Phukusi la Eustachian (lotchedwa dzina la Bartolomea Eustachio), yemwe tsopano amatchedwa chubu la khutu, ndi ngalande yolumikiza khutu lapakati ndi nasopharynx. Atha kukhala tsamba lamatenda osiyanasiyana okhala ndi zotsatira zakumva bwino.

Wopangidwa ndi gawo lakumbuyo kwa mafupa ndi gawo lakumbuyo kwa mawonekedwe am'mimba, chubu la Eustachian ndi ngalande yopingasa pang'ono kumtunda, yotalika pafupifupi 3 cm kutalika ndi 1 mpaka 3 mm m'mimba mwake ali wamkulu. Amalumikiza khutu lapakati (lopangidwa ndi tympanic cavity ndi unyolo wa tympano-ossicular wopangidwa ndi ma ossicles atatu) kupita kumtunda kwa khosi, nasopharynx. Imatseguka mozungulira kumbuyo kwa mphuno.

Monga valavu, chubu cha eustachi chimatseguka mukamameza ndi kuyasamula. Potero zimapangitsa kuti mpweya uziyenda khutu komanso kupsinjika komweko mbali zonse ziwiri za nembanemba ya tympanic, pakati pa khutu lamkati ndi kunja. Zimatsimikiziranso kuti mpweya wabwino wa khutu lapakati komanso ngalande yolowera kummero kwa zotulutsa khutu, motero zimapewa kusungunuka kwa timadzi tating'onoting'ono m'mimbamo ya khutu. Kupyolera mu ntchito zake za chitetezo ndi chitetezo cha mthupi ndi makina, chubu la Eustachian limathandizira kuti thupi likhale lolimba komanso liziyenda bwino la tympano-ossicular system, motero kumvetsera bwino.

Dziwani kuti kutsegulidwa kwa chubu cha Eustachi kungachitike yogwira kuthamanga kwamlengalenga kukachulukirachulukira, ndikumeza kosavuta ngati kusiyanasiyana pakati pa thupi ndi akunja kuli kofooka, monga momwe zimakhalira mwachitsanzo mukatsika ndege, mumphangayo, ndi zina zambiri, kuteteza makutu "osachedwa ”, Kapena mwa njira zingapo zolipira (Vasalva, Frenzel, BTV) pomwe kukakamiza kwakunja kumakulirakulira mwachangu, monganso wolandila ufulu.

Kwa makanda ndi ana, chubu cha eustachian ndi chachifupi (pafupifupi 18 mm kutalika) komanso chowongoka. Zotupa za nasopharyngeal zimakonda kupita kukhutu lamkati - fortiori osatsuka mphuno kapena kuphulika bwino - komwe kumatha kubweretsa ku otitis media (AOM), yodziwika ndi kutupa kwa khutu lapakati ndikupezeka kwa retrotympanic fluid. . Ngati sanalandire chithandizo, otitis imatsagana ndi kutayika kwakumva chifukwa cha madzimadzi kuseri kwa eardrum. Kutayika kwakanthawi kwakanthawi kumeneku kumatha kukhala gwero, mwa ana, lochedwa chilankhulo, zovuta zamakhalidwe kapena zovuta zamaphunziro. Itha kupitilirabe mpaka ku otitis osachiritsika ndi, mwazovuta zina, kutaya kwakumva kudzera pakhungu la khutu kapena kuwonongeka kwa ossicles.

Ngakhale atakhala akuluakulu, chubu cha eustachian chimakhala chachitali komanso chopindika pang'ono, sichikhala ndi mavuto. Chubu cha Eustachian chimatsegukira m'ming'alu kudzera m'kanyumba kakang'ono kamene kakhoza kutsekedwa mosavuta; dera lake laling'ono limatha kutsekedwa mosavuta. Kutupa kwa m'mphuno nthawi ya chimfine, rhinitis kapena vuto linalake, adenoids, ma polyps m'mphuno, chotupa chosaopsa cha cavum chitha kulepheretsa chubu cha eustachian ndikuletsa mpweya wabwino wa khutu lapakati, zomwe zimabweretsa zizindikilo : kumva kuti khutu lanu latsegulidwa, kumva kuti mukumva kulankhula, kudina khutu mukameza kapena mukamayasamula, tinnitus, ndi zina zambiri.

Kulephera kwa Tubal kumadziwikanso ndi kutsekeka kwa chubu cha eustachian. Izi zitha kukhala zopyapyala kwambiri komanso osatseguka mwakuthupi, popanda matenda aliwonse omwe amapezeka, kupatula mawonekedwe amtundu wa anatomical. Chombochi sichimagwira ntchito yake bwino, mpweya wabwino ndi kuthamanga pakati pa khutu lapakati ndi chilengedwe sizikuchitikanso moyenera, monganso ngalande. Zilonda zam'madzi zimadzikundikira mumimbayo. Ndi otitis media.

Kulephera kwa chubu la Eustachian kumathandizanso kuti pakhale thumba lochotsera m'makutu (kutulutsa khungu la tympanic nembanemba) komwe kumatha kudzetsa vuto lakumva ndipo nthawi zina kuwonongedwa. zolemba.

Chubu cha Patust's Eustachian, kapena tubal bite bite, ndichinthu chovuta kwambiri. Amadziwika ndi kutseguka kwachilendo, kwakanthawi, kwa chubu cha eustachian. Munthuyo amatha kumva kuti akuyankhula, eardrum ikusewera ngati chipinda chokomera.

Pakachitika mobwerezabwereza otitis media, kuchotsedwa kwa tympanic, serum-mucous otitis yomwe ili ndi zotsatira zoyipa komanso kukana chithandizo chamankhwala, kuyika pansi pa anesthesia ya ma trans-tympanic aerators, omwe amadziwika kuti yoyos, atha kufunsidwa. . Awa ndi machitidwe ophatikizidwa mu khutu la khutu kuti pakhale mpweya wabwino pakati khutu.

Omwe amalankhula olankhula ndi ma physiotherapists, kukonzanso kwamachubu kumatha kuperekedwa nthawi zina chifukwa cha kulephera kwa tubal. Izi ndizochita masewera olimbitsa thupi komanso njira zodzipezera ndalama zomwe cholinga chake ndi kukulitsa kuthekera kwa minofu yomwe ikukhudzidwa kuti atsegule chubu cha eustachian.

Balloon tuboplasty, kapena balloon tubal dilation, idaperekedwa m'malo ena kwazaka zingapo. Kuchita izi opaleshoni yopangidwa ndi ENT komanso wofufuza waku Germany a Holger Sudhoff kumaphatikizapo kuyika, pansi pa anesthesia wamba, catheter yaying'ono mu chubu la Eustachian, pogwiritsa ntchito microendoscope. Baluni ya mamilimita angapo a 10 mm imalowetsedwa mu chubu kenako ndikuthira bwino kwa mphindi ziwiri, kuti ichepetse chubu ndikulola kutulutsa bwino kwa madzi. Izi zimakhudza odwala okhawo akulu, onyamula ma eustachian chubu kukanika ndi zomwe zimakhudza khutu.

Kuti awone momwe tubal imagwirira ntchito, dokotala wa ENT ali ndi mayeso osiyanasiyana: 

• otoscopy, yomwe imawunika kuwunika kwa ngalande yamakutu pogwiritsa ntchito otoscope;
• audiometry kuwunika kumva
• tympanometry imagwiritsidwa ntchito pogwiritsa ntchito chipangizo chotchedwa tympanometer. Imabwera ngati kafukufuku wofewa wa pulasitiki wolowetsedwa mu ngalande ya khutu. Chochititsa chidwi chimapangidwa mu ngalande ya khutu. Mufukufuku womwewo, cholankhulira chachiwiri cholemba mawu omwe abwerera ndi nembanemba ya tympanic kuti adziwe mphamvu yake. Munthawi imeneyi, chida chodziwikiratu chimapangitsa kuthekera kosiyanasiyana kukakamiza chifukwa chazida zopopera. Zotsatira zimafalikira ngati mawonekedwe. Tympanometry itha kugwiritsidwa ntchito poyang'ana kupezeka kwa madzimadzi pakati pakhutu, kuyenda kwa dongosolo la tympano-ossicular komanso kuchuluka kwa ngalande yakunja. Zimapangitsa kuti matendawa, pakati pazinthu zina, akhale a otitis media, kutsekeka kwamachubu;
• nasofibroscopy;
• chojambulira kapena IMR.