Ðe ƒunukpeƒetetedɔ aɖe si mebɔ o le wò aɖu ƒe akpa aɖea? Mina míasrɔ̃ nu tso Jaw Cysts kple Tumors ŋu pɛpɛpɛ!

Ðe nède dzesi ƒunukpeƒetetedɔ alo dɔdzẽ sue aɖe le wò nu alo aɖu me eye nèbia ɖokuiwò kpɔ be nukae wònyea? Alo ɖe nèvɔ̃ kpɔ esi aɖudɔdala aɖe lé ŋku ɖe wò X-ray ŋu hegblɔ be, "Nu sue aɖe le afisia"? Togbɔ be le nyateƒe me la, nu siawo mebɔ kura o hã la, woate ŋu adzɔ ɖe ame sia ame dzi. Eyata egbea, mina míaƒo nu tso Jaw Cysts kple Tumors ŋu.

Nukae nye aɖuɖɔtoe kple dɔdzẽ siawo?

Kpuie ko la, esiawo nye tsitsi siwo ate ŋu adzɔ ɖe wò nu me, ɖe wò aɖu ƒe ƒuwo dzi (wò aɖuwo hã le eme), alo ɖe lãkusi falɛfalɛwo dzi. Aɖuɖɔtoe nye kotoku si me tsi alo nusi me tsi le ƒe akpa aɖe yɔ fũ. Bu eŋu abe ʋuʋudedi sue aɖe ene, gake edzɔna le lãkusi me. Gake dɔdzẽ ya nye lãkusi sesẽ aɖe si me lãmenugbagbevi siwo mesɔ o le. Zi geɖe la, tsitsi siawo evea siaa nye esiwo me dɔlékui aɖeke mele o, alo menye kansa o. Esia fia be woate ŋu alolo, si agblẽ nu le wò mo kple nu ƒe lãkusiwo ŋu, gake zi geɖe la, womekakana ɖe wò ŋutilã ƒe akpa bubuwo o.

Gake ƒã ŋutɔ be ƒunukpeƒetetedɔ alo dɔdzẽ siawo siwo do ƒome kple aɖuwo ate ŋu ava zu nu vɔ̃ɖi, alo kansa. Ðɔktawo yɔa esia hã be aɖuɖɔtoe me dɔdzẽ . Ne womeda dɔ na wo o la, kansa ƒe ƒuƒu kple dɔdzẽ siawo ate ŋu akaka ayi ŋgɔ wu wò aɖu ayi wò ŋutilã ƒe akpa bubuwo.

Eyata ne ède dzesii be nu yeye aɖewo le tsitsim le wò aɖu ƒe akpa si le wò nu me alo le wò nu me la, ele vevie be nàtsɔe afia ɖɔkta. Ne ƒunukpeƒetetedɔ alo dɔdzẽ aɖe menyo o hã la, ƒomevi aɖewo ate ŋu ana ame nase veve, agblẽ nu le aɖuƒu ŋu, alo aɖuwo gɔ̃ hã navuvu.

Nukawoe nye aɖuɖɔtoewo kple dɔdzẽ ƒomeviwo?

Aɖuɖɔtoe kple dɔdzẽ ƒomevi vovovowo li. Ðɔktawo bua wo be wonye esiwo me dɔléle aɖeke mele o alo esiwo gblẽa nu le ame ŋu, eye nenye be wodzea egɔme tso lãkusi siwo do ƒome kple aɖu ƒe tsitsi (odontogenic cysts and tumors) alo lãmenugbagbevi bubuwo (nonodontogenic cysts and tumors) me.

Aɖuɖɔtoe me dɔdzẽ kple dɔdzẽ ƒomevi siwo mebɔ o

Zi geɖe la, esiawo menye kansa o, si fia be dɔdzẽ kple tsitsi ƒomevi siwo ‘menyo o’. Mina míalé ŋku ɖe vevitɔwo ŋu:

• Ameloblastoma: Esia nye aɖuɖɔtoe si tsina blewu, si dona tso lãkusi siwo wɔa aɖuwo me. Zi geɖe la, edzɔna le wò aɖu si le ete, si te ɖe wò megbe aɖuwo (molars) ŋu. Togbɔ be zi geɖe la, dɔléle aɖeke mele eŋu o hã la, ameloblastoma ƒomevi aɖewo ate ŋu ava zu dɔléle vɔ̃ɖi le ɣeyiɣi aɖe megbe. Togbɔ be enye dɔdzẽ si me dɔlékui aɖeke mele o hã la, ate ŋu alolo ɣeaɖewoɣi ale gbegbe be wòatrɔ wò aɖu ƒe nɔnɔme alo agblẽ nu le wò aɖuwo ŋu.
• Titina lãmenugbagbevi gã granuloma:Esiae nye dɔdzẽ si me aɖuɖɔtoe si me aɖu mele o si nye ‘dɔlékui nyui’ si bɔ wu. Zi geɖe la, edzɔna le aɖu si le ete ƒe ŋgɔgbe. Gake ate ŋu adzɔ le aɖu si le etame hã. Aɖu ƒe vuvu si me vevesese aɖeke mele o koe ƒunukpeƒe akpa gãtɔ hea vɛ. Gake dɔdzẽ siwo le tsitsim kabakaba ate ŋu ana aɖuwo navuvu vevesesetɔe eye aɖu nadzo.
• Aɖuɖɔtoewo: Esiae nye aɖuɖɔtoe ƒomevi evelia si bɔ wu, eye wòdzɔna tso lãkusi siwo wɔa aɖuwo me. Esiawo nye aɖu siwo tsina blewu siwo ƒoa xlã aɖu siwo megbã o ƒe lãkusiwo le nu me. Zi geɖe la, wodzɔna le wò megbe aɖuwo (molars) gbɔ. Ɣeaɖewoɣi la, woate ŋu akpɔ wo le aɖu siwo le etame hã gbɔ, siwo nye aɖu siwo le wò ŋgɔgbe aɖuwo ƒe akpa eveawo.
• Odontogenic keratocysts: Esiawo hã nye cysts siwo tsina blewu. Zi geɖe la, wodzɔna le megbe aɖuwo (molars) gbɔ. Zi geɖe la, keratocyst suewo mevea ame o, gake cyst siwo lolo wu ate ŋu ana ame navuvu si me vevesese le. Ɣeaɖewoɣi la, ƒunukpeƒetetedɔ siawo ate ŋu anye domenyiŋusẽfianu si woyɔna be Gorlin ƒe dɔléle ƒe dzesi . Nɔnɔme sia dzia afɔku si le odontogenic keratocysts kple ŋutigbalẽ me kansa ƒomevi aɖewo xɔxɔ me ɖe edzi.
• Odontogenic myxoma / myxofibroma: Esia nye dɔdzẽ si me dɔlékui aɖeke mele o, si tsina blewu. Gake dɔdzẽ sia ate ŋu alolo ale gbegbe be wòagblẽ nu le wò aɖu ŋu eye wòaɖe aɖuwo ɖa.
• Odontoma: Esiae nye dɔdzẽ si me aɖuɖɔtoewo mele o si bɔ wu. Zi geɖe la, ƒomevi ɖeka dzɔna le aɖu si le ete eye aɖu ƒe wɔwɔme geɖewo nɔa eme (`compound type`). Zi geɖe la, ƒomevi bubua dzɔna le aɖu si le etame eye lãkusi si mesɔ o si meɖi aɖu o (`complex type`) le eme.
• Periapical cysts: Esiae nye aɖuɖɔtoe ƒomevi si bɔ wu. Wotsoa aɖuɖɔtoe si aɖu ƒe nuveviwɔame hena vɛ gbɔ.

Aɖuɖɔtoe Vɔ̃ɖiwo Kple Dɔdzẽ Siwo Mebɔ O

Dzɔgbenyuietɔe la, aɖuɖɔtoe siwo nye kansa, alo ‘vɔ̃ɖi’, mebɔ kura o. Kpɔɖeŋu aɖewoe nye esi:

• Kansa: Esia nye kansa ƒomevi aɖe si dzea egɔme tso lãkusi siwo le ŋutinuwo, mɔ siwo le eme, kple ŋutigbalẽ me la me.
• Sarcoma: Esia nye kansa si dzea egɔme tso ƒuwo alo lãkusi falɛfalɛ siwo ƒo xlãe me.
• Carcinosarcoma: Esia nye kansa ƒomevi eveawo siaa ƒe ƒuƒoƒo, `(Carcinoma)` kple `(Sarcoma).`

Aleke gbegbee ƒunukpeƒetetedɔ kple dɔdzẽ siawo siwo do ƒome kple aɖuwo bɔe?

Le nyateƒe me la, dɔdzẽ kple ƒunukpeƒetetedɔ siwo do ƒome kple aɖuwo mebɔ nenema gbegbe o. Gake dɔlékui vɔ̃ɖiwo alo kansa ƒomeviwo mebɔ kura o.

Gake numekukuwo ɖee fia be amesiwo le nuto aɖewo me ate ŋu axɔ wo bɔbɔe wu. Le kpɔɖeŋu me, le Dziehe Amerika la, tsitsi siwo mesɔ o le nu me ƒe 1% koe nye odontogenic tumors. Ke hã, le Afrika dukɔ aɖewo me la, xexlẽme sia de 20%.

Dzesi kawoe dzena ne ƒu alo dɔdzẽ le nye aɖu ŋu?

Zi geɖe la, ƒunukpeƒetetedɔ kple dɔdzẽ siawo tsina blewu eye womehea dzesiwo vɛ o. Ðewohĩ mànya gɔ̃ hã be ɖe le ye ŋu o negbe ɖe wokpɔe le vo me le aɖu ƒe X-ray alo nɔnɔmetatawo dodokpɔ me hena ta kple kɔ ƒe kuxi bubu aɖe ko hafi.

Gake ne tsitsiawo va lolo, si fia be wodze lãmenugbagbevi siwo te ɖe wo ŋu siwo le lãmesẽ me dzi dzedze gɔme la, dzesiwo ate ŋu adze. Dzesiawo dometɔ aɖewoe nye:

• Vevesese, sesẽ, alo lãmetutudɔ le aɖu ƒe akpa si le lãme na ame.
• Vuvu (esia ate ŋu ase veve alo ate ŋu adzo).
• Tɔtrɔ siwo vaa wò mo ƒe dzedzeme me.
• Kpe yeye aɖe si le aɖuƒu me (esia ate ŋu asesẽ alo afa).
• Tɔtrɔ le alesi aɖuawo doa goe ŋu (Changing bite).
• Aɖuwo ƒoƒo.

Nukae hea aɖuɖɔtoe me ʋuʋudedi kple dɔdzẽ siawo vɛ?

Aɖuɖɔtoe kple dɔdzẽ akpa gãtɔ dona elabena lãmenugbagbevi siwo kpena ɖe aɖuwo ŋu wɔa nu le mɔ si mesɔ o nu, eye wowɔa dɔdzẽ alo kotoku siwo me tsi yɔ fũ (cysts). Esiae nye nusi dzɔna le ``odontogenic`` ƒe tsitsiwo me. Gake mehiã be lãmenugbagbeviwo nakpɔ gome le aɖuwo wɔwɔ me hafi woatsi le mɔ si mesɔ o nu o.

Zi geɖe la, tɔtrɔ siwo vaa DNA (domenyiŋusẽfianu ƒe tɔtrɔ) gbɔe lãmenugbagbeviwo ƒe tsitsi si mesɔ o tsona . Abe alesi nènyae ene la, DNA ye nye kɔda si gblɔa alesi míaƒe lãmenugbagbeviwo natsi kple ɣeyiɣi si woadzudzɔ. Ne kuxiwo do mo ɖa le kɔda sia ŋu la, lãmenugbagbeviwo ƒe mama ƒe ɖoɖoa ate ŋu agblẽ, si ana woatsi si womedi o.

Le kpɔɖeŋu me, lãmenugbagbeviwo ƒe tɔtrɔ siwo nana lãmenugbagbeviwo yia edzi mamã ne ele be woadzudzɔ gɔ̃ hã. Esia wɔnɛ be zi geɖe la, ame siwo ŋu dɔléle sia le la va xɔa odontogenic keratocysts geɖe. Afɔku hã le wo me be woaxɔ basal cell carcinoma, si nye ŋutigbalẽ me dɔdzẽ ƒomevi si bɔ wu.

Aleke wowɔa dea dzesi aɖuɖɔtoe kple dɔdzẽ siawo?

Wò ɖɔkta ato wò dzesiwo, atikewɔwɔ ŋutinyawo me, eye wòado wò ŋutilã kpɔ. Nɔnɔmetatawo dodokpɔ ate ŋu aɖe dɔdzẽ alo ʋuʋudediwo afia le wò aɖu me kple eƒe golɔgoewo me. Esiawo dometɔ aɖewoe nye:

• X-ray-wo wɔwɔ.
• Magnetic resonance imaging (MRI) ƒe nɔnɔmetatawo zazã.
• Kɔmpiuta dzi tomography scan (CT scan) ƒe fotoɖeɖe.

Tsɔ kpe ɖe eŋu la, ɖewohĩ ahiã be woawɔ dɔ na wò . Le ŋutilã ƒe akpa aɖewo ɖeɖeɖa me la, ɖɔkta ɖea tsi alo lãkusi aɖe tso tsitsia me. Dɔléleŋutinunyala aɖe léa ŋku ɖe kpɔɖeŋua ŋu le nusuekpɔmɔ̃ me be yeakpɔ lãmenugbagbevi ƒomevi siwo le eme. Nyatakaka siawo ate ŋu akpe ɖe wò ɖɔkta ŋu wòanya:

• Cyst alo tumor ƒomevi ka ƒomevie le ŋuwò?
• Ðe wònye ‘nu gbegblẽ’ alo ‘nu vɔ̃ɖi’?
• Ðe wòle tsitsim blewu loo alo ɖe wòwɔa adã?

Nu siawo katã kpena ɖe wò ɖɔkta ŋu wòtsoa nya me le atikewɔmɔnu siwo nyo na wò ŋu.

Aleke wodaa aɖuɖɔtoe kple dɔdzẽ siawoe?

Ele be woaɖe ʋuka alo dɔdzẽ aɖe ɖa le ame geɖe ŋu to amekoko me . Tsɔ kpe ɖe tsitsia ɖeɖeɖa ŋu la, wò amekola ate ŋu aɖe lãmeka siwo ŋu wògblẽ nu le hã ɖa. Esia ate ŋu anye aɖu siwo gblẽ, alo aɖu si le ete alo aɖu si le etame ƒe akpa aɖewo. Woyɔa amekoko be woaɖe aɖu si le ete ƒe akpa aɖewo ɖa be mandibulectomy , eye woyɔa amekoko be woaɖe aɖu si le etame katã alo eƒe akpa aɖe ɖa be maxillectomy .

Le amekoko vɔ megbe la, àte ŋu ahiã atikewɔmɔnu siawo abe esiawo ene be woagbugbɔ wò aɖu atu eye wòakpe ɖe ŋuwò le dɔyɔyɔa me:

• Amekoko si woagbugbɔ awɔ: Be wò aɖu nadze abe alesi wònɔ hafi dɔdzẽa va do ene la, wò ɖɔkta ate ŋu azã ƒu aɖe si tso wò ŋutilã ƒe akpa bubu (abe wò akɔta, abɔta, alo afɔ si le ete ene).
• Aɖuɖɔɖɔɖɔ: Ðewohĩ ahiã be nàde aɖu siwo wowɔ kple asi be woatsɔ aɖɔli aɖu siwo wò ɖɔkta ɖe ɖa.
• Nuƒoƒo ƒe dɔdamɔnu: Ne esesẽna na wò be nàƒo nu alo ayɔ nyawo nyuie le amekoko vɔ megbe la, nuƒoƒo kple gbegbɔgblɔ ŋuti dɔléleŋutinunyala (SLP) ate ŋu akpe ɖe ŋuwò.
• Nunyiame ŋuti mɔfiame: Ðewohĩ ahiã be nàkpɔ eŋutinunyala bibi aɖe, abe nuɖuɖuŋutinunyala alo nuɖuɖuŋutinunyala ene, be wòaɖo aɖaŋu na wò le nuɖuɖu siwo le dedie be nàɖu ne èle hayahayam ŋu.

Ne aɖu me kansa le ŋuwò la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò hã be nàzã kansadɔdamɔnu, abe keklẽŋusẽdɔdamɔnu kple/alo atikewɔmɔnu ene . Atike nyuitɔ kekeake si woawɔ na wò anɔ te ɖe dɔdzẽ alo ƒunukpeƒetetedɔ ƒomevi si le ŋuwò dzi.

Nukae mate ŋu akpɔ mɔ na ne aɖu alo dɔdzẽ le ŋunye?

Woate ŋu ada aɖuɖɔtoe kple dɔdzẽ akpa gãtɔ keŋkeŋ ne amekoko. Gake le ƒomevi si nèzã nu la, ahiã be nàyi edzi awɔ sasrãkpɔ siwo akplɔ wò ɖo be nàkpɔe ɖa be dzidziɖedzi yeyewo hã le ŋuwò hã.

Le kpɔɖeŋu me, zi geɖe la, periapical cysts, odontomas, kple dentigerous cysts megadzɔna le amekoko vɔ megbe o. Gake central giant cell granuloma, odontogenic myxoma, kple odontogenic keratocysts ate ŋu agadzɔ ake. Ameloblastoma gadzɔna ake le dɔléle siwo ade 20% me.

Ɣekaɣie wòle be madi atikewɔlawo ƒe aɖaŋuɖoɖo?

Ne wò aɖu le veve sem alo vuvu, alo nède dzesii be wò dzedzeme trɔ, abe ƒuƒu le wò aɖu me alo aɖu siwo me mekɔ o ene la, yi ɖɔkta gbɔ enumake. Ate ŋu anye aɖuɖɔtoe, dɔdzẽ, alo aɖudɔ bubu aɖe si ɖɔkta ate ŋu adae ƒe dzesi.

Ele vevie ŋutɔ be nàyi edzi anɔ wò aɖudɔdala gbɔ kpɔm. Aɖu ƒe X-ray si wowɔna edziedzi ate ŋu ade dzesi aɖuɖɔtoe alo dɔdzẽ ne egakpɔtɔ le sue eye mehea dzesi aɖeke vɛ o.

Nya kawoe wòle be mabia nye ɖɔkta?

Nya aɖewo siwo nàte ŋu abia wò ɖɔktae nye esi:

• Dɔdzẽ alo cyst ka ƒomevie le ŋunye?
• Ðe wònye dɔlékuiwutike alo dɔléle vɔ̃ɖia?
• Ðe wòahiã be woawɔ dɔ nam?
• Mɔnukpɔkpɔ kawoe li be esia nagadzɔ ake le amekoko vɔ megbe?
• Aleke wòle be malé be na ɖokuinye esime mele hayahayam tso amekoko me?

Ɣekaɣie wòle be matsi dzi ɖe ƒunukpeƒetetedɔ aɖe si le aɖukpodzi ŋu?

Nu geɖe li siwo ate ŋu ahe ƒunukpeƒetetedɔ vɛ le aɖuɖɔtoea me. Wo dometɔ akpa gãtɔ metsɔ ɖeke le eme ale gbegbe be woate ŋu adzi ŋɔ o. Woate ŋu atso nusiwo le abe ƒunukpeƒetetedɔ kple dɔdzẽ ene gbɔ, alo woate ŋu anye nu bɔbɔe aɖe abe nulɔdɔ alo ʋuka si vuvu ene .

Anyo be wòanɔ susu me na wò be tsitsi siwo mewɔa nuvevi ame o ƒe akpa gãtɔ sena le wo ɖokui me be wofa eye woate ŋu aʋuʋu ne woka asi wo ŋu. Ne kansa nye tsitsi aɖe la, anɔ eme be asesẽ wu. Nusi to vovo na esia koe nye kansa si woyɔna be liposarcoma , si ate ŋu ase le eɖokui me abe ƒunukpeƒe falɛfalɛ si te ŋu ʋãna ene.

Ne ƒu yeye aɖe le ŋuwò la, madzo o, ele veve sem, eye wòle nu gblẽm le wò aɖu ƒe ʋuʋu ŋu - ekema ɣeyiɣia de be nàyi ɖɔkta gbɔ.

Mlɔeba la, nusi dzi nàɖo ŋkui (Take-Home Message) .

Togbɔ be aɖuɖɔtoe kple dɔdzẽ akpa gãtɔ nye esiwo me dɔlékui aɖeke mele o, alo menye kansa o hã la, ebɔ be dzi naɖe le ƒowò ne èva nya be dɔléle aɖe le ye ŋu si hiã be woawɔ dɔ na ye. Ke hã, ele vevie be nàɖe wo ɖa hafi woahe dzesi siwo ana wòasesẽ be woanɔ agbe kpli wo, abe vevesese kple nu me vuvu ene. Ne dzesi siawo le fu ɖem na wò xoxo la, amekoko ate ŋu akpe ɖe ŋuwò nàɖe wo ɖa keŋkeŋ. Bia wò ɖɔkta tso atikewɔmɔnu siwo nàte ŋu azã kple nusiwo ate ŋu ado tso eme na wò ʋuka alo dɔdzẽ ƒomevi tɔxɛa ŋu. Mègaŋe aɖaba ƒu naneke si mebɔ o le wò nu alo aɖu me dzi gbeɖe o. Nunya le eme be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo kaba ale si nàte ŋui.

` Aɖuɖɔtoe, aɖu me dɔdzẽ, nu me ʋuʋudedi, aɖu ƒe ʋuʋudedi, nu me ƒe lãmesẽ, aɖu ƒe ʋuʋudedi, aɖu me dɔdzẽ, nu me dɔdzẽ