E noʻonoʻo inā loaʻa i kekahi ka maʻi ʻaʻai waha, a i ʻole kahi maʻi koʻikoʻi ma ka iwi ʻāwae lalo ... i kekahi manawa pono e wehe loa ʻia ka ʻāpana maʻi ma ke ʻoki ʻana. No laila, ma kēia ʻatikala i kēia lā, e kamaʻilio mākou e pili ana i kahi ʻoki koʻikoʻi loa i hana ʻia ma ia ʻano kūlana. ʻOiai he kumuhana paʻakikī iki kēia, e kamaʻilio kākou e pili ana i ia mea me ka maʻalahi.
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He aha ka mandibulectomy?
I ka ʻōlelo maʻalahi, ʻo ka mandibulectomy ka wehe ʻoki ʻana i kahi hapa a i ʻole kou iwi ʻauwae/mandible haʻahaʻa a pau. Hana pinepine nā kauka i kēia ʻoki e wehe i kahi puʻupuʻu kanesa a i ʻole kahi ʻāpana maʻi ʻē aʻe o ka ʻauwae. Ua kapa ʻia hoʻi kēia he mandibular resection .
He aha nā ʻano nui o kēia ʻoki kino?
Hiki ke hoʻokaʻawale ʻia kēia ʻoki kino i ʻelua ʻano nui. E nānā kākou i ke ʻano o lākou.
| ʻAno o ke ʻoki kino | Wehewehe wale nō |
|---|---|
| ʻO ka Mandibulectomy hapa (Marginal Mandibulectomy) | ʻO kēia ka wehe ʻana i kahi ʻāpana liʻiliʻi wale nō o kou ʻāwae lalo. ʻO ka maʻamau, hoʻopau kēia i ka pono no ke ʻoki hana hou ʻana. |
| ʻO ka Mandibulectomy Segmental | Ma kēia kaʻina hana, ua wehe ʻia kahi hapa nui o ka ʻāwae haʻahaʻa. No laila, pono e hana hou ʻia ka ʻāwae. No ka hana ʻana i kēia, lawe nā kauka ʻoki i ka iwi, nā kīʻaha koko, a me nā ʻiʻo mai kahi ʻāpana ʻē aʻe o kou kino (e laʻa, ka wāwae, ka poʻohiwi) e hana hou i ka ʻāwae. Ua kapa ʻia kēia kaʻina hana he hana hou ʻana o ka flap free . |
Ma hea ʻoe e loaʻa ai ka iwi e kūkulu hou i kou ʻauwae?
Ma kahi mandibulectomy segmental, ʻōlelo mākou ua lawe ʻia nā ʻāpana iwi e pono ai ke kūkulu hou ʻana i ka ʻāwae mai nā ʻāpana ʻē aʻe o ke kino. ʻO nā ʻano hana maʻamau i hoʻohana ʻia no kēia:
- Ka wāwae haʻahaʻa
- ʻŌpae poʻohiwi
- ʻŪhā
I kekahi mau hihia, hiki ke hoʻohana ʻia nā papa metala a i ʻole ka iwi mai kahi mea hāʻawi no kēia kumu.
ʻO wai ka mea e pono ai kēia ʻoki kino?
Aia kekahi mau kūlana e hiki ai i kāu kauka ke ʻōlelo aku i kēia ʻano hana.
- Inā loaʻa iā ʻoe ka maʻi ʻaʻai waha .
- Ke loaʻa iā ʻoe ka maʻi kanesa ma ka ʻāpana waena o ka ʻāʻī (ka maʻi kanesa oropharyngeal) .
- Ke loaʻa kahi maʻi koʻikoʻi o ka iwi ʻauwae (osteomyelitis) .
- Ke hoʻoulu kekahi mau lāʻau lapaʻau (bisphosphonate therapy) i ka pohō nui o ka iwi ma ka ʻāwae (osteonecrosis o ka ʻāwae) .
- I ka wā e loaʻa ai kahi ʻeha koʻikoʻi loa ma ka ʻāwae lalo.
ʻO ka mea nui loa, ʻo ia ka hoʻoholo ʻana o kāu hui lapaʻau i ka lāʻau lapaʻau kūpono loa iā ʻoe ma kēia kūlana. No laila, he mea nui loa e kamaʻilio ākea me lākou a hoʻoponopono i kāu mau nīnau a me kou mau hopohopo.
He aha ka mea e hana ʻia ma mua o ke ʻoki kino?
Ma mua o ka hana ʻana i kēia ʻano hana, e hana kāu hui lapaʻau i kekahi mau hoʻokolohua, me kahi CT scan, e loiloi maikaʻi i ka nui a me ke kūlana o ka puʻupuʻu i loko o kou ʻā.
Inā pono ʻoe i ke ʻoki hana hou ʻana o ka ʻāwae, hiki ke hana ʻia nā hoʻokolohua hou aʻe e nānā i ke olakino o nā kīʻaha koko ma kahi o ka mea hāʻawi.
Eia kekahi, e aʻo aku kāu kauka iā ʻoe e pale i kēia mau mea ma mua o ke ʻoki ʻana, no ka mea hiki i kēia ke hoʻonui i ke kahe koko i ka wā o ke ʻoki ʻana a hoʻopaneʻe i ka ho'ōla ʻana o ka ʻeha ma hope.
- ʻAila
- Nā lāʻau hoʻopau ʻeha e like me ka aspirin a me ka ibuprofen
- Puhipaka
- ʻO kekahi mau mea hoʻohui lāʻau lapaʻau
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
He ʻoki lōʻihi ka mandibulectomy e mau ana no kekahi mau hola. Hana ʻia ia i kou wā e hiamoe ana ma lalo o ka anesthesia laulā .
I ka Marginal Mandibulectomy ...
1. E hana ke kauka ʻoki i kahi ʻoki ma loko o kou papālina.
2. Wehe ʻia ka ʻāpana maʻi ʻaʻai o ka ʻāwae lalo a me nā ʻiʻo a puni ia.
3. Ua humuhumu ʻia nā ʻoki me ka pani ʻia.
I ka ʻoki ʻana o ka Mandibulectomy Segmental...
He hana paʻakikī kēia.
1. ʻO ka mea mua, wehe ʻia ke kanesa ʻauwae a me nā ʻiʻo a puni ia.
2. Hoʻouna ʻia nā ʻāpana i wehe ʻia no kahi biopsy e nānā inā aia nō nā hunaola kanesa.
3. Nānā ʻia hoʻi e ʻike inā ua pālahalaha ke kanesa i nā lymph nodes.
4. A laila, lawe ʻia kahi ʻāpana iwi, ʻiʻo, a me ka ʻili mai kahi i hoʻoholo mua ʻia (e like me ka wāwae, poʻohiwi, a pēlā aku).
5. Hoʻohālikelike ʻia ka iwi i unuhi ʻia e kūpono i ka ʻāpana o ka ʻāwae i wehe ʻia.
6. Hoʻopili ʻia nā kīʻaha koko (nā aʻa a me nā veins) mai kahi i ʻohi ʻia i nā kīʻaha koko ma ke poʻo a me ka ʻāʻī. Hana akahele ʻia kēia.
7. ʻO ka hope loa, hoʻopaʻa ʻia ka ʻāwae hou me nā papa a me nā wili, a ua humuhumu ʻia nā ʻoki me ka pani ʻia.
Ma hope o ke ʻoki ʻana, pono paha ʻoe i kekahi o kēia mau mea:
- Nā kaola hoʻāʻo a me nā kaula laholio i loko o ka waha e mālama i nā niho a me ka ʻāwae i ke kaulike.
- ʻO kahi ʻōmole tracheostomy e kōkua iā ʻoe e hanu.
- ʻO ka ʻōmole hānai he ʻōmole i hoʻoili ʻia mai ka ihu a i ka ʻōpū e hāʻawi i ka meaʻai kūpono.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma muli o ke ʻano o ke ʻoki ʻana i loaʻa iā ʻoe, pono paha ʻoe e noho ma ka haukapila no ʻelua lā a ʻelua pule. Ma hope o kou hoʻi ʻana i ka home, pono ʻoe e hahai i nā ʻōlelo a kāu kauka e pili ana i ka mālama ʻana i kou mau ʻoki i hoʻomaʻemaʻe ʻia a me ka ʻai ʻana . I ka wā mua, pono paha ʻoe e ʻai ma ka papaʻai wai a i ʻole ma o kahi paipu hānai. E kamaʻilio pū me kāu kauka e pili ana i ke ʻano o ka mālama ʻana i kou ʻeha.
I ka wā o ke kaʻina hana ho'ōla, pono paha ʻoe i ka hoʻōla ʻōlelo a me ka hoʻōla kino. Inā loaʻa iā ʻoe ka maʻi kanesa, hiki ke ʻōlelo ʻia ka hoʻōla radiation a i ʻole chemotherapy e pepehi i nā hunaola kanesa i koe.
He aha nā hōʻailona e pono ai ke kōkua koke ʻia e ke kauka?
He mea nui loa e ʻimi koke i ke kōkua lapaʻau inā ʻike ʻoe i kekahi mau hōʻailona ma hope o ka hoʻi ʻana i ka home mai ke ʻoki kino. E makaʻala i nā hōʻailona aʻe:
| Hiʻohiʻona e hoʻolohe ai |
|---|
| Ke kuni ʻoi aku ma mua o 100.5 Fahrenheit (38.05 Celsius) |
| ʻEha poʻo nui |
| ʻEha nui ʻaʻole e emi iho ʻoiai ke lawe nei i nā lāʻau painkillers |
| Ka paʻakikī o ka hanu ʻana (dyspnea) |
| ʻO ka pehu nui (angioedema) ma kahi ʻoki a i ʻole ma kahi ʻē aʻe |
| Ka luaʻi a i ʻole ka luaʻi |
| He ʻano ʻili e like me ka ʻulaʻula |
Inā ʻike ʻoe i kekahi mea e like me kēia, e hoʻomaopopo koke i kāu kauka. I ka wā o kahi pilikia, e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.
Leka Lawe-Home
- ʻO ka Mandibulectomy kahi hana ʻoki nui i hoʻohana ʻia no nā maʻi koʻikoʻi e like me ke kanesa waha a me nā maʻi ʻino.
- Ma kēia, ua wehe ʻia kahi ʻāpana liʻiliʻi a nui paha o ka ʻāwae, a i kekahi manawa ua kūkulu hou ʻia ka ʻāwae me ka hoʻohana ʻana i ka iwi i lawe ʻia mai kahi ʻē aʻe o ke kino.
- He lōʻihi ka manawa no ke kaʻina hana ho'ōla a koi aku i ke kākoʻo o kahi hui lapaʻau, me nā kauka a me nā mea hoʻōla ʻōlelo.
- He mea nui loa e hahai i nā ʻōlelo a pau a kāu kauka e hāʻawi ai iā ʻoe ma mua a ma hope o ke ʻoki ʻana.
- Inā ʻike ʻoe i kekahi mau hōʻailona ma hope o ke ʻoki ʻana, mai hoʻokaʻulua a e ʻimi koke i ke kōkua lapaʻau.
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