Maxillary Antrostomy

Endoscopic Sinus Surgery

Maxillary Antrostomy

Amadziwikanso monga: endoscopic pakati pa ma ARV, antrostomy pakati

Mankhwala otchedwa Maxillary antrostomy ndi opaleshoni yopititsa patsogolo (ostium) ya maxillary sinus. Izi zimathandiza kuti athandizidwe mowonjezera mkati mwazitsulo za maxillary sinus komanso mitsuko yowonjezera bwino. Mankhwala otchedwa Maxillary antrostomy akhala akuchitidwa kuyambira m'ma 1980 ndipo ndi njira yoti opaleshoni ikwaniritsidwe ngati muli ndi matenda aakulu a sinusitis omwe sagonjera kuchipatala china.

Pachifukwa ichi njirayi ndi mbali ya opaleshoni yotchedwa endoscopic sinus yomwe ingakhale yotsatira yabwino. Mankhwala ochiritsira odwala amaphatikizapo mayeso a antibiotic (masabata 3-6), nasal steroids, ndi kuthirira kwa saline.

Kuzindikira Sinusitis Yosatha

Musanachite opaleshoni ya sinus, dokotala wanu akufuna kutsimikiza kuti sinusitis ndi matenda a CT. Ma X-ray siwomwe amafunidwa nthawi zambiri, chifukwa amatha kuwonetsa matenda a sinus komanso mauthenga ochepa okhudzana ndi mavuto ena. Kuwunika kwa CT sikungowonetsera kukula kwa kuvuta kwa maxillary sinus, koma kumaperekanso dokotala wanu mfundo zina zofunika izi:

• malo a ndondomeko yowonongeka
• ndondomeko ya uncinate - yomwe ndi yofunika kwambiri pa ntchito yopaleshoni
• kuphulika kwa mucus membranes
• mpweya wotsutsana ndi madontho amadzi m'matope
• polyps
• matenda osokoneza bongo osteomeatal - amaletsa madzi a maxillary sinus

Ngakhale kuti izi ndizolemba zamankhwala ambiri, mauthenga onsewa adzapatsa dokotala wanu zomwe mukufunikira kuti zikonzekere bwino kuti mugwiritse ntchito.

Mafupa osteomeatal amapangidwa ndi nyumba zinayi izi:

• Njira ya uncinate - ndi fupa lopangidwa ndi L limene lidzachotsedwa
• maxillary ostium (kutsegula kwa maxillary sinus)
• infundibulum - kanjira yopindika m'mphuno
• mtundu wa ethmoid bulla - umodzi wa machismo a ethmoid

Kukonzekera Endoscopic Sinus Surgery ndi Maxillary Antrostomy

Musanachite opaleshoni, mwapatsidwa malangizo kuti musadye kapena kumwa kuchokera pakati pausiku tsiku la opaleshoni mpaka opaleshoniyo ikachitika.

Izi zidzakuthandizani kuteteza chiopsezo chanu chokhudzidwa m'mimba (aspiration). M'deralo la preop, mumapezeka opron nasal spray kuti muwononge mavesi anu kuti muthandize kuonjezera malo omwe mumawonekera pamene mukuchitidwa opaleshoni. Mukadetsedwa, mungakhale ndi tiyi ya Afrin kapena topical cocaine yomwe ikugwiritsidwa ntchito m'mphuno yanu kuti mupitirize kuwoneka ngati pakufunikira.

Pa Maxillary Antrostomy

Pali zifukwa zitatu zomwe dokotala wanu adzayesa kukwaniritsa pa nthawi ya Antrosstomy

1. Chotsani njira ya uncinate
2. Kupeza chilengedwe cholowera ku maxillary sinus
3. Kukulitsa chitseko mu maxillary sinus
4. Chotsani polyps kuchokera mkati mwa maxillary sinus cavity

Ndikofunika kuti dokotala wanu achotse ntchito ya uncinate kumayambiriro kwa ndondomekoyo kuti muwone bwino momwe mawonekedwe a maxillary akuyambira. Ngati kutseguka kwa sinus kulibe ndipo kutsegula kwatsopano kumayambika, mukhoza kukonzanso kayendedwe kake, kumene madzi amachoka kutsegula ndi kubwezeretsanso kachidutswa kameneko.

Atakhala ndi Maxillary Antrostomy

Pambuyo pa opaleshoni yanu yatha, mudzauka mu eh post-anesthesia care unit unit (PACU). Kumeneko mudzayang'aniridwa kuti muwone magazi, nthenda (yomwe ikhoza kuchitika ngati magazi ameza), kapena mavuto ena omwe angakhalepo kuchokera ku opaleshoni.

Mukatero mudzatsatirana ndi dokotala wanu pakati pa masiku atatu ndi asanu kuti mutenge phukusi lanu. Malingana ndi kupambana ndipo ngati muli ndi zizindikiro zotsalira zidzatsimikiziranso njira zina zamankhwala zomwe amayesedwa pambuyo pa opaleshoni.

Mavuto Ogwirizana ndi Maxillary Antrostomy

Kuwonjezera pa zoopsa zonse zomwe zimachitika ndi opaleshoni iliyonse yomwe imadalira anesthesia wamba, antrosstomy ya maxillary ili ndi zifukwa zotsatirazi:

• Kuvulazidwa kumadera oyandikana ndi diso (kuvulazidwa kwa orbital)
• khungu
• nthata zosavulaza
• (epistaxis)
• nthendayi yamadzimadzi (CSF) yamkuntho
• meningitis

Kuwonjezera pa zowonjezera, zifukwa zambiri zomwe zatchulidwa kale ndizochepa.

Mazira a Maxillary amavomerezedwa, koma izi ndizimene zimayambitsa chiopsezo. Zambiri mwazifukwazi zimagwirizana ndi zipangizo zopangira opaleshoni zomwe zimagwiritsidwa ntchito monga microdebrider , yomwe imakhala yotetezeka komanso imakhala yovuta. Komabe zifukwa zomwe zili pamwambazi ndizovuta ngakhale zili choncho, chonde chonde khalani ndi luso la ENT kuti mugwire ntchitoyi.

_Zotsatira:

_{Chiu, AG & Palmer, JN (2013). Atlas of Endoscopic Sinus ndi Surgery Base Fufupa, Mutu 8: Maxillary Antrostomy. Masamba 65-74.}

_{Patel, A., Vaughan, WC & Meyers, AD (2015). Kuchiza Opaleshoni kwa Ma Maxillary Sinusitis Wopangira Opaleshoni.}