Pakafika zaka zisanu, pafupifupi mwana aliyense wakhala akumana ndi kachilombo kamodzi ka HIV. Matenda ambiri amamva amadzipangira okha (mavairasi) kapena amachiritsidwa ndi antibiotic (mabakiteriya). Koma nthawi zina, matenda a khutu ndi / kapena zamadzimadzi pakati pa khutu zingakhale vuto lalikulu lomwe limayambitsa mavuto ena monga kumva kutaya, khalidwe, ndi mavuto.
M'mayesero awa, kuyika kwa chubu la khutu ndi otolaryngologist (khutu, mphuno, ndi mpweya wa opaleshoni) angaganizidwe.
Miphika yamkati ndi timing'onoting'ono tomwe timayika pamphuno (tympanic membrane) kuti tipeze mpweya pakatikati. Angathenso kutchedwa tympanostomy tubes, myringotomy tubes, machubu a mpweya, kapena PE (pressure equalization).
Miphika imeneyi ingapangidwe ndi pulasitiki, zitsulo, kapena Teflon ndipo ikhoza kukhala ndi chofunda chochepetsera kuchepa kwa matenda. Pali mitundu iwiri yofunikira ya mabala a khutu: nthawi yayitali komanso yayitali. Miphika yaifupi ndi yaying'ono ndipo nthawi zambiri imakhalapo kwa miyezi isanu ndi umodzi pachaka isanayambe yodwala. Miphika ya nthawi yayitali ndi yaikulu ndipo imakhala ndi mapuloteni omwe amawateteza nthawi yaitali. Mipata ya nthawi yayitali ingawonongeke yokha, koma kuchotsedwa ndi otolaryngologist nthawi zambiri n'kofunika.
Nthawi zambiri anthu amatha kupopera mabala a makutu pamene munthu amamva mobwerezabwereza matenda opweteka pakati pa makutu (kapena otitis media) kapena ali ndi vuto lokumva chifukwa cha kukhalapo kwapakatikati kwa khutu lakumutu (otitis media ndi effusion).
Izi zimachitika makamaka kwa ana, koma zimatha kuchitanso achinyamata komanso akuluakulu ndipo zingayambitse kuyankhula ndi kuthetsa mavuto, kuchepa kwa kumva, kapena kusintha kwa kapangidwe kake. Zinthu zina zochepa zomwe zimachititsa kuti makutu amvekedwe amatha kukhala ndi vuto la eardrum kapena Eustachian chubu, Down Syndrome , cleft palate , ndi barotrauma (kuvulala kwa khutu lakati lomwe limapangitsa kuchepetsa kuthamanga kwa mpweya), zomwe zimawoneka ndi kusintha kwazitali monga ndege kusambira pansi pamadzi.
Chaka chilichonse, opaleshoni ya opaleshoni ya makutu oposa theka la milioni amachitidwa pa ana, ndipo amachititsa opaleshoni yocheperapo ana ali ndi anesthesia. Avareji ya zaka zowonjezera makutu amodzi ndi a zaka zitatu. Kuika makutu a khutu kumatha:
- kuchepetsa chiopsezo cha matenda a makutu amtsogolo
- kubwezeretsanso kumva kumva chifukwa cha khutu lamkati pakati
- kukulitsa mavuto a kulankhula ndi mavuto oyenera, ndi
- kusintha khalidwe ndi kugona chifukwa cha matenda akuluakulu.
Miphika yamkati imayikidwa kudzera mu njira yopaleshoni yopita kuchipatala yotchedwa myringotomy . Myringotomy imatanthawuza kutengeka (dzenje) m'dothi la tymanic kapena tympanic. Izi zimachitika kawirikawiri pang'onopang'ono pogwiritsa ntchito kachipangizo kakang'ono ka opaleshoni kamene kali ndi kanyumba kakang'ono (kapeni kakang'ono), komabe kangathe kukwaniritsidwanso ndi laser. Ngati phula la khutu sililowetsedwa, dzenje likhoza kuchiza ndi kutseka mkati mwa masiku angapo. Pofuna kupewa izi, phula la khutu limayikidwa mu dzenje kuti likhale lotseguka komanso kulola mpweya kuti ufike pakati pa khutu lakumutu.
Mankhwala osakanikirana amodzi amathandizidwa kwa ana aang'ono. Ana ena okalamba ndi akuluakulu angathe kulekerera ndondomekoyi popanda kupweteka. A myringotomy imachitidwa ndipo madzi oundana kumbuyo kwa denga (pakatikati mwa khutu danga) amachotsedwa.
Phukusi la khutu limayikidwa mu dzenje. Madontho akumutu angaperekedwe pambuyo phukusi la khutu limayikidwa ndipo zingakhale zofunikira kwa masiku angapo. Njirayi imakhala yosachepera mphindi 15 ndipo odwala amadzuka mofulumira.
Nthawi zina otolaryngologist amavomereza kuchotsa minofu ya adenoid ( minofu yam'mimba yomwe ili pamwamba pamphepete mwa mphuno) pamene makutu amkati akuyikidwa. Izi nthawi zambiri zimaganiziridwa ngati kubwereza chubu ndikufunika. Kafukufuku wamakono akuwonetsa kuti kuchotsa minofu ya adenoid yokhazikika ndi kukhazikitsidwa kwa makutu a khutu kumachepetsa chiopsezo cha matenda opatsirana afupipafupi ndi kufunikira kwa opaleshoni yowonjezereka.
Pambuyo pa opaleshoni, wodwalayo akuyang'aniridwa m'chipinda chotsezeramo ndipo nthawi zambiri amapita kunyumba mkati mwa ora ngati palibe mavuto. Odwala nthawi zambiri amamva kupweteka pang'ono kapena kupwetekedwa koma kupwetekedwa mtima, kupsa mtima, ndi / kapena kunyozedwa kwa anesthesia kumachitika kanthawi.
Kumva kutayika kumene kumayambira pakati pa makutu amchere kumatanganidwa nthawi yomweyo ndi opaleshoni. Nthawi zina ana amamva bwino kwambiri moti amadandaula kuti ziwomveka bwino zikuwoneka mokweza.
Otolaryngologist amapereka malangizo apadera kwa wodwala aliyense kuphatikizapo nthawi yoti ayang'anire mwamsangamsanga ndi otsogolera. Angathe kupatsanso madontho a antibiotic kwa masiku angapo.
Pofuna kupewa mabakiteriya kuti alowe mkati mwa khutu la mpweya wabwino, madokotala angalimbikitse kusunga makutu pogwiritsa ntchito makutu kapena zipangizo zina zamadzi panthawi yosamba, kusambira, ndi madzi. Komabe, kafukufuku waposachedwapa amasonyeza kuti kuteteza khutu sikungakhale kofunikira, pokhapokha pamene kumayenda kapena kugwira ntchito yamadzi m'madzi osayera monga nyanja ndi mitsinje. Makolo ayenera kufunsa dokotala wodwalayo za chitetezo cha khutu pambuyo pa opaleshoni.
Kuyankhulana ndi opaleshoni ya otolaryngologist (kumvetsera, mphuno ndi kupweteka kwa khosi) kungakhale koyenera ngati inu kapena mwana wanu mwakhala mukukumana ndi matenda opatsirana mobwerezabwereza kapena ovuta, matenda a khutu omwe sathetsedwe ndi antibiotics, kutaya kwa kumva chifukwa cha madzi pakati, khutu la barotrauma, kapena kukhala ndi chinthu chachilendo chomwe chimalepheretsa kumutu kwa khutu.
Myringotomy ndi kuika makutu a makutu ndi njira yodziwika bwino komanso yotetezeka ndi zovuta zambiri. Pamene mavuto amapezeka, angaphatikizepo:
Kuperewera - Izi zikhoza kuchitika pamene chubu ikhoza kutuluka kapena phukusi lakutali litachotsedwa ndipo dzenje la tympanic (khutu la khutu) silitseka. Mphuno imatha kupangidwa kudzera mu njira yachipatala yaying'ono yotchedwa tympanoplasty kapena myringoplasty.
Kuwopsya - Kukhumudwa kulikonse kwa matenda osokoneza bongo, kuphatikizapo kubwereza mobwerezabwereza kwa makutu a khutu, kungayambitse matenda otchedwa tympanosclerosis kapena myringosclerosis. Nthaŵi zambiri, izi zimabweretsa mavuto.
Matenda - Matenda a makutu angathe kuchitika pakati pa khutu kapena pafupi ndi khutu la khutu. Komabe, matendawa kawirikawiri amakhala ochepa, amachititsa kuchepa pang'ono, ndipo amachiritsika mosavuta - nthawi zambiri pamatope. Nthawi zina mankhwala am'kamwa amathabe.
Ziphuphu zamphuno zimatulukira kwambiri kwambiri kapena zimakhala motalika kwambiri - Ngati phokoso la khutu limatuluka kuchokera kumutu mwamsanga (zomwe sizingatheke), madzi amatha kubwerera ndi kubwereza opaleshoni. Miphika yamakutu yomwe yayitali kwambiri ingayambitse kupweteka kapena kufunika kuchotsedwa ndi otolaryngologist.
> Zotsatira:
> Zamakono zamakono zovuta otitis media. Weber SM - Pachipatala chakumayi North Am - 01-APR-2003; 50 (2): 399-411.
> Mitu yodziwika mu matenda a otolaryngology. MP Pizzuto MP - Pachipatala Clin Clin North Am - 01-AUG-1998; 45 (4): 973-91.
> Tippanostomy tubes: mitundu, zizindikiro, njira, ndi mavuto. Morris MS - Chipatala cha Otolaryngol North Am - 01-JUN-1999; 32 (3): 385-90.
> Paradise JL, Feldman HM, Campbell TF, Dollaghan CA, DK Colborn, Bernard BS, et al. N Engl J Med 2001; 344: 1179-87.
> Zotsatira zapamwamba za moyo mutatha kuchita opaleshoni kwa otitis media. Richards M - Chigoba Chakumutu cha Otolaryngol - 01-JUL-2002; 128 (7): 776-82.
> Mphamvu ya tippanostomy tubes pa khalidwe la mwana wa moyo. Rosenfeld RM - Chitsulo Chotsitsa Chotsatira Mutu - 01-MAY-2000; 126 (5): 585-92.