Ðe dɔdzẽ aɖe si le abe esia ene le wò to mea? (Acoustic Neuroma) Na míasrɔ̃ nu tso eŋu!

Ðe nèsena le ɖokuiwò me ɣeaɖewoɣi be yeƒe to ɖeka ƒe nusese dzi ɖe kpɔtɔa? Alo ɖeko nèsea to me ɖiɖi atraɖii, wò ta ʋuʋuna ɣeaɖewoɣi, alo mègadaa asɔ oa? Togbɔ be nusiawo nye nusiwo ŋu míeléa ŋku ɖo boo ɣeaɖewoɣi o hã la, susu sue aɖe ate ŋu anɔ megbe na esia. Egbea míele nu ƒom tso dɔdzẽ aɖe si ate ŋu anye susu ma tɔgbe, gake menye kansa o, eye ema nye nɔnɔme si woyɔna be ‘Acoustic Neuroma’ .

Nukae Nye Acoustic Neuroma?

Kpuie ko la, gbeɖiɖi ƒe ahɔhɔ̃mekawo nye dɔdzẽ si me dɔlékui aɖeke mele o . Esia fia be mekakana ɖe ŋutilã ƒe akpa bubuwo o. Wogayɔnɛ be vestibular schwannoma . Dɔdzẽ sia dona le lãmeka aɖe si tso wò to ememetɔ me yia wò ahɔhɔ̃ me. Ne míagblɔe tututu la, etsina ɖe tagbɔ ƒe lãmeka 8 lia (vestibulocochlear nerve) si le míaƒe ta me la dzi. Lãmetsi sia kpena ɖe ŋuwò koŋ be nàse nu (se) eye nàlé wò dadasɔ (dadasɔ) me ɖe asi.

Bu lãmeka sia be enye ka sue aɖe si tsɔa gbedasiwo tso to me yia ahɔhɔ̃a me. Eyata ne dɔdzẽ sue aɖe do mo ɖa le ka sia dzi la, ate ŋu ado kplamatse gbedasi mawo ƒe kaka. Aleae wògblẽa nu le tosese kple dadasɔ ŋui.

Togbɔ be dɔdzẽ siawo mekakana ɖe ŋutilã bliboa me abe kansa ene o hã la , ne wole tsitsim la, woate ŋu agblẽ nu le nusese ŋu, ana towo naƒo atraɖii (tomeʋuʋu), womeda sɔ o, eye ɣeaɖewoɣi la, mo ƒe akpa ɖeka natsi alo gbɔdzɔ. Esia ƒe atikewɔwɔ dometɔ aɖewoe nye amekoko kple keklẽŋusẽdɔdamɔnu. Ƒã hafi wòhiãna be woazã atikewo.

Ðe nɔnɔme sia si woyɔna be acoustic neuroma bɔa?

Ao, le nyateƒe me la, mebɔ nenema gbegbe o. Ame siwo ade ɖeka le 100,000 ɖesiaɖe me xɔa dɔlélea ƒe sia ƒe. Ame siwo xɔ tso ƒe 65 va ɖo ƒe 74 la ate ŋu axɔ dɔlélea wu ɖevi suewo kple ɖevi suewo.

Nukawoe nye gbeɖiɖi ƒe ahɔhɔ̃mekawo ƒe dɔléle ƒe dzesiwo?

Esia ƒe dzesiwo meva kpata o. Zi geɖe la, wodzena vivivi.

Dzesi siwo woate ŋu akpɔ le eƒe gɔmedzedze:

• To ɖeka ƒe tosese vivivi: Esiae nye dzesi si bɔ wu le gɔmedzedzea me. Ðewohĩ màte ŋu ase nu nyuie le to ɖeka me ne èle nu ƒom le telefon dzi o, alo àse le ɖokuiwò me be gbeɖiɖia nu tsi le akpa ɖeka ne ame aɖe le nu ƒom.
• Tome ƒe ʋuʋu: Esia nye gbeɖiɖi vovovowo sese ɣesiaɣi le to me (e.g., gbeɖiɖi si le ɖiɖim, le ɣli dom, alo le ɣli dom). Esia ate ŋu aɖe fu na ame aɖewo ŋutɔ.
• Dadasɔ ƒe kuxiwo: Ðewohĩ àse le ɖokuiwò me be yele gegem esime nèle zɔzɔm, eye ate ŋu asesẽ be nànɔ teƒe ɖeka.
• Vertigo: Seselelãme si nye be èle tsatsam alo le tsatsam le ŋuwò. Esia ate ŋu asẽ ŋutɔ.

Ne dɔdzẽa le tsitsim la, dzesi siwo gbɔna hã ate ŋu ado mo ɖa:

• Mo ƒe lãmetutudɔ alo lãmetutudɔ: Ate ŋu anɔ mo ƒe akpa ɖeka ʋuʋu, alo lãmekawo ƒe gbɔdzɔgbɔdzɔ le akpa ma.
• Taɖuame: Taɖuame enuenu, ɣeaɖewoɣi la, esẽna ŋutɔ.
• Aɖuɖɔtoe kple ʋuʋudedi.
• Vivi ƒe tɔtrɔ: Nuɖuɖu ate ŋu avivi ato vovo na alesi wònɔna ɖaa.
• Nu mimi sesẽ (Dysphagia).
• Nukpɔkpɔ ƒe kuxiwo: Nukpɔkpɔ si me kɔ o alo nukpɔkpɔ eve.

Ðo ŋku edzi be ne dzesi siawo le ŋuwò la, mefia be gbeɖiɖi ƒe ahɔhɔ̃mekawo ƒe dɔléle le ŋuwò o. Gake ne dzesi siawo dometɔ ɖeka alo esi wu nenema yi edzi le fu ɖem na wò la, ele vevie be nàyi ɖɔkta gbɔ aɖaɖo aɖaŋu na wò.

Nukatae gbeɖiɖi ƒe ahɔhɔ̃meka sia dzɔna?

Numekulawo menya nusi tututu hea dɔdzẽ siawo vɛ haɖe o. Gake nusi wonyae nye be lãmenugbagbevi ƒomevi aɖe si woyɔna be Schwann lãmenugbagbeviwo ƒe tsitsi si mesɔ o gbɔe wotsona . Schwann lãmenugbagbevi siawo nye lãmenugbagbevi siwo wɔa dɔ abe ametakpɔnu ene ƒo xlã lãmeka siwo le míaƒe lãmekawo me, vevietɔ esiwo kpɔa gome le tosese kple dadasɔ me.

Nu bubue nye be amesiwo ŋu domenyiŋusẽfianu ƒe dɔléle aɖe si woyɔna be ‘Neurofibromatosis type 2’ (NF2) le la ate ŋu axɔ gbeɖiɖi ƒe ahɔhɔ̃meka siwo le akpa eve me le tomeka siwo le ahɔhɔ̃a ƒe akpa eveawo dzi.

Aleke nèwɔna dea dzesi esia?

Ne èyi ɖɔkta gbɔ la, abia wò gbã tso wò dzesiwo ŋu. Emegbe woawɔ ŋutilãmedɔdada. Tsɔ kpe ɖe eŋu la, woate ŋu awɔ dodokpɔwo abe:

• Nɔnɔmetatawo dodokpɔ: Esiawo ate ŋu akpe ɖe ame ŋu wòanya nenye be dɔdzẽ aɖe le eŋu, alesi gbegbe wòloloe, kple afisi wòle.
• MRI (Magnetic Resonance Imaging) scan: Esiae nye mɔ nyuitɔ si dzi woato ade dzesi gbeɖiɖi ƒe ahɔhɔ̃mekawo ƒe dɔléle.
• CT (Computed Tomography) scan: Wozãa esia hã ɣeaɖewoɣi.
• Tosese dodokpɔ: Wowɔa dodokpɔ vovovowo be woakpɔ alesi gbegbe nèle tosesem nyuie. Dodokpɔ mawo dometɔ ɖekae nye Auditory Brainstem Response (ABR) .
• Dodokpɔ siwo me nàda asɔ le: Dodokpɔwo hã li siwo dzi nàto akpɔ wò dadasɔ.
• Electronystagmography (ENG): Esia doa ƒomedodo si le ŋku ƒe ʋuʋu kple dadasɔ dome kpɔna.

Nukawoe nye atike siwo wozãna na gbeɖiɖi ƒe ahɔhɔ̃mekawo?

Alesi woawɔ akpɔ esia gbɔe nɔ te ɖe nu geɖe dzi. Esiawo dometɔ aɖewoe nye:

• Dɔdzẽa ƒe lolome kple afisi wòle.
• Alesi gbegbe dɔdzẽa kpɔ ŋusẽ ɖe wò tosese kple wò dadasɔ dzii.
• Wò ƒexɔxɔ kple wò lãmesẽ bliboa.

Atikewɔwɔ ƒe mɔnu vevi geɖewo li:

1. 1. .Nukpɔkpɔ:

• Ɣeaɖewoɣi la, ne dɔdzẽa le sue ŋutɔ, ne ele tsitsim blewu ŋutɔ, eye ne dzesi gã aɖeke mele ŋuwò o la, wò ɖɔkta ate ŋu agblɔ be mègawɔ naneke fifia o eye nàlé ŋku ɖe dɔdzẽa ŋu to MRI-dɔdamɔnu siwo wowɔna edziedzi dzi . Ame geɖe yia edzi ƒe geɖe kuxi aɖeke manɔmee.

2. Stereotactic Radiosurgery ƒe dɔwɔwɔ:

• Esia le abe keklẽŋusẽ ƒe atikewɔwɔ amekoko manɔmee ene. Enaa keklẽŋusẽ ƒe keklẽ sesẽwo nɔa dɔdzẽa ŋu. Ate ŋu axe mɔ na dɔdzẽa be wòagatsi o eye ɣeaɖewoɣi la, ana wòaɖiɖi. Megblẽa nu boo aɖeke le lãmeka siwo le lãmesẽ me siwo ƒo xlãe ŋu o. Zi geɖe la, enyea dɔdamɔnu si wozãna ŋkeke ɖeka.

3. Amekoko suesuesuewo:

• Esia koe nye mɔ si dzi woato aɖe dɔdzẽa ɖa keŋkeŋ. Ahɔhɔ̃mekaŋutinunyalawo zãa dɔwɔnu tɔxɛwo tsɔ wɔa amekoko sia nyuie ŋutɔ. Amekokomɔnu ate ŋu ato vovo le afisi dɔdzẽa le kple eƒe lolome nu.

• Amekoko suesuesue ƒomevi vovovowo li:
• Middle fossa mɔnu: Wozãa mɔnu sia ne dɔdzẽa le to me eye wòle sue vie. Woɖea dɔdzẽa to lãɖeɖe sue aɖe si le ta ƒe axadzi me.
• Retrosigmoid mɔnu: Le esia me la, woɖea to megbe, eye woɖea dɔdzẽa toa taɖua ƒe akpa aɖe me yia to ememetɔ me.
• Translabyrinthine mɔnu: Woate ŋu akafu mɔnu sia ne wò to ɖeka megate ŋu sea nu kura o. Woɖea dɔdzẽa ɖa to lãɖeɖe ɖe to megbe kple to ememetɔ ƒe ƒu ɖeɖeɖa me. Le dɔwɔwɔ sia megbe la, màgase nu le to ma me ake o.

4. Atikewo zazã:

• Ƒã hafi wozãa esia. Atike aɖe si woyɔna be bevacizumab ate ŋu akpe ɖe ame ŋu ɣeaɖewoɣi be dɔdzẽwo dzi naɖe akpɔtɔ, vevietɔ be ɖevi siwo ŋu NF2 le ƒe tosese natsi. Wozãnɛ hã tsɔ daa keklẽŋusẽ ƒe kuku, si nye kuxi si ate ŋu ado mo ɖa le keklẽŋusẽdɔdada vɔ megbe.

5. Vestibular Gbugbɔgaɖɔɖo ƒe Atikewɔwɔ:

• Ɣeaɖewoɣi le amekoko me la, ehiãna be woaɖe lãmeka siwo kpɔa gome le dadasɔ me ƒe akpa aɖewo ɖa. Esia ate ŋu akpɔ ŋusẽ ɖe ŋutilãa ƒe dadasɔ dzi. Vestibular rehabilitation therapy nye kamedede kple hehexɔxɔ siwo kplɔ wo nɔewo ɖo siwo gbugbɔ naa hehe ŋutilãa be wòaxe fe ɖe lãmekawo ƒe dɔwɔwɔ si bu la ta. Lãmesẽŋutinunyala aɖee wɔa esia.

Kuxi kawoe ate ŋu ado mo ɖa le amekoko suesuesuewo wɔwɔ vɔ megbe?

Abe alesi wòle le amekoko ɖesiaɖe gome ene la, kuxi aɖewo li siwo ate ŋu ado mo ɖa le amekoko sia megbe. Wò atikewɔlawo ƒe ƒuƒoƒoa aɖe nusiawo me na wò do ŋgɔ. Mègatsi dzi o, atikewɔwɔ kple atikewɔwɔ ƒe tiatia aɖewo li na esiawo katã kloe.

• To ɖeka ƒe tosese ƒe bu alo edzi ɖeɖe kpɔtɔ.
• Mo ƒe lãmetutudɔ (ate ŋu anɔ anyi ɣeyiɣi kpui aɖe alo anɔ anyi ɖaa).
• Tome ƒe ɖiɖi (si le ɖiɖim le to me).
• Ahɔhɔ̃ me tsi (CSF) ƒe sisi.
• Dadasɔ ƒe kuxiwo.
• Nu mimi sesẽ.
• Taɖuame.
• Nukpɔkpɔ zi eve alo ŋku ƒe ƒuƒu.
• Taɖuame.
• Dɔlékuiwo.
• Meningitis ( ahɔhɔ̃ ƒe nɔnɔme si le abe dzoxɔxɔ ene - ƒã ŋutɔ).
• Tumor gbugbɔgatsi (ƒã hafi).

Ne acoustic neuroma le ŋunye la, nukae wòle be makpɔ mɔ na?

Enɔ te ɖe nu geɖe dzi, abe wò nɔnɔmea, atike si ƒomevi wowɔ na wò, kple kuxi ɖesiaɖe si do mo ɖa ene. Wò ahɔhɔ̃ŋutinunyala aɖe atikewɔmɔnu siwo nàte ŋu azã kple kuxi siwo ate ŋu ado tso eme la me na wò.

Ɣeaɖewoɣi la, ne wò to me gblẽ la, mɔ̃ aɖewo li siwo ate ŋu akpe ɖe ŋuwò. Le kpɔɖeŋu me, àte ŋu azã nuwo abe ‘ƒu ƒe tomemɔ̃wo’ alo ‘cross hearing aids’ (CROS - contralateral routing of signals hearing aids) ene .

Aleke malé be na ɖokuinye?

Ne èva nya be gbeɖiɖi ƒe ahɔhɔ̃meka aɖe le ye ŋu la, àte ŋu avɔ̃ vie eye nàtsi dzimaɖi, vevietɔ ne wò ɖɔkta tso nya me be yealé ŋku ɖe ŋuwò atike aɖeke manɔmee. Àte ŋu abu nuwo abe, "Ðe dɔdzẽ sia alolo ɖe edzia? Ðe nye tosese agblẽ ɖe edzia?" Ɣemaɣi la, bia wò ɖɔkta be tɔtrɔ kawoe ɖee fia be dɔdzẽa le ŋusẽ kpɔm ɖe lãmekawo dzi hã.

Ne dzesiwo le ŋuwò, eye wò ɖɔkta ɖo aɖaŋu be nàwɔ dɔ na wò la, ate ŋu agblẽ nu le wò dadasɔ ŋu le amekokoa megbe. Ne nenemae la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò be nàzã vestibular rehabilitation therapy, si ŋu míeƒo nu tsoe va yi. Esia ate ŋu akpe ɖe ŋuwò nàgawɔ dɔ siwo nèwɔna ɖaa.

Nya kawoe wòle be mabia nye ɖɔkta?

Ne gbeɖiɖi ƒe ahɔhɔ̃mekawo ƒe dɔléle le ŋuwò la, àte ŋu abia nya siawo abe esiawo ene ɖɔkta:

• Ðe wòhiã be woawɔ atike nam, alo ɖe woalé ŋku ɖe dɔdzẽa ŋua?
• Nukae nye nusi ate ŋu adzɔ be nye to nate ŋu ase nu si ŋu viɖe le?
• Mɔnukpɔkpɔ kae li be dɔdzẽ sia agadzɔ ake le amekoko alo keklẽŋusẽdɔdada vɔ megbe?
• Ðe mele afɔku gã aɖe me be dɔdzẽ ƒomevi bubuwo nadze dzinyea?
• Viɖe kple kuxi kawoe le gbeɖiɖi ƒe ahɔhɔ̃mekawo ƒe dɔwɔwɔ na ame ŋu?
• Ðe mahiã be woawɔ atike na maɖɔ ŋu ɖo le amekoko vɔ megbea?

Mlɔeba la, nusiwo dzi wòle be woaɖo ŋkui (Take-Home Message) .

Acoustic neuroma nye dɔdzẽ si tsina blewu, si menye kansa o, si ate ŋu akpɔ ŋusẽ ɖe wò tosese kple dadasɔ dzi. Gake mègatsi dzi o, atike nyuiwo li na esia.

Ðewohĩ wò ɖɔkta aɖo aɖaŋu be nàwɔ dɔ na wò atsɔ aɖe dɔdzẽa ɖa. Ne nenemae la, ke biabia geɖe ate ŋu anɔ asiwò ku ɖe amekokoa, nu si adzɔ le ewɔwɔ vɔ megbe, nenye be akpɔ ŋusẽ ɖe wò tosese dzi, kple eƒe nugbegblẽ le ame ŋu bubuwo ŋu. Esia sɔ. Wò atikewɔlawo ƒe ƒuƒoƒoa le klalo be yewoaɖo wò biabiawo katã ŋu eye yewoaɖe wò vɔvɔ̃wo dzi akpɔtɔ. Eya ta, ƒo nu tso nusianu si le susu me na wò ŋu na wo.

Nu vevitɔe nye be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo enumake ne dzesi siawo le ŋuwò. Zi alesi wokpɔ dɔlélea kaba la, zi nenemae atikewɔwɔa ate ŋu akpɔ dzidzedzee.

` Acoustic neuroma, to me dɔdzẽ, vestibular schwannoma, tosese ƒe lãmeka, tosese ƒe dɔmawɔmawɔ nyuie, tome ƒe ʋuʋu, vertigo