I-cochlea yingxenye yendlebe yangaphakathi enikelwe ekuzweni. Ngakho-ke, lo mzila wethambo omise okomoya uqukethe isitho seCorti, esakhiwe ngamangqamuzana ezinwele athatha amaza omsindo ahlukene, lawa maseli azokhiqiza kuwo umyalezo wezinzwa. Ngenxa yomucu wezinzwa ozwakalayo, imininingwane izobe isidluliselwa ebuchosheni. EFrance, cishe abantu abangu-6,6% banokuzwa, futhi lokhu kuthinta abangafika kuma-65% kulabo abaneminyaka engaphezu kwengama-70. amaseli ku-cochlea, noma ngisho nasekugugeni, okunciphisa inani lamaseli ezinwele ezindlebeni. kwangaphakathi. Ngokuya ngezinga lokulahleka kokuzwa kanye nesidingo sesinxephezelo, kungafakwa ukufakwa kwe-cochlear, ikakhulukazi uma izinsiza-kuzwa zingenamandla anele okukhokhela ubuthulu. EFrance, unyaka ngamunye, ukufakwa okungu-1 kwalolu hlobo kuyenziwa.

Ngaphambili ibizwa ngokuthi "umnenke", i-cochlea yingxenye yendlebe yangaphakathi enikeza ukuzwa. Itholakala ethanjeni lesikhashana futhi ibizwa ngegama layo ngokugwedla kwayo okuvunguza. Ngakho-ke, umsuka we-etymological waleli gama uvela ku-Latin "cochlea", okusho ukuthi "umnenke", futhi, ngezikhathi zobukhosi, angaqoka izinto ezinesimo somoya. I-cochlea itholakala engxenyeni yokugcina yendlebe yangaphakathi lapho iseduze ne-labyrinth, isitho sebhalansi.

I-cochlea yakhiwa ama-canaliculi amathathu ahlanganiswe ngokuvunguza azungeze i-axis yamathambo ebizwa ngokuthi i-modiolus. Iqukethe isitho seCorti, esitholakala phakathi kwalezi ezimbili ze-canaliculi (okungukuthi, phakathi komsele we-cochlear nodonga lwe-tympanic). Lesi sitho sikaCorti siyisitho sezinzwa ezithinta izinzwa, futhi esinye sezazi zokwakheka komzimba sokuqala esasichaza sona saqanjwa ngokuthi u-Alfonso Corti (1822-1876). Yenziwe uketshezi kanye nezindonga ezimbozwe ngamangqamuzana ezinwele angaphakathi nangaphandle atholakala kulwelwesi lwawo lwe-basilar, i-cochlea izoguqula ukuzamazama koketshezi nezakhiwo ezisondelene kuzo kube ngumlayezo othusayo, futhi imininingwane izodluliselwa ebuchosheni ngomxhumanisi i-fiber yenzwa yokuzwa.

I-cochlea ibamba iqhaza elibalulekile ekuzweni, ngamaseli ezinwele zesitho sikaCorti. Eqinisweni, indlebe yangaphandle (efaka iphinikhoni yasemoyeni indima yayo ukukhulisa amaza kanye nomsele ongaphandle wokuhlola) iqinisekisa, ngendlebe ephakathi, ukuqhutshwa komsindo kuye endlebeni yangaphakathi. Futhi lapho, sibonga i-cochlea, isitho sale ndlebe yangaphakathi, ukuhanjiswa kwalo mlayezo kuzokwenziwa kuma-cochlear neurons, wona ngokwawo azowuthumela ebuchosheni nge-nerve auditory.

Ngakho-ke, umgomo wokusebenza kokuzwa ulandelayo: lapho imisindo isakazwa emoyeni, lokhu kubangela ukungqubuzana kwama-molecule omoya okunyakaza kwawo kuzodluliswa kusuka emthonjeni womsindo kuya eardrum yethu, ulwelwesi olusezansi kwendlebe yangaphandle umsele. Ulwelwesi lwe-tympanic, oluntengantenga njengesigubhu, bese ludlulisela lokhu kudlidlizela kuma-ossicles amathathu endlebe ephakathi eyenziwe ngesando, isembozo kanye ne-stirrup. Ngemuva kwalokho, ukudlidlizela koketshezi okwenziwe yi-caliper kuzodala ukuthi kusebenze ukusebenza kwamaseli ezinwele, akha i-cochlea, ngaleyo ndlela kwakheke amasiginali we-bi-kagesi ngendlela yemizwa yezinzwa. Lezi zimpawu zizoguqulwa futhi zichazwe ubuchopho bethu.

Amaseli ezinwele, ngokuya ngendawo akuyo e-cochlea, athatha amaza ahlukahlukene: empeleni, lawo atholakala emnyango we-cochlea azophinda aqondise amaza aphakeme, kanti lawo atholakala phezulu kwe-cochlea, amaza e-bass.

Okungahambi kahle kanye ne-pathologies ye-cochlea kuxhunyaniswe neqiniso lokuthi amangqamuzana ezinwele kubantu awavuseleli uma esonakele noma ebhujisiwe. Ngakolunye uhlangothi, ukuchayeka kwabo emisindweni ephezulu kakhulu kubangela ukubhujiswa kwabo. Ngakolunye uhlangothi, ukukhula ngeminyaka kunciphisa inani lamaseli ezinwele ezindlebeni zangaphakathi.

Ngakho-ke, i-acoustic overstimulation iyimbangela ye-sequelae eminingi ye-physiological ye-cochlea. Lokhu kubangelwa ukwenziwa kusebenze kwezinhlobo ze-oxygen esebenzayo (noma i-ROS, isikhathi eside ibhekwa njengemikhiqizo enobuthi ye-oxygen metabolism evamile futhi ihileleke ezintweni eziningi ezingavamile, kodwa abacwaningi abasanda kukhombisa ukuthi babambe iqhaza ekugcineni ibhalansi yamaseli). Lokhu kungezwani kubangelwa futhi i-apoptosis, ukufa okuhleliwe kwamangqamuzana ezinwele.

Ngokuqondile, isifundo sesayensi esenziwe e2016, ikakhulukazi, sikhombisile ukuthi ukusayinwa kwe-calcium yangaphakathi (Ca²⁺) wabandakanyeka ezinhlelweni zokuqala ze-pathophysiological ze-cochlea, kulandela ukuvezwa ngokweqile komsindo. Futhi-ke, kufanele kuqashelwe ukuthi ukuhlukumezeka kwe-acoustic okudalwe yimisindo eyeqile, namuhla, isigaba sokuqala sezici zokungezwa.

Ukufakwa kwe-cochlear ukwelashwa okukhonjisiwe ukusungula ukuzwa okusebenzayo ezimweni ezithile zokungezwa okujulile kwamazwe womabili, futhi lapho izinsiza ezijwayelekile zokuzwa zinganele. Ukubekwa kwalokhu kufakelwa njalo kufanele kwandulelwe yisivivinyo sokufakelwa. Isimiso sokufakwa lokhu? Beka ku-cochlea inqwaba yama-electrode ezokwenza ugesi uvuselele imizwa ngokuya ngemisindo yemisindo ethathwa yingxenye yangaphandle yokufakwa. EFrance, ukufakwa okungu-1500 kwalolu hlobo kwenziwa minyaka yonke.

Ngaphezu kwalokho, ukubekwa kokufakwa kwe-brainstem nakho kungenzeka, esimweni lapho i-cochlear nerve ingasasebenzi khona, ngakho-ke ukuvimbela ukufakwa kwe-cochlear. Lokhu kushoda kwe-cochlear nerve kungaxhunyaniswa, ikakhulukazi, nokususwa kwesimila sendawo noma kwi-anatomical anomaly. Lezi zinhlayiya ze-brainstem, empeleni, ziye zazuza kubuchwepheshe obenzelwe ukufakelwa ama-cochlear.

Ubuthakathaka, nakho kwesinye isikhathi kubizwa njengokulahleka kokuzwa, kubhekisa ekwehleni kobuthakathaka bokuzwa. Kunezimo ezingavamile zokungezwa okuphakathi (okubandakanya ubuchopho) kepha ezimweni eziningi, ubumpumputhe buxhunyaniswa nokushoda endlebeni:

• ukulahleka kokuzwa okuphathekayo kungenxa yendlebe yangaphandle noma ephakathi;
• Ukulahlekelwa kokuzwa kwe-sensorineural (okubizwa nangokuthi ukulahleka kokuzwa kwe-sensorineural) kubangelwa ukwehluleka endlebeni yangaphakathi.

Kulezi zigaba ezimbili, ubuthulu obuthile buyizakhi zofuzo, kanti ezinye ziyatholakala.

Ukungasebenzi kahle kwendlebe yangaphakathi, ngakho-ke i-cochlea, kungumsuka wokungezwa kwe-sensorineural (of perception): kuvamise ukukhombisa izilonda zamaseli ezinwele noma i-nerve auditory.

Izinga legolide lokuhlola izinga lomsindo ozwakalayo endlebeni yi-audiogram. Yenziwa ngudokotela wezwi noma i-acoustician yezwi lokuzwa, i-audiogram ngakho-ke izovumela ukuxilongwa kokulahleka kokuzwa kwezinzwa: lolu vivinyo lokuzwa luzohlola ukulahleka kokuzwa, kodwa futhi lilinganise.

KwakungoSepthemba 1976 lapho ukufakelwa kokuqala kwe-multi-electrode intracochlear kwenziwa, kwenziwa, kwavunyelwa futhi kwafakwa. Empeleni, ngokuqhubeka nomsebenzi waseFrance waseDjourno no-Eyries lapho udokotela nodokotela ohlinzayo onguchwepheshe we-otolaryngology uClaude-Henri Chouard, esizwa ithimba lakhe lesibhedlela iSaint-Antoine, ezokwakha khona lokhu kufakwa. Ngenxa yezimbangela eziningi zezomnotho kepha nezimboni, ukwakhiwa nokumaketha kokufakwa kwe-cochlear ngeshwa, eminyakeni engamashumi amane kamuva, kweqe ngokuphelele eFrance. Ngakho-ke, yizinkampani ezine kuphela emhlabeni manje ezenza le misebenzi futhi ziyi-Australia, iSwitzerland, i-Austrian neDenmark.

Ekugcineni, qaphela: i-cochlea, phakathi kwazo zonke izimfanelo zayo ezinhle, inenye engaziwa kangako, kodwa ewusizo kakhulu kubavubukuli: ingabasiza impela ukuthi babone ubulili bamathambo. I-cochlea itholakala ethanjeni elinzima kakhulu logebhezi - idwala lethambo lesikhashana -, futhi kuzokwenzeka, ngokusebenzisa inqubo ethile yemivubukulo, ukusungula, ngenxa yayo, ubulili basendulo kakhulu, noma ngabe izinsalela hhayi. Futhi lokhu, noma kukhulunywa ngezicucu.