Opaleshoni Yopangira Palate Chithandizo cha Aperea Yogona

Ndondomeko Zambiri kuphatikizapo Zothandiza

Ngati mwapezeka kuti muli ndi matenda obisala osokoneza bongo (OSA) , mukhoza kukhala ndi chidwi chophunzira za njira zochizira opaleshoni. Pali opaleshoni zingapo zomwe zingasinthe maonekedwe a phokoso lofewa ndikuthandizira kugona tulo tomwe timakhala tomwe timakhala tomwe timakhala tomwe timakhala tomwe timakhala tomwe timakhala tomwe timakhala tomwe timakhala tomwe timapanga. Koma ndi njira ziti zamankhwala zomwe zingapezeke?

Phunzirani za njira zosiyanasiyana zomwe zimatchedwa pharyngoplasty, ndi ngozi zomwe zimayenderana ndi njirazi.

Kodi Ndondomeko Zowongoka Ndi Zotani?

Kuchita opaleshoni ya palate kumaphatikizapo gulu la njira zomwe zimachitika pansi pa anesthesia ambiri mu chipinda chogwiritsira ntchito. Njira zosiyanasiyana zochepetsera palati zikuphatikizapo opaleshoni zotsatirazi:

• Uvulopalatopharyngoplasty (UPPP) kapena palatopharyngoplasty
• Kuchulukitsa sphincter pharyngoplasty
• Pambuyo pake pharyngoplasty
• Chizindikiro cha Uvulopalatal
• Palatal progress pharyngoplasty
• Z-palatoplasty
• Kusamukira pharyngoplasty

Kuchita opaleshoni ya palate kumagwirizanitsidwa ndi tonsillectomy kwa odwala ambiri omwe ali ndi matoni omwe sanachotsedwe kale. Kuchita opaleshoni ya palate (popanda kapena tonsillectomy) imagwiritsidwa ntchito makamaka pofuna kuthetsa vuto la kugona tulo, ndipo njirayi ingagwiritsidwe ntchito yokha kapena yogwirizana ndi njira zamakono. Njirazi zimaphatikizapo kuchotsa minofu ndi mawonekedwe omwe amapanga kukula kwa kayendetsedwe ka ndege popanda kuthana ndi ntchito zachizolowezi monga kupuma, kulankhula, ndi kumeza.

Zina mwazochitika payekha ndizo zotsatirazi:

• UPPP inayamba kufotokozedwa kuti yothandizira matenda obisala obettive ogonana m'chaka cha 1982, ndipo kwa zaka zambiri ndiye njira yokhayo yopezeka. Njirayi imaphatikizapo kuchotsedwa kwa chiwindi ndi gawo la phula lofewa, ndi kubwezeretsanso gawo lotsalira la khola lofewa ndipo mbali zonse za mmerozi zimapangidwa makamaka ndi kusoka mipando pamodzi. Poyerekeza ndi njira zina, UPPP imaphatikizapo kuchotsa minofu yambiri kuchokera ku zofewa. Ngati mvulayo isachotsedwe, njirayi imatchedwa palatopharyngoplasty.

• Kuwonjezeka kwa sphincter pharyngoplasty kumaphatikizapo pafupifupi kuchotsa minofu, koma minofu yowonjezera. Mwa njira iyi, minofu yomwe imayendetsa mzere wa matanoni (palatopharyngeus minofu) imamasulidwa kuchokera kumbali ya mmero ndi kuyima patsogolo ndi pambuyo pake. Izi zimakoka phula lofewa kutsogolo, ndi cholinga chotsegula dera lakumbuyo kwa khola lofewa kuti lipume. M'magulu osankhidwa a odwala, ndondomekoyi inasonyeza zotsatira zabwino kuposa UPPP mu mayesero osadziwika bwino poyerekeza awiriwa.
• Pambuyo pa pharyngoplasty ikhoza kuchitidwa pamene odwala ali ndi matani. Zimaphatikizapo kuchotsa minofu, komanso kuwonjezeranso minofu yambiri yapamwamba (denga la pakamwa) komanso mitsempha yothandizira (pamphepete mwa mmero). Njirayi imakhudzidwa kwambiri kuposa UPPP, koma ikuwonetseratu zotsatira zabwino pakati pa gulu losankhidwa la odwala mu mayesero osasinthika poyerekeza awiriwo.
• Chovala cha Uvulopalatal chimagwiritsidwa ntchito kwa odwala omwe ali ndi matumbo ochepa. Ndondomekoyi imaphatikizanso pafupifupi kuchotsapo kwa minofu ya phokoso lofewa; M'malo mwake, chikhomo cha m'kamwa (mucosa) pamtambo wofewa chimachotsedwa kuti chilowetse minofu. Mwachidziwitso, zimapangitsa kuti phokosolo likhale lalifupi pang'onopang'ono popanda kuchotsa minofu, chifukwa kuchotsa minofu kuyenera kukhudza kumeza kwamba.

• Kupita patsogolo kwa Palatal pharyngoplasty kumapangitsa mkamwa mwa kuchotsa ena mwa fupa padenga la pakamwa pakamwa kumbuyo, kumene kumakomana ndi mkodzo wofewa. Pambuyo pa kuchotsedwa kwa fupa, phula lofewa limatulutsidwa kutsogolo ndikugwedezeka m'malo.
• Z-palatoplasty imafuna pang'ono kugawanika pakamwa kofewa pakati ndikukoka hafu iliyonse patsogolo ndi kenako. Izi zingakhale zothandiza kwambiri kwa odwala omwe ali ndi ululu m'mphepete mwa mmero, zomwe zingachitike pambuyo pa tonsillectomy kapena njira zina zowonjezera. Z-palatoplasty imakhudzidwa ndi vuto lalikulu pakumeza opaleshoni yotsatira kusiyana ndi njira zina zamakhalidwe.

• Kutuluka kwa pharyngoplasty kumaphatikizapo minofu yaing'ono yochotsedwera ndi kusoka pamodzi minofu kumbali ya mmero mwa njira inayake.

Njira yopaleshoni yomwe ili yoyenera kwa inu idzafunika kuyang'anitsitsa bwino, ndi kukambirana ndi dokotala wanu.

Kuopsa kwa Ndondomeko za Palate

Mofanana ndi njira iliyonse yopaleshoni, pali zoopsa zomwe ziyenera kuganiziridwa. Ululu kawirikawiri umapezeka ngati gawo la opaleshoni yofewa. Zina mwa zovuta zambiri zomwe zimakhalapo ndizo zotsatirazi:

• Kusuta

  Kuchita opaleshoni yonse kumayambitsa kuika magazi, koma zambiri mwaziopsezo zimagwirizanitsidwa ndi tonsillectomy. Chiwerengero cha kutaya mwazi pambuyo pa tonsillectomy ndi 2 mpaka 4 peresenti.

• Kutenga

  Kutenga ndiko kotheka koma kosatheka.

• Zovuta kumeza

  Mlomo ndi wofunika kumeza chifukwa umasindikiza kugwirizana pakati pa msana ndi kumbuyo kwa mphuno. Pambuyo pa opaleshoni ya palate, n'zotheka kukhala ndi zakudya, makamaka zamadzimadzi, zimabwera kumbuyo kwa mphuno kapena nthawi zina kudzera m'mphuno. Izi zimachitika pakatha masabata awiri oyambirira, koma vutoli silokhalitsa kapena lofunika.

• Kusintha mkulankhula

  Malungo ndi ofunikira kuyankhula. Ngakhale kusintha kwachinsinsi pamalankhula (kutchulidwa mwa kufufuza kozama molondola) kungathe kuchitika, kusintha kwakukulu kwa nthawi yaitali pamalankhula sikunali kozolowereka.

• Akukwera pamwamba pa mmero

  N'zotheka kuti machiritso osayenerera amatha kupangitsa kuti pang'onopang'ono pakhale malo ochepa kwambiri.

Ngati mukufuna kukambirana za opaleshoni kuti mugwiritse ntchito matenda obisala, muyenera kuyamba ndi kuyankhula ndi ogona anu ogona . Ngati opaleshoni yofewa ndi njira yosankha, malinga ndi vuto lanu, kutumiza kwa opaleshoni yogona kungakhale koyamba kuti mufufuze chithandizo chochipatala chomwe chili choyenera kwambiri kwa inu.

_Zotsatira:

_{Cahali MB. "Pambuyo Pa Pharyngoplasty: Chithandizo Chatsopano Choletsedwa Kugona kwa Apnea-Hypopnea Syndrome." Laryngoscope . 2003 Nov; 113 (11): 1961-8.}

_{Friedman M, Ibrahim HZ, Vidyasagar R, Pomeranz J, ndi Joseph NJ. "Z-Palatoplasty (ZPP): Njira Yopangira Odwala Opanda Zida." Chovala cha Otolaryngol Mutu . 2004 Jul; 131 (1): 89-100.}

_{Fujita S, Conway W, Zorick F, ndi Roth T. "Kukonzekera Opaleshoni ya Matenda Osokonekera Bwino Othandiza Kugonana Kwamabedi: Uvulopalatopharyngoplasty." Chovala cha Otolaryngol Mutu . 1981 Nov-Dec; 89 (6): 923-34.}

_{Kezirian EJ, Maselli J, Vittinghoff E, Goldberg AN, ndi Auerbach AD. "Kulepheretsa Kugona kwa Apnea Surgery Kuchita Zitsanzo ku United States: 2000 mpaka 2006." Chovala cha Otolaryngol Mutu . 2010 Sep; 143 (3): 441-7.}

_{Kezirian EJ, Weaver EM, Yueh B, Deyo RA, Khuri SF, Daley J, ndi Henderson W. "Zotsatira za Zovuta Kwambiri Pambuyo pa Uvulopalatopharyngoplasty." Laryngoscope . 2004 Mar; 114 (3): 450-3.}

_{Kezirian EJ, Weaver EM, Yueh B, Khuri SF, Daley J, ndi Henderson WG. "Zinthu Zowopsa Chifukwa cha Kuvuta Kwambiri Pambuyo pa Uvulopalatopharyngoplasty." Chigoba Chakumutu cha Otolaryngol . 2006 Oct; 132 (10): 1091-8.}

_{Li HY, ndi Lee LA. "Relocation Pharyngoplasty Yopanda Kulepheretsa Kugonana Kwakufa." Laryngoscope . 2009 Dec; 119 (12): 2472-7.}

_{Pang KP, ndi Woodson BT. "Kuwonjezeka kwa Sphincter Pharyngoplasty: Njira Yatsopano Yopangira Opaleshoni Yopewera Apnea Yogona." Otolaryngol Head Neck Surg . 2007 Jul; 137 (1): 110-4.}

_{Powell N, Riley R, Guilleminault C, ndi Troell R. "Uvulopalatal Flap Reversible kwa Kugonana ndi Kugona kwa Matenda a Abele." Kugona . 1996; 19: 593-9.}

_{Sher AE, Schechtman KB, ndi Piccirillo JF. "Njira Yabwino Yopangira Opaleshoni Kusintha Kwambiri Kumtunda wa Kumtunda kwa Anthu Achikulire Okhala ndi Matenda Ati Akhale Otupa Odwala." Kugona . 1996 Feb; 19 (2): 156-77.}

_{Woodson BT, Robinson S, ndi Lim HJ. "Transpalatal Advancement Pharyngoplasty Zotsatira Poyerekeza ndi Uvulopalatopharyngoplasty." Chovala cha Otolaryngol Mutu. 2005 Aug; 133 (2): 211-7.}

_{Woodson BT, ndi Toohill RJ. "Transpalatal Advancement Pharyngoplasty Yopanda Kulepheretsa Kugonana Kwakufa." Laryngoscope . 1993 Mar; 103 (3): 269-76.}