Ishubhu le-Eustachian (eliqanjwe ngesazi sokwakheka kwendlebe yase-Italy u-Bartolomea Eustachio), manje esibizwa ngokuthi ithubhu lendlebe, liwumsele oxhuma indlebe emaphakathi ne-nasopharynx. Kungaba yindawo yezifo ezahlukahlukene ezinemiphumela ekuzweni okuhle.

Yakhiwe ingxenye yamathambo angemuva kanye nengxenye yangaphambili yemvelo ye-fibro-cartilaginous, ishubhu le-Eustachian liwumsele ogobe kancane ubheke phezulu, ukala cishe u-3 cm ubude no-1 kuya ku-3 mm ububanzi uma usumdala. Ixhuma indlebe ephakathi (eyakhiwe yi-tympanic cavity kanye neketango le-tympano-ossicular elakhiwe ama-ossicles angu-3) engxenyeni engenhla yomphimbo, i-nasopharynx. Ivula eceleni ngemuva komgodi wamakhala.

Njengevalvu, ishubhu le-eustachian liyavuleka ngesikhathi sokugwinya nokuzamula. Ngakho yenza kube nokwenzeka ukujikeleza umoya endlebeni nokugcina ukucindezela okufanayo ezinhlangothini zombili ze-membrane ye-tympanic, phakathi kwendlebe yangaphakathi nangaphandle. Iphinde iqinisekise ukungena komoya wendlebe ephakathi nendawo kanye namapayipi abheke emphinjeni wezimfihlo zendlebe, ngaleyo ndlela kugweme ukuqongelelwa kwezicubu ze-serous emgodini we-eardrum. Ngemisebenzi yayo yokuvikela nokuvikela izivikeli mzimba kanye nemishini, ithubhu le-Eustachian lifaka isandla ebuqothweni bomzimba nasekusebenzeni kahle kohlelo lwe-tympano-ossicular, ngakho-ke ekuzweni kahle.

Qaphela ukuthi ukuvulwa kweshubhu le-Eustachian kungenziwa asebenzayo ngokushesha nje lapho ukucindezela komkhathi kwanda, ngokugwinya okulula uma ukuhluka kwengcindezi phakathi komzimba nangaphandle kubuthakathaka, njengoba kunjalo ngokwesibonelo lapho wehla endizeni, emhubheni, njll., Ukuvimbela izindlebe "zingaphumi" ”, noma ngokuqondisa okuhlukahlukene okuyisinxephezelo (Vasalva, Frenzel, BTV) lapho ingcindezi yangaphandle ikhula ngokushesha, njengaku-freediver.

Ezinsaneni nasezinganeni, ithubhu le-eustachian lifushane (lingaba ngu-18 mm ubude) futhi liqondile. Ngakho-ke izimfihlo ze-nasopharyngeal zivame ukukhuphukela endlebeni yangaphakathi - i-fortiori ngaphandle kokuhlanza ikhala noma ukuphefumula okuphumelelayo - okungase kuholele ku-acute otitis media (AOM), ebonakala ngokuvuvukala kwendlebe ephakathi nokuba khona kwe-retrotympanic fluid. . Uma ishiywe ingalashwa, i-otitis ihambisana nokulahlekelwa ukuzwa ngenxa yoketshezi ngemuva kwe-eardrum. Lokhu kulahleka kwesikhashana kokuzwa kungaba ngumthombo, ezinganeni, wokubambezeleka kolimi, izinkinga zokuziphatha noma ubunzima bezemfundo. Ingase futhi ithuthukele ku-otitis engapheli, phakathi kwezinye izinkinga, ukulahlekelwa ukuzwa ngokubhobozwa kwe-eardrum noma ukulimala kwama-ossicles.

Noma ngabe kubantu abadala, ishubhu le-eustachian lide futhi ligobile kancane esimweni, alivikelekile ezinkingeni. Ishubhu le-Eustachian livuleka lingene embotsheni yamakhala ngembobo encane engase ivaleke kalula; i-isthmus yayo ewumngcingo nayo ingavimbeka kalula. Ukuvuvukala kolwelwesi lwekhala ngesikhathi somkhuhlane, i-rhinitis noma isiqephu se-allergies, i-adenoids, ama-polyps ekhaleni, isimila esibucayi se-cavum singavimba ishubhu le-eustachian futhi kuvimbele ukungena komoya okulungile kwendlebe ephakathi, okuholela ezimpawu ezijwayelekile. : umuzwa wokuba indlebe ixhunywe, ukuzwa umuntu ekhuluma, ukuchofoza indlebe lapho ugwinya noma lapho uzamula, i-tinnitus, njll.

Ukungasebenzi kahle kwe-tubal kubonakala ngokuvinjwa kwe-eustachian tube. Lokhu kungaba mncane kakhulu futhi kuvuleke kabi ngokomzimba, ngaphandle kokutholakala kwe-pathology, ngaphandle kokuhlukile kwe-anatomical. I-proboscis ayisadlali indima yayo kahle, ukuphefumula komoya kanye nokulinganisa kwengcindezi phakathi kwendlebe emaphakathi nendawo akusaqhubeki kahle, njengoba kwenza ukugeleza kwamanzi. I-serous secretions bese iqoqa emgodini we-tympanic. I-otitis media engapheli.

Ukungasebenzi kahle kweshubhu le-Eustachian nakho kungagcina kuholele ekwakhekeni kwephakethe lokuhlehla le-eardrum (ukuhoxiswa kwesikhumba se-tympanic membrane) okungaholela ekulahlekelweni kokuzwa futhi kwezinye izimo ukubhujiswa. ama-ossicles.

I-Patulous's Eustachian tube, noma i-tubal open bite, iyisimo esiyivelakancane kakhulu. Kubonakala ngokuvulwa okungavamile, ngezikhathi ezithile, kweshubhu le-eustachian. Umuntu uyabe esezizwa ekhuluma, isigubhu sendlebe sidlala njenge-resonance chamber.

Uma kwenzeka ukuphindaphinda kwe-acute otitis media, ukuhoxiswa kwe-tympanic, i-serum-mucous otitis enemiphumela yokuzwa nokumelana nokwelashwa, ukufakwa ngaphansi kwe-anesthesia ejwayelekile ye-trans-tympanic aerators, evame ukubizwa ngokuthi i-yoyos, kungase kuphakanyiswe. . Lezi yizinhlelo ezifakwe ngaphakathi kwe-eardrum ukuhlinzeka umoya ngendlebe ephakathi.

Okwenziwa abelaphi benkulumo kanye nama-physiotherapist, ukuvuselelwa kweshubhu kungase kunikelwe ezimeni ezithile zokungasebenzi kahle kweshubhu. Lezi zivivinyo zemisipha kanye nezindlela zokuzikhukhumeza okuhloswe ngazo ukwandisa ukusebenza kahle kwemisipha ehilelekile ekuvuleni ithubhu le-eustachian.

I-balloon tuboplasty, noma i-balloon tubal dilation, inikezwe kwezinye izikhungo iminyaka eminingana. Lokhu kungenelela kokuhlinzwa okuthuthukiswe ngu-ENT kanye nomcwaningi waseJalimane u-Holger Sudhoff kuhlanganisa ukufaka, ngaphansi kwe-anesthesia ejwayelekile, i-catheter encane e-Eustachian tube, usebenzisa i-microendoscope. Ibhaluni elingu-10 mm ambalwa bese lifakwa kubhubhu bese lifuthwa kamnandi imizuzu emi-2, ukuze kunwetshwe ishubhu futhi ngaleyo ndlela livumele ukugeleza okungcono kwemfihlo. Lokhu kuthinta iziguli zabantu abadala kuphela, abathwali bokungasebenzi kahle kweshubhu le-eustachian elinemiphumela endlebeni.

Ukuhlola ukusebenza kwe-tubal, udokotela we-ENT unokuhlolwa okuhlukahlukene: 

• i-otoscopy, okuwukuhlolwa okubonakalayo komsele wezindlebe usebenzisa i-otoscope;
• audiometry ukuqapha ukuzwa
• I-tympanometry yenziwa kusetshenziswa idivayisi ebizwa ngokuthi i-tympanometer. Iza ngendlela ye-plastic probe ethambile efakwe kumsele wendlebe. Isisusa somsindo sikhiqizwa endlebeni. Ku-probe efanayo, i-mouthpiece yesibili yokurekhoda umsindo obuyiselwe ulwelwesi lwe-tympanic ukuze kutholakale amandla ayo. Ngalesi sikhathi, idivayisi ezenzakalelayo yenza kube lula ukushintsha ukubonga kwengcindezi kumshini wepompo we-vacuum. Imiphumela idluliswa ngendlela yejika. I-Tympanometry ingasetshenziselwa ukuhlola ukutholakala koketshezi endlebeni ephakathi, ukuhamba kohlelo lwe-tympano-ossicular kanye nomthamo womsele wokuhlola wangaphandle. Kwenza kube nokwenzeka ukwenza ukuxilongwa, phakathi kwezinye izinto, i-acute otitis media, ukungasebenzi kwe-tubal;
• i-nasofibroscopy;
• isithwebuli noma i-IMR.