiogram da tympanogram sun sami sabani.
A takaice
Tympanometry yana kimanta aiki na tsakiyar kunne, kuma acoustic reflex yana kimanta amincin hanyar sauraron. Nau'in Tympanogram (A, B, C) dole ne a karanta tare da ƙarar canal kuma a haɗa shi da audiogram, otoscopy da tarihi. AI na iya fayyace madaidaicin fassarar daga waɗannan binciken da kuma tunatar da jajayen tutoci waɗanda ke buƙatar neman ENT; amma ganewar asali, jagorar likita da yanke shawara na ƙarshe na likitan audio da likita.
Aikin aikace-aikace
Saita shari'ar da ba a bayyana sunanta ba, ƙirar ƙira: nau'in tympanogram + ƙarar canal + gano sautin murya + taƙaitaccen taƙaitaccen audiogram. Samo jita-jita tare da samfurin "haɗin kai", sannan a yi amfani da samfuri na "jajayen tuta". Sannan sake sake tambayar nau'in B iri ɗaya ta hanyar canza ƙarar tashar da gangan (misali, daga al'ada zuwa babba) kuma duba yadda fassarar ke canzawa. Wannan ya ƙunshi dalilin da ya sa girma ya zama makawa.
jerin abubuwan dubawa
- [ ] Na ba da nau'in tympanogram tare da ƙarar canal.
- [ ] Na ƙara ganowa acoustic reflex da taƙaitaccen odiyogram.
- [ ] Na tambayi AI don daftarin sharhi a cikin yaren "mai yiwuwa".
- [ ] Ina da alamar jajayen tuta/ ENT da aka yiwa alama daban.
- [] Na tabbatar da otoscopy da mahallin asibiti.
- [ ] Na isar da yanayin da ke buƙatar jagorar likita zuwa amincewar ƙwararren / likita.