Matenda a Frey amadziwikanso kuti amawotcha thukuta kapena amafinya hyperhidrosis
Pambuyo kudya zakudya zotentha ndi zokometsera, anthu ena amawuluka kuchokera kumaso-milomo, mphumi, mphuno, ndi khungu. Kwa ambiri, reflexinovascular reflex imeneyi ndi yachilendo.
Komabe, kulumpha kuchokera kumaso mukatha kudya mtundu uliwonse wa chakudya ndi chizindikiro cha matenda omwe amatchedwa kutukuta, kapena kuti hyperhidrosis. Kuwonjezera pamenepo, kutuluka kwa thukuta sikungangokhala kokhafunafuna chakudya koma komanso kuganiza kapena kulankhula za chakudya.
Zizindikiro zowoneka ngati thukuta, kutuluka thukuta, kufiira, ndi kuvutika kwakukulu zimakhala pamasaya. Zosazolowereka, anthu omwe ali ndi vutoli amamva kutentha kapena kupweteka ndi kutafuna.
Kutuluka thukuta kungakhale kovuta kwambiri ndipo kumakhudza kwambiri khalidwe la munthu. Malingana ndi Sood ndi olemba mabuku, kutukumula "kungachititse kuti anthu asamagwirizane kwambiri chifukwa chosowa nthawi zonse kuti azikhala panyumba." Mwa kuyankhula kwina, kufunika koti nthawi zonse "kutulutsa" thukuta kungakhale kovuta kwa ena kuchoka panyumbamo.
Ambiri omwe amawotchedwa hyperhidrosis ndi ma Frey syndrome. Matenda a frey amatanthauza kutuluka thukuta komanso kuthamanga pamagazi a auriculotemporal. Mitsempha yotchedwa auriculotemporal imapereka chidwi kumbali ya mutu. Matenda a frey amatchedwanso mchere wa hyperhidrosis.
Kodi Frey Syndrome N'chiyani?
Matenda a frey ndi osowa, osachepera 20,000 a ku America omwe amapezeka chaka chilichonse.
Chofunika kwambiri, matenda a Frey amachokera ku zolakwika zomwe zimachititsa kuti mitsempha yothandizidwa ndi salivation, thukuta, ndi kuthamanga. Limatchulidwa ndi katswiri wa zamagulu a ku France Lucia Frey, yemwe anafotokoza kuti matendawa ndi "auriculotemporal nerve syndrome" mu 1923.
Frey anasindikiza lipoti lonena za matenda ake omwe sanawoneke pambuyo pochiza msirikali wa ku Poland amene adamva thukuta atatha kulandira chilonda chokhudza kachilombo ka parotid .
Gland yamapiri ndi yaikulu kwambiri pa glands ndipo imapezeka pamsaya wa tsaya. Amapanga phula, yomwe imathandiza kumeta ndi kudyetsa chakudya. Ngakhale Frey sanali dokotala woyamba kuti adziŵe vutoli, ndiye anali woyamba kugwiritsira ntchito mitsempha ya auriculotemporal pakukula kwa matendawa.
Kutulutsidwa kwa mphutsi ndi chigoba cha parotid ndikulumikizana ndi ndondomeko yovuta yomwe imaphatikizapo mitsempha ya auriculotemporal. Kwa anthu omwe ali ndi matenda a Frey, atapwetekedwa ndi mitsempha ya auriculotemporal, mitsempha iyi imabweretsanso mosavuta. M'malo mongopereka chithandizo chokhalitsa pamatenda amtunduwu, zomwe zimapangitsa kuti thupi likhale labwino pambuyo pake, chakudyacho chimayambanso kutulutsa mitsempha ya thukuta ndi mitsempha yambiri ya magazi, zomwe zimapangitsa kutukuta ndi kuthamanga, motero . Kawirikawiri, thukuta ili ndikuthamanga kuli pansi pa kumvetsetsa mwachifundo.
M'mawu ena, mitsempha ya auriculotemporal ikuvulala, mafinya ake omwe amachititsa kuti asamangogonjetsa salivation koma amachititsanso kutukuta ndi kuthamanga munthu atakhala ndi chakudya. Komanso, mwa anthu ena, mawonekedwe a thukuta amatha kupitirira pambali pa nkhope yonse ndikukhudza thunthu, mikono, ndi miyendo.
Pamene thupi limakhudzidwa kwambiri, zimakhala zovuta kwambiri.
Zimayambitsa
Chilichonse chomwe chimawononga mitsempha ya auriculotemporal chingayambitse matenda a Frey, kuphatikizapo zotsatirazi:
- Kuchita opaleshoni yamatenda (chifukwa chachikulu)
- Kusokonezeka kopweteka kwa tsaya
- Kuchita opaleshoni yamsana
- Matenda opatsirana a dera la parotid
- Mandibular fracture
- Kusweka kwa mgwirizano wa temporomandibular
- Kuchita opaleshoni kwa gulu la temporomandibular
- Kuchotsedwa kwa glands za submandibular
- Kuchotsa khungu la chithokomiro
- Thoracic sympathectomy (opaleshoni yachitidwa pofuna kuteteza thukuta)
- Zoopsa za kubadwa kapena kuvulala pambuyo pa mphamvu yoperekera (mwa makanda)
M'zaka za m'ma 1940, opaleshoni ya parotid inachititsa anthu ambiri ku United Kingdom kuti athetse mavuto osiyanasiyana, omwe ali ndi khansa komanso osakanikirana.
Kuwomba thukuta limodzi ndi zotsatira zina zingapo, kuphatikizapo kuvulala kwa nkhope, kuchepa kwa nkhope, kuchepa kwa fistula, hematoma, ndi keloids kunkapezeka kawirikawiri pakati pa odwala omwe analandira opaleshoni ya parotid. Zindikirani, anthu omwe ali ndi ubweya wawo wa parotid achotsedwa amakhala ndi mwayi wodwala matenda a Frey kusiyana ndi omwe ali ndi mbali imodzi ya ubweya wa parotid wachotsedwa.
Matenda a frey amatha kuonanso ndi zina zotsatirazi:
- Zodzoladzola za m'maso zoster
- Kuvulala kwa Chorda tympani
- Mutu wamagulu
- Matenda a shuga
- Encephalitis
- Syringomyelia
- Kutupa mu thumba lachifundo lachiberekero
Anthu ambiri omwe amawoneka thukuta sakhala ndi vuto ndi-pakati pa 10 ndi 15 peresenti ya anthu omwe amawapeza akufunika kuchipatala. Komanso, pambuyo pa opaleshoni ya opaleshoni, odwala 10 pa 100 alionse amafotokoza zizindikiro zosonyeza kuti ali ndi vutoli. Komabe, pakufunsanso mafunso, 30 mpaka 50 peresenti ya odwala amavomereza zizindikiro za kutukuta. Matenda a frey amawonekera pakapita miyezi isanu ndi iwiri mutatha opaleshoni.
Matenda a frey angathe kuchitika kwa anthu a msinkhu uliwonse. Komabe, sizowoneka mwa ana ndi ana omwe amangowonongeka kudera lamapiri atatha kubereka, ndipo kuvulala kwa forceps yobereka sikusowa.
Kwa ana, zakudya zowonjezera zimatha kulakwa ndi matenda a Frey. Komabe, zizindikiro za zakudya zowonongeka zimachitika mutangodya chakudya osati panthawi yafunafuna.
Kudziwa
Njira yosavuta yodziwira matenda a Frey kumaphatikizapo kugwiritsa ntchito ufa wodetsedwa (iodinated) (onani) powonekera. Njirayi imatchedwa kuyesa kochepa. Wodwalayo amapatsidwa maswiti a mandimu kapena zakudya zina zotsekemera kuti azitulutsa thukuta. Malo okhudzidwa kumene madontho a thukuta amapanga mawonekedwe a buluu. Mankhwalawa amatha kupukutidwa mosavuta kuchoka pamaso kuti mayeso ayambe kubwerezedwa. Mayesowa angagwiritsidwe ntchito poyesera matenda a Frey mwa anthu omwe alibe zizindikiro (ie, asymptomatic patients).
Ngakhale mayesowa ali olondola, sangasonyeze kuopsa kwake. Kuwonjezera apo, mayesowa ali ndi chiopsezo cha kufooka kwa wowuma ufa. Mayesowa ayenera kuperekedwa pa khungu louma, ndipo sayenera kugwiritsidwa ntchito kwa anthu omwe akutopa kwambiri.
Chiyeso china chofunika kwambiri komanso chodziŵika bwino choyesa kudziwa ngati munthu ali ndi matenda a Frey chimaphatikizapo njira yogwiritsira ntchito mankhwala omwe amagwiritsa ntchito mapuloteni otchedwa enzymatic electrode omwe amazindikira kuti maselo a L-lactate pakhungu.
Kuyesedwa kovuta kwambiri kwa matenda a Frey kumaphatikizapo kugwiritsa ntchito mapepala amodzi pamaso kuti ayang'ane thukuta pamene wodwala akulimbikitsidwa ndi chakudya chokoma.
Pomalizira, mankhwala ofufuza odwala operewera amagwiritsidwa ntchito kuti awonetsere matenda a Frey. Kuyezetsa magazi uku kumafuna kuti kutentha ndi chinyezi mu chipinda zizikhala nthawi zonse. Choyamba, pambuyo pa kukondoweza, malo otenthedwa amawonekera kuti akugwirizana ndi kusintha kwa mitsempha ya m'magazi. Chachiwiri, malo ozizira amawonetsedwa kuti amawoneka thukuta. Kusintha uku kuli kovuta kuwonetsera mwa anthu omwe ali ndi khungu lakuda.
Chithandizo
Kwa anthu ambiri, matenda a Frey amachoka paokha pakapita zaka zisanu. Anthu omwe ali ndi zizindikiro zochepa ayenera kutsimikiziridwa kuti chikhalidwecho chidzadutsa paokha popanda chithandizo.
Kwa iwo omwe amakhudzidwa kwambiri ndi vutoli, kutukuta kwachizolowezi kawirikawiri ndi chizindikiro chovuta kwambiri ndipo chimapangitsa munthu kufunafuna thandizo.
Botox
Kafukufuku wamakono watsopano wokhudzana ndi kafukufuku wa Botox ndi njira yodalirika komanso yothandiza kwambiri yotengera thukuta komanso kuthamanga kwa Frey syndrome. Makamaka, Botox therapy yatsimikiziridwa kuti ndi 98 peresenti yothandiza pochiza zizindikiro za thukuta lopweteka. Botox mankhwalawa awonetsetsanso ogwira mtima mwa anthu omwe amamva thukuta lachilendo lachiwiri ku matenda a shuga, mtundu wa mitsempha ya shuga chifukwa cha shuga.
Mu nkhani ya 2017, Lovato ndi olemba anzake analemba izi:
Mankhwala a BTX [Botox] amathandiza kwambiri pochizira matenda otukumula (Frey syndrome), ndipo amatha kuonedwa kuti ndi mankhwala a golide omwe amachititsa kuti pakhale vutoli.
Pochiza Frey syndrome ndi Botox therapy, dokotala ayenera poyamba kudziwa malo omwe akugwiritsidwa ntchito pogwiritsa ntchito mayeso ochepa. Malowa amagawidwa m'magulu ang'onoang'ono, omwe ali pakati pa 1 ndi 1.5 masentimita. Botox imayikidwa jekeseni iliyonse m'mabwalo awa kuti izikhala ndi zotsatira zofanana.
N'zochititsa chidwi kuti mankhwala ena a Frey syndrome ayesedwa. Kawirikawiri, mankhwalawa amapereka chithandizo chochepa kapena palibe.
Otsutsa
Choyamba, anthu omwe amagwiritsa ntchito mankhwala ozunguza thupi agwiritsidwa ntchito kuderalo lomwe lakhudzidwa ndi kutukuta. Odwala ena awonetsa kuti mpumulo waung'ono wakhalapo kwa milungu ingapo chifukwa cha okhulupirira anzawo. Zotsatira zabwino kwambiri, mawonekedwe a gel a antiperspirant amagwiritsidwa ntchito usiku kuti aume khungu ndikutsuka m'mawa. Tsitsi la tsitsi lingagwiritsidwe ntchito kuyuma antiperspirant pambuyo pa ntchito.
Kwa nthawi ya maola khumi ndi awiri kuchokera pamene akugwiritsidwa ntchito, wodwalayo ayenera kupewa kumeta malo omwe akuchitidwa. Pakapita nthawi, ngati kutukuta kumakhala koyambira ndipo kumatsimikiza nokha, miyezo yochepa ya antiperspirants ingagwiritsidwe ntchito, ndipo odwala sadzafunika kugwiritsa ntchito antiperspirants tsiku ndi tsiku. Zindikirani, antiperspirants akhoza kuchita ngati khungu lakhungu ndipo amachititsa kutupa. Chenjezo liyeneranso kuthandizidwa kuti musayambe kulengeza za antiperspirant mu diso.
Matenda a Anticholinergics
Chachiwiri, mankhwala otchedwa anticholinergics agwiritsidwa ntchito pochiza matenda a Frey. Mankhwala otchedwa anticholinergics awa ndi scopolamine, glycopyrrolate, ndi diphemnanilmethylsulfate ndipo angagwiritsidwe ntchito ngati njira zowonjezera kapena zokometsera. Anticholinergics imatha kusintha zizindikiro za masiku atatu.
Chofunika kwambiri, anticholinergics amadziwika ndi khungu ndipo amatha kuyambitsa zotsatira zoyipa monga kuphwanya kamwa, maso osaoneka bwino, maso ovuta, kusungidwa kwa mkodzo, kuwonjezeka kwa mtima, ndi kudwala. Kuwonjezera apo, anticholinergics sayenera kugwiritsidwa ntchito kwa anthu omwe ali ndi glaucoma, matenda a shuga, matenda a chithokomiro, chiwerewere chosokoneza bongo, komanso matenda opatsirana, amphongo, mtima wamtima kapena matenda amanjenje.
Njira Zothandizira
Chachitatu, opaleshoni yayesa kuyesa kuchepetsa zizindikiro za matenda a Frey. Opaleshoni imeneyi imaphatikizapo sympathectomy ya chiberekero, tympanic neurectomy, kutuluka kwa sternocleidomastoidtransfer, ndi graerm-fat grafts. Kuonjezerapo, zipangizo zosiyanasiyana ndi zolepheretsa kugwiritsidwa ntchito pochita chithukuku chotukumula.
Ndizomveka kuti anthu ambiri omwe amapanga thukuta lachiwiri ndi opaleshoni sakufuna kulandira opaleshoni yowonjezereka kuti athetse vutoli.
> Zotsatira:
> Kusokonezeka Kwambiri, Kupembedzera, ndi Glands za Atumwi. Mu: Wolff K, Johnson R, Saavedra AP, Roh EK. eds. Mtambo wa Fitzpatrick ndi Zojambula za Clinical Dermatology, 8e New York, NY: McGraw-Hill.
> Fealey RD, Hebert AA. Chaputala 84. Kusokonezeka kwa Mkwatulo Wotentha Kwambiri ndi Kukwapula. Mu: Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, DJ Leffell, Wolff K. eds. Dermatology ya Fitzpatrick mu General Medicine, 8e New York, NY: McGraw-Hill; 2012.
> Lovato, A, ndi al. Botulinum mankhwala ophera poizoni: kuchepetsa kugwira ntchito kwa matenda osokoneza bongo. Acta Otorhinolaryngologica Italica. 2017; 37: 168-171
> Soda S, Quraishi MS, Bradley PJ. Matenda a frey ndi opaleshoni ya parotid. Otolaryngology yachipatala. 1998; 23: 291-301.