ʻO nā aʻalolo e holo ana ma loko o ko kākou kino ua like ia me kahi pūnaewele o nā uwea e lawe ana i nā leka uila. ʻO lākou ka mea e lawe i ka ʻike i mua a i hope mai ka lolo a i ke koena o ke kino, a mai ke kino a i ka lolo. E noʻonoʻo ua kāʻei ʻia kēia mau hunaola aʻalolo, ko lākou mau hui, i loko o nā membrane pale kūikawā, e like me ka ʻūpā palakiko a puni ka uwea, e pale iā lākou a kōkua i ka holo wikiwiki ʻana o nā hōʻailona uila. Aia i loko o kēia mau membrane pale e ulu ai kēia mau mea i kapa ʻia he mau puʻupuʻu ʻūpā aʻalolo i kekahi manawa.
He aha nā ʻōhū o ka ʻaʻalolo?
I ka ʻōlelo maʻalahi, hana ʻia kēia mau puʻupuʻu i loko o nā "ʻūpā" pale e hoʻopuni ana i ko kākou mau aʻalolo. Hana ʻia kēia "ʻūpā" a i ʻole ka uhi ʻana i kekahi mau papa:
- Nā pūnaewele Schwann: ʻO kēia nā pūnaewele e hoʻopuni ana i ka axon, ka ʻāpana lōʻihi o ke kelepona nerve, e like me ka insulation a puni ka uea.
- Endoneurium: ʻO kēia ka ʻiʻo hoʻopili e hoʻopuni ana i kēlā me kēia fiber nerve, e like me ka ʻūpā a puni kahi uea keleawe hoʻokahi i loko o kahi uea.
- ʻO Perineurium: ʻO kēia ka mea e hoʻopuni ana i nā puʻupuʻu o nā olonā nerve.
Hiki ke puʻunaue ʻia ko kākou ʻōnaehana nerve i ʻelua ʻāpana:
- ʻŌnaehana nerve waena: Hoʻokomo pū kēia i ko mākou lolo a me ke kaula iwi kuamoʻo.
- ʻŌnaehana nerve peripheral: ʻO kēia ka pūnaewele o nā aʻalolo e lālā ana mai ka lolo a me ke kaula spinal i nā ʻāpana āpau o ke kino.
ʻO ka hapa nui o ka manawa, hoʻokumu ʻia kēia mau neurofibromas i loko o ka ʻōnaehana nerve peripheral .
He aha nā ʻano nati i laila?
Aia kekahi mau ʻano nui o nā neuromas. E nānā kākou i ko lākou ʻano.
ʻO Schwannomas
Hoʻomohala kēia mau puʻupuʻu i loko o nā pūnaewele Schwann i ʻōlelo ʻia ma mua. Ma kahi o 60% o nā schwannomas e ulu ana i loko o ke aʻalolo vestibular i loko o ko kākou pepeiao i loko . Kōkua kēia aʻalolo i ko kākou kino e mālama i ke kaulike. Hiki i nā schwannomas ʻē aʻe ke ulu i kekahi manawa ma lalo o ko kākou ʻili, a i ʻole i loko o nā ʻiʻo a me nā ʻōpū o ke kino. ʻO nā wahi maʻamau e ʻike ʻia ai kēia mau puʻupuʻu:
- Ma nā lima a me nā wāwae
- I loko o ke poʻo
- I loko o ke kino (ʻo ia hoʻi, ka wahi ma waena o nā poʻohiwi a me nā pūhaka)
ʻO Schwannomas kahi ʻano puʻupuʻu i uhi pinepine ʻia e kahi papa lahilahi o nā ʻiʻo, a i ʻole "encapsulated." ʻO kēia mau puʻupuʻu he ʻano maʻamau ʻaʻole cancerous (benign). Eia naʻe, he mea kākaʻikahi loa, hiki i kahi puʻupuʻu lōʻihi ke lilo i cancerous (malignant).
Nā Neurofibromas
ʻO kēia ʻano puʻupuʻu e pili ana i kekahi mau ʻano ʻiʻo i kapa ʻia ʻo nā pūnaewele Schwann, endoneurium, a me ka perineurium e uhi ana i nā aʻalolo. ʻIke pinepine ʻia kēia mau mea he mau puʻupuʻu ma lalo o ka ʻili, akā hiki ke ulu i kekahi manawa ma nā aʻalolo i loko o ke kino.
ʻAʻole e like me nā schwannomas, ʻaʻole i hoʻopili ʻia nā neurofibromas. Ulu lākou i loko o nā pūʻolo aʻalolo. ʻO nā neurofibromas Plexiform kahi ʻano puʻupuʻu e pālahalaha ana e like me ka ʻupena, e hoʻopuni ana i nā pūʻolo aʻalolo he nui a hiki ke pālahalaha i loko o nā ʻiʻo a puni.
ʻAʻole ka hapa nui o nā neurofibromas he maʻi kanesa. Eia nō naʻe, ma kahi o 5% a 10% o kēia mau puʻupuʻu hiki ke lilo i maʻi kanesa . Ua kapa ʻia lākou he mau maʻi ʻaʻai peripheral malignant (MPNST) . Ma kahi o ka hapalua o ka poʻe me kēia mau maʻi ʻino ua laha mua i nā ʻāpana ʻē aʻe o ke kino i ka manawa i ʻike ʻia ai lākou.
Pehea ka maʻamau o kēia hua?
He mea kākaʻikahi nā ʻōʻō ʻupena nerve noncancerous.
- ʻO ka hapa nui o ka poʻe i loaʻa i nā Schwannomas he 50 a 60 mau makahiki.
- ʻIke pinepine ʻia nā neurofibromas i nā kānaka ma waena o 20 a me 40 mau makahiki.
- ʻO ka maʻamau, ulu ka plexiform neurofibromas ma mua o ka piha ʻana o 5 mau makahiki.
He ʻano maʻi kanesa kakaikahi loa nā ʻōhū ʻaʻa Peripheral Nerd , e hoʻopilikia ana i hoʻokahi wale nō i loko o 10 miliona mau kānaka i kēlā me kēia makahiki.
No ke aha e like ai kēia ʻano o nā puʻupuʻu? He aha nā kumu?
He hopena nui ko nā loli genetic i ka ulu ʻana o kēia mau neurofibromas.
- ʻO ka ulu ʻana o Schwannomas e pili ana me nā loli i ka gene i kapa ʻia ʻo NF2.
- Ua pili nā neurofibromas me kahi gene i kapa ʻia ʻo (NF1).
ʻO ka hapa nui o ka manawa, hana pinepine ʻia kēia mau loli genetic, me ke kumu ʻole . Eia nō naʻe, ua hoʻokumu ʻia kahi helu liʻiliʻi o nā schwannomas a me nā neurofibromas e kahi maʻi genetic laha ʻole i kapa ʻia ʻo neurofibromatosis , hiki ke holo i loko o nā ʻohana.
Nā ʻano o Neurofibromatosis
ʻEkolu mau ʻano nui o kēia maʻi:
- ʻAno Neurofibromatosis 1 (NF1): Loaʻa i ka poʻe me NF1 ka nui o nā neurofibromas. Loaʻa iā lākou kahi pilikia nui o ka hoʻomohala ʻana i nā neuromas plexiform a me nā ʻōpū nerve peripheral malignant (MPNST). ʻO nā kūlana ʻē aʻe i ʻike ʻia i ka poʻe me NF1 e komo pū me ka macrocephaly , scoliosis, a me nā pilikia aʻo .
- ʻAno Neurofibromatosis 2 (NF2):ʻAneʻane hiki i nā kānaka a pau me NF2 ke loaʻa nā schwannomas vestibular ma nā pepeiao ʻelua ma mua o 30 mau makahiki. Eia kekahi, hiki i nā ʻano schwannomas a me nā puʻupuʻu ke ulu i loko o ko lākou ʻili, nā maka, a me ka ʻōnaehana nerve waena.
- Schwannomatosis: Ma kēia ʻano, ulu nā schwannomas he nui i loko o ke aʻalolo vestibular (ma nā pepeiao ʻelua) ma mua o ke aʻalolo vestibular.
He aha nā hōʻailona o kēia mau puʻupuʻu?
ʻAʻole ʻike ka hapa nui o ka poʻe me nā ʻōpū neuromastoid i kekahi ʻeha a i ʻole nā hōʻailona ʻē aʻe . Eia nō naʻe, inā ulu nui ka ʻōpū a kaomi paha i kahi aʻalolo, nā hōʻailona e like me:
- He puʻupuʻu a puʻupuʻu paha ma lalo o ka ʻili (hiki ke ʻeha ke kaomi ʻia).
- Ka nāwaliwali o nā ʻiʻo .
- Ka mae ʻana o ka ʻōpū .
- ʻEhaʻeha, ʻehaʻeha, a ʻeha nui paha .
- He ʻano ʻūlili, e like me ke pā ʻia ʻana e ka uila .
Ma muli o kahi o ka puʻupuʻu, hiki ke ʻike ʻia nā hōʻailona kikoʻī ʻē aʻe. Eia kekahi mau laʻana:
- He puʻupuʻu o ke aʻalolo sciatic: ʻEha e hele ana mai ke kua i lalo i ka wāwae (sciatica).
- He puʻupuʻu ma ka pulima: Nā hōʻailona like me nā hōʻailona o ka Carpal Tunnel Syndrome.
- ʻO ka maʻi ʻaʻa Vestibular: Poho ka lohe, tinnitus, pilikia kaulike.
ʻO ka maʻamau, inā loaʻa i kekahi ka neurofibromatosis, he puʻupuʻu hoʻokahi ia. Eia nō naʻe, i nā poʻe me ke ʻano neurofibromatosis i ʻōlelo ʻia ma mua, hiki ke ʻike ʻia nā puʻupuʻu he nui (pinepine ma ka ʻili).
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe kēia mau nati?
E nānā mua kāu kauka iā ʻoe ma ke kino a loiloi i kou olakino holoʻokoʻa. E komo pū ana kēia me ka nīnau ʻana e pili ana i kou mōʻaukala olakino, ka mōʻaukala olakino ʻohana, a me nā hōʻailona āu e ʻike nei.
No ka noiʻi hou ʻana i kahi puʻupuʻu i ʻike mua ʻia a i ʻole he puʻupuʻu i manaʻo ʻia, hiki i kāu kauka ke ʻōlelo i nā hoʻokolohua aʻe:
- Nā hoʻokolohua kiʻi lapaʻau: Hoʻokomo pū ʻia kēia me nā scan MRI, nā scan ultrasound, a me nā scan PET e ʻike maopopo i ka puʻupuʻu.
- Biopsy: Lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupuʻu a nānā ʻia ma lalo o kahi microscope e hoʻoholo ai i ke ʻano o nā cell i loaʻa. ʻO kēia ka mea e hiki ke haʻi iā ʻoe inā he maʻi kanesa ka puʻupuʻu a ʻaʻole paha.
Inā he nui kāu mau puʻupuʻu, hiki i kāu kauka ke ʻōlelo aku i ka hoʻāʻo genetic e ʻike inā he mau maʻi kou i kapa ʻia ʻo (NF1), (NF2), a me Schwannomatosis.
He aha nā lāʻau lapaʻau no kēia?
Inā ʻaʻohe ou hōʻailona mai kahi neuromastoid, hiki i kāu kauka ke ʻōlelo aku "e nānā a kali."Hiki iā ʻoe ke hele me ke ʻano i kapa ʻia ʻo "monitoring." ʻO ia hoʻi ke nānā pinepine ʻana i ka ʻōpū e ʻike ai inā e nui ana a e loli ana paha.
No nā ʻōpū hōʻailona, a inā makemake ʻoe e wehe i ka ʻōpū no nā kumu hoʻonaninani, ʻo ke ʻoki ʻana wale nō ke koho maʻamau .
ʻO kekahi mau neurofibromas, ʻoiai nā mea i kapa ʻia ʻo plexiform neurofibromas, he paʻakikī ke wehe loa no ka mea ulu lākou i loko o ke aʻalolo a ma waena o nā papa o ka uhi. Inā ʻaʻole hiki ke wehe loa ʻia ka puʻupuʻu ma hope o ke ʻoki ʻana, e nānā pono kāu kauka iā ʻoe, no ka mea hiki i ka puʻupuʻu ke ulu hou.
Ka mālama ʻana i nā schwannomas ma ke poʻo
ʻO nā Schwannomas i hana ʻia ma ke poʻo, e like me nā schwannomas vestibular, hiki ke hoʻopilikia i nā aʻalolo e kāohi ana i nā hana koʻikoʻi i loko o ko mākou kino. I kēia mau hihia, hoʻohana nā kauka i kahi ʻano hana i kapa ʻia ʻo stereotactic radiosurgery (e.g., Gamma Knife®) e pale aku i ka hōʻino ʻana i nā aʻalolo.
ʻAʻole kēia he ʻoki kuʻuna e pili ana i ka hana ʻana i kahi ʻoki. Pili ia i ka hoʻouna ʻana i kahi kukuna radiation i kuhikuhi pono ʻia ma o ka ʻili e luku a hoʻēmi paha i ka puʻupuʻu.
Ka mālama ʻana i nā ʻōpū ʻōpū aʻalolo peripheral cancerous
Ma waho aʻe o ke ʻoki kino, hiki ke hoʻohana ʻia nā lāʻau lapaʻau maʻi kanesa e like me ka radiation therapy a me ka chemotherapy e mālama ai i nā ʻōpū ʻeha nerve peripheral malignant.
He aha nā pilikia e hiki ke loaʻa mai ke ʻoki kino?
E like me nā hana ʻoki kino a pau, aia kekahi mau pilikia maʻamau e hiki ke hana me kēia mau hana ʻoki kino:
- Ke kahe ʻana o ke koko
- Ka maʻi ʻeha
- ʻEha
- Ka ʻeha
Eia kekahi, loaʻa i ke ʻoki ʻana i nā aʻalolo kahi pilikia o ka hōʻino ʻana i nā aʻalolo a me ke kīnā mau loa . E kōkua kāu hui lapaʻau iā ʻoe e hoʻokele i kekahi kīnā lōʻihi e kū mai ana ma hope o ke ʻoki ʻana. Hiki i nā ʻano lāʻau like ʻole (physical therapy, occupational therapy, a me ka speech therapy) ke kōkua iā ʻoe e hoʻōla.
Hiki ke pale ʻia ke kūkulu ʻia ʻana o kēia mau puʻupuʻu?
ʻAʻohe ala i ʻike ʻia e pale aku ai i ka hoʻokumu ʻia ʻana o kēia mau puʻupuʻu. Eia nō naʻe, hiki i kāu kauka ke paipai i ka hoʻāʻo ʻana i ka genetic inā ʻoe:
- Inā he moʻolelo ko kekahi o kou ʻohana no ka hoʻomohala ʻana i nā neurofibromas.
- Inā he nui kou mau puʻupuʻu ʻōpū nerve (hiki i kēia ke hōʻailona o ke ʻano neurofibromatosis).
He aha kā mākou e noʻonoʻo ai e pili ana i kēia mau nati i ka wā e hiki mai ana? (Outlook)
ʻAʻole ka hapa nui o nā neurofibromas he maʻi kanesa . Hiki ke ho'ōla ʻia me ke ʻoki ʻana a ʻaʻole pinepine e hoʻi hou mai. Eia nō naʻe, inā ʻaʻole hiki ke wehe loa ʻia kou puʻupuʻu me ke ʻoki ʻana, pono ʻoe e hoʻomau ma lalo o ka nānā ʻana o ke kauka.
Ma kahi o 3 mai loko mai o 4 mau kānaka i loaʻa ka lāʻau no ka vestibular schwannoma hiki iā lākou ke mālama i ko lākou lohe .
He haʻahaʻa loa ka pilikia o ka lilo ʻana o kahi puʻupuʻu ʻaʻalolo i maʻi kanesa. ʻO ka pilikia kiʻekiʻe loa no ka poʻe me ke ʻano (NF1) i loaʻa i ka Plexiform neurofibroma. ʻAʻole maikaʻi ka wānana no nā ʻōpuʻu ʻaʻalolo peripheral malignant (MPNST), ʻoiai inā ʻoi aku ka nui o ka puʻupuʻu ma mua o 2 ʻīniha. ʻAʻole i hiki i ka hapalua o ka poʻe me kēia ʻano ke ola i ʻelima mau makahiki ma hope o ka ʻike ʻia ʻana.
Āhea ʻoe e ʻike ai i ke kauka?
Inā ʻike ʻoe i kahi puʻupuʻu ma lalo o kou ʻili, a i ʻole e ʻike i kekahi mau hōʻailona āu e manaʻo ai he neurofibromatosis paha , e ʻike koke i ke kauka . Eia kekahi, e haʻi i kāu kauka inā loaʻa i kekahi o kou ʻohana kēia ʻano puʻupuʻu.
Leka Hoʻihoʻi Hope Loa
E hoʻomanaʻo, ʻo ka hapa nui o nā puʻupuʻu neuroendocrine he mau ulu maikaʻi ʻole, ʻaʻole cancerous e ulu mālie ana . Inā ʻaʻohe ou hōʻailona, hiki i kāu kauka ke hoʻoholo e nānā wale iā ʻoe. Inā pono e wehe ʻia kahi puʻupuʻu, ʻoi aku ka holomua o ke ʻoki ʻana. He mea kākaʻikahi loa nā pilikia (e like me ka hiki ʻole ke wehe loa i ka puʻupuʻu, ka hōʻino ʻana o ke aʻalolo), a i ʻole ka lilo ʻana o kahi puʻupuʻu i cancerous. E kōkua kāu kauka iā ʻoe e hoʻomohala i kahi hoʻolālā lapaʻau a me kahi papa hana no nā hoʻokolohua e hiki mai ana e kōkua iā ʻoe e hoʻokele i kou kūlana. No laila, mai makaʻu e kamaʻilio me kāu kauka e pili ana i kekahi mea.
nā puʻupuʻu ʻaʻalolo, schwannoma, neurofibroma, neurofibromatosis, nā puʻupuʻu aʻalolo, maʻi ʻaʻai, nā maʻi hoʻoilina, nā puʻupuʻu ʻaʻalolo
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