Wafuna obujjanjabi obw’amasannyalaze (radiation treatment) ku kookolo w’omutwe n’ensingo? Kikosa amagumba go? Ka tuyige ku (Osteoradionecrosis - ORN)!

Wali obaddeko obulumi, okuzimba oba okulumwa munda mu kamwa oba akawanga oluvannyuma lw’okuweebwa obujjanjabi obw’amasannyalaze (radiation therapy) ku kookolo w’omutwe oba mu bulago? Kiyinza okuba nga kye kiseera oyige ku mbeera eyitibwa osteoradionecrosis. Tofaayo, tujja kukyogerako mu bujjuvu era mu ngeri ennyangu ennyo.

Obulwadde bw’amagumba (Osteoradionecrosis) (ORN) kye ki?

Mu ngeri ennyangu, osteoradionecrosis (ORN) kwe kufa kw’obutoffaali bw’amagumba olw’okukwatibwa obusannyalazo. Embeera eyinza okubaawo ng’ekizibu ekiva mu bujjanjabi bw’amasannyalaze ku kookolo naddala kookolo w’omutwe n’ensingo. Jjukira nti emisinde egikozesebwa okutta obutoffaali bwa kookolo oluusi giyinza okwonoona n’obutoffaali bw’amagumba obulamu. Kiyinza okubaawo nga wayise emyezi oba n’emyaka oluvannyuma lw’okufuna obujjanjabi obw’amasannyalaze.

Embeera eno etera okukosa eggumba ly’akawanga erya wansi (mandibular osteoradionecrosis). Wabula kiyinza okubaawo mu ggumba lyonna eribadde lifunye obusannyalazo, gamba ng’eggumba ly’akawanga erya waggulu (maxillary osteoradionecrosis) oba ekitundu eky’omu maaso eky’omugongo (vertebral osteoradionecrosis). Si bulijjo nnyo, embeera eno nayo esobola okukosa ekiwanga, naye eyinza okuba ey’amaanyi katono.

Obujjanjabi bw'amasannyalaze n'obulamu bw'amagumba - lwaki kino kibaawo?

Kati, ka tulabe lwaki kino kibaawo. Emisinde gyonoona emisuwa emigonvu egy’omusaayi mu magumba. Okufaananako n’ekitundu ekirala kyonna eky’omubiri gwaffe, amagumba geetaaga omusaayi omulungi okusobola okusigala nga galamu bulungi n’okuwona amangu singa gaayonoonebwa.

Lowooza, ng’omuti bwe gukala nga teguliimu mazzi, eggumba bwe litafuna musaayi gumala, nalyo lijja kufiirwa obulamu ne litandika okufa.

Kiki ekibaawo ng’omusaayi guno gutaataaganyizibwa?

• Amagumba n’ebitundu ebibyetoolodde byangu okukwatibwa obuwuka.
• Tekisoboka kuwona bulungi.
• Kitandise okufa mpolampola.

Ekitundu ky’akawanga kaffe naddala kye kisinga okukosebwa kino. Kino kiri bwe kityo kubanga kizibu okuziyiza obusannyalazo okutuuka ku ggumba ly’akawanga mu kiseera ky’obujjanjabi bw’obusannyalazo ku kookolo w’omutwe n’ensingo. Ate era, obulabe bwa `(ORN)` eno bwongera okweyongera olw'obuwuka obubeera mu butonde mu kamwa kaffe.

Okwonooneka kw’obusannyalazo munda mu kamwa kuyinza okuvaako ebintu nga:

• Okubikkulwa kw’amagumba (ekitegeeza nti eggumba libikkulwa nga liyita mu nnyindo).
• Oluusi n'oluusi okulumwa n'okuzimba mu bbwa .
• Okubeera n'ekiwundu ekitawona .

Embeera eno ya bulijjo etya?

Okusinziira ku kibiina kya American Head & Neck Cancer Society, osteoradionecrosis eyinza okubaawo mu bantu wakati wa 4% ne 8% abalina kookolo w’omutwe n’ensingo.

Bubonero ki obw’obulwadde bwa osteoradionecrosis (ORN)?

Kati ka tulabe obubonero bw’oyinza okufuna mu mbeera eno. Bw’oba ​​olina ekimu oba ebisingawo ku bino, kirungi onoonye omusawo amagezi.

• Ekiwundu oba amabwa ku ludda olw’ebweru w’ennyindo, ensingo oba akawanga.
• Obulumi.
• Okuzimba.
• Obulwadde (nga amasira).
• Amannyo obutakwatagana bulungi (malocclusion).
• Okuwulira okuwunya oba okuwunya .
• Ebitundutundu by’amagumba ebifuluma munda mu kamwa.
• Oluusi, wansi w'akalevu, olususu lukutuka era eggumba ne lifuluma (kino era kiyitibwa ``fistula`').
• Okumenya amagumba g’akawanga.
• Okunyiga ebinywa by’akawanga ekiremesa akamwa okugguka obulungi (trismus).

Lwaki obulwadde bwa osteoradionecrosis (ORN) bubaawo?

Ekisinga okuvaako obulwadde buno bwe bujjanjabi bw’amasannyalaze (radiation therapy) ku mutwe n’ensingo. Embeera eno esinga kubeera mu bantu abafunye dose z’obusannyalazo ezisukka mu yuniti 60 eza Grey (Gy). (Gy ye yuniti y’okupima emisinde).

Osteoradionecrosis `(ORN)` Ensonga eziyinza okuvaako akabi - Ani asinga okubufuna?

Abantu abamu bali mu bulabe bw’okufuna embeera eno okusinga abalala. Laba oba ensonga zino zikukwatako:

• Obuyonjo bw’omu kamwa obubi (obutasenya mannyo, obutafaayo ku buyonjo bw’omu kamwa).
• Singa ebizibu by’amannyo (nga ebituli n’obulwadde bw’ennyindo) tebyakolebwako bulungi nga obujjanjabi bwa radiation tebunnatandika.
• Singa ofuna obulwadde bw’akamwa obukalu (xerostomia) oluvannyuma lw’okujjanjabwa n’amasannyalaze.
• Singa wabaawo akabenje oba obuvune bwonna ku bbwa oluvannyuma lw’okujjanjabwa n’amasannyalaze naddala mu mwaka ogusooka.
• Singa erinnyo liggyibwa mu kitundu ekyali kimaze okufukibwako obusannyalazo.

Jjukira nti embeera eno ey’obulwadde bw’amagumba esobola okubaawo ne bwe wayise emyaka mingi ng’ofunye obujjanjabi obw’amasannyalaze (radiation treatment) ku kookolo w’omutwe n’ensingo.

Kino kizuulibwa kitya?

Osteoradionecrosis (ORN) etera okubaawo oluvannyuma lw’emyaka egiwerako oluvannyuma lw’obujjanjabi obw’amasannyalaze. Omusawo bw’aba ateebereza kino, ajja kukukebera omutwe n’ensingo mu bujjuvu. Era ajja kutuukirira omusawo wa kkansa ow’amasannyalaze eyakuwa obujjanjabi obw’amasannyalaze okumanya ddoozi yonna ey’obusannyalazo bwe wafuna.

Biki ebikeberebwa ebiyamba mu kuzuula obulwadde?

Okukakasa nti olina obulwadde buno, omusawo ayinza okukuwa amagezi okukeberebwa nga:

• X-ray z’amannyo.
• CT scan y’akawanga (CT - computed tomography scan) ekolebwa.
• Okukebera kookolo kuyinza okukolebwa okukebera oba kookolo azzeemu.

Bujjanjabi ki obukolebwa ku kino?

Obujjanjabi bw’obulwadde bw’amagumba (ORN) businziira ku bunene n’obuzibu bw’embeera yo. Ekisinga obukulu kwe kutandika obujjanjabi amangu ddala nga bwe kisoboka.Gy’okoma okutandika amangu obujjanjabi, emikisa gyo egy’okuwona gye gikoma okubeera emirungi. Waliwo obujjanjabi obw’okulongoosa n’obutali bwa kulongoosa ku kino.

Enzirukanya y’okulongoosa

Waliwo okulongoosa okuwerako okukolebwa ku mbeera eno:

• Okulongoosa okusalako: Kino omusawo alongoosa bw’aggyamu amagumba n’ebitundu ebifu oba ebirimu obuwuka, okufaananako n’okuyonja ekifo ekibi.
• Okulongoosa okuddamu okuzimba ekifuba ku bwereere: Kuno kulongoosa kuzibu katono. Kizingiramu okuggya emisuwa, ebitundu by’omubiri, era oboolyawo ekitundu ky’eggumba okuva mu kitundu ekirala eky’omubiri gwo (okugeza, ekigere oba omukono) n’okisimbuliza mu kitundu ky’akawanga ekyonoonese.
• ALTFL (Anterolateral Thigh Fascia Lata Rescue Flap): Kino nakyo kika kya kifuba eky’obwereere. Mu nkola eno, ekitundu ky’ebitundu ebiyunga (fascia) kiggyibwa emabega w’ekisambi ne kisimbibwa. Ekitundu kino kirimu emisuwa mingi, ekisobozesa ekitundu ekyonoonese okufuna omukka gwa oxygen n’ebiriisa. Okunoonyereza okwakakolebwa kulaga nti enkola eno ekola nnyo mu bantu abalina ORN.
• Okusimba amagumba mu bujjuvu: Enkola eno ey’ekinnansi ey’okulongoosa ekozesebwa ng’amagumba amafu mangi naddala mu bbwa erya wansi. Mu nkola eno, eggumba eryonoonese liggyibwawo ddala ne basimbibwamu ekifuba eky’eddembe ekirimu amagumba mu kifo kyalyo. Wadde nga eno nkola ya buwanguzi, nkola ya maanyi nnyo. Kiyinza okuvaamu okumala ebbanga eddene mu ddwaaliro n’okuwona ekiseera ekiwanvu. N’olwekyo abasawo bagezaako okuzuula n’okujjanjaba embeera eno nga bukyali.

Enzirukanya y’emirimu etali ya kulongoosa

Waliwo n’obujjanjabi obutali bwa kulongoosa:

• Eddagala eritta obuwuka: Singa wabaawo yinfekisoni mu ggumba oba mu bitundu ebigyetoolodde, omusawo ajja kukuwa eddagala eritta obuwuka.
• PENTOCLO: Kino kigatta eddagala eriwerako: pentoxifylline, tocopherol (vitamin E), ne clodronate. Pentoxifylline akola nga ayongera omusaayi okugenda mu ggumba eryonoonese. Tocopherol (vitamin E) ayamba okunyweza abaserikale b’omubiri n’okuziyiza omusaayi okuzimba. Clodronate ayamba okuziyiza amagumba okwongera okufiirwa. Oluusi pentoxifylline ne tocopherol ziweebwa nga tezirina clodronate (kino kiyitibwa PENTO).
• Obujjanjabi bwa okisigyeni omungi (Hyperbaric oxygen therapy - HBO - obujjanjabi):Abasawo abamu bakozesa obujjanjabi buno okwanguya omubiri okuwona. Mu kino, oteekebwa mu kisenge eky’enjawulo n’okolebwa okussa omukka gwa oxygen omulongoofu. Omukka gwa oxygen munda mu kisenge gusinga emirundi nga esatu okusinga mu mbeera eya bulijjo. Ekigendererwa ekikulu kwe kwongera omukka gwa oxygen ogumala mu musaayi okuddaabiriza ebitundu ebyonooneddwa. Wabula waliwo endowooza ez'enjawulo mu basawo ku bujjanjabi buno obwa ``Hyperbaric oxygen``. Wadde nga ekozesebwa ng’obujjanjabi obw’omutindo mu bifo ebimu, n’okutuusa kati tewali kunoonyereza kufugibwa kukakasizza obuwanguzi bwayo.

Obulwadde bw’amagumba obuyitibwa osteoradionecrosis (ORN) busobola okuziyizibwa?

Embeera eno eyinza obutaziyizibwa bulijjo, naye nga tonnatandika kujjanjaba masanyalaze ku mutwe oba mu bulago, omusawo ajja kwogera naawe ku ngeri y’okukendeeza ku bulabe buno.

Nga tonnatandika kujjanjaba masanyalaze, olina okukola bino wammanga:

• Lambula omusawo w’amannyo , yoze akamwa ko obulungi, era okebere mu bujjuvu .
• Funa obujjanjabi bwonna obw’amannyo bukolebwe (nga okujjuza amannyo, okuggyamu amannyo).
• Tandika okujjanjaba eddagala lya fluoride buli lunaku .

Ebintu bino olina okubikola ng’ojjanjabwa n’obusannyalazo n’oluvannyuma lw’okujjanjaba:

• Kuuma obuyonjo bw’omu kamwa obulungi (okusenya amannyo emirundi ebiri buli lunaku, okuyonja wakati w’amannyo).
• Kendeeza ku mmere n'ebyokunywa ebirimu ssukaali .
• Laba omusawo w’amannyo buli kiseera akukebere era oyoze akamwa.
• Funa obujjanjabi ku buzibu bwonna obupya obw'amannyo mu bwangu .
• Weeyongere okujjanjaba fluoride buli lunaku .

Obulwadde bw’amagumba obuyitibwa osteoradionecrosis (ORN) busaasaana mangu butya?

Emirundi egisinga, osteoradionecrosis (ORN) ekula mpola. Kiyinza okukutwalira emyaka egiwerako okusobola okufuna obubonero.

Obulwadde bw’amagumba obuyitibwa osteoradionecrosis (ORN) busobola okuwona?

Wadde ng’abasawo abalongoosa tebasobola kuzzaawo ggumba lifudde, obujjanjabi obutuufu busobola okuyimiriza okukula kw’obulwadde bw’amagumba (ORN). Kigambibwa nti singa obujjanjabi butandikibwawo nga bukyali, embeera eno esobola okuyimirizibwa mu balwadde 96% .

Kale, bw’oba ​​olina obulwadde bw’amagumba (ORN), okutandika obujjanjabi nga bukyali gwe mukisa gwo ogusinga obulungi okutuuka ku buwanguzi. Okulongoosebwa kwo kuyinza okuba okumpi, era oyinza okuwona amangu. Gy’okoma okujjanjaba amangu (ORN), gy’okoma okujjanjaba.

Obulwadde bw’amagumba (Osteoradionecrosis) (ORN) Okuteebereza

Osteoradionecrosis (ORN) mbeera ejjanjabibwa nnyo. Ekika ky’obujjanjabi obwetaagisa kisinziira ku kifo eggumba eryonoonese we liri, amagumba gye gafa, n’obujjanjabi bw’ogezezzaako emabegako.

Okutwalira awamu, ekitundu ky’amagumba gye kikoma okuba ekitono, emikisa gy’okuwona nga tolongooseddwa nnyo. Emisango egimu egya ORN giyinza obutaddamu ku bujjanjabi obutonotono era giyinza okugenda mu maaso ne gifuuka yinfekisoni y’amagumba (osteomyelitis) oba okumenya amagumba. Mu mbeera ng’ezo, abasawo abalongoosa bayinza okwetaaga okulongoosa okunene (free flap).

Ddi lwe nnina okulaba omusawo?

Bw’oba ​​wali ofunye obujjanjabi bw’amasannyalaze ku mutwe oba mu bulago n’otandika okufuna obubonero ng’okulumwa, okuzimba oba okunyiga, laba omusawo amangu ago. Basobola okukakasa nti olina obulwadde bwa osteoradionecrosis (ORN) ne batandika mangu obujjanjabi bwonna obwetaagisa.

Bibuuzo ki bye nnina okubuuza omusawo wange?

Bw’oba ​​ggwe oba omwagalwa wo ozuuliddwa n’obulwadde bw’amagumba (ORN), oyinza okwebuuza ebibuuzo bino:

• Obulwadde buno obw’amagumba busaasaanidde wa?
• Bujjanjabi ki bwe nnina?
• Nnaaba nneetaaga okulongoosebwa?
• Endowooza yange (okuwona) eri etya?

N’ekisembayo, jjukira (Obubaka bw’Okutwala Awaka) .

Osteoradionecrosis (ORN) kizibu kya maanyi ekiva mu bujjanjabi bw’amasannyalaze ku mutwe n’ensingo. Kiyinza okutwala emyaka obubonero okulabika. Wadde nga ORN tesobola "wonyezebwa" ddala, esobola okuddukanyizibwa n'obujjanjabi. Ebivaamu bisinziira ku kifo eggumba eryonoonese we liri, obunene bw’amagumba we gafudde, n’obuzibu bw’amagumba.

Bw’oba ​​olina obulumi, okuzimba, okukwatibwa amagumba oba obubonero obulala obw’obulwadde bw’amagumba, laba omusawo amangu ago. Bayinza okukuwa amagezi ku bujjanjabi obutuufu n’okukuyamba okuddukanya embeera yo. Okukuuma obuyonjo obulungi mu kamwa n’okulaba omusawo w’amannyo buli kiseera kikulu mu kuziyiza n’okuzuula embeera eno nga bukyali.

` Osteoradionecrosis, ORN, ebizibu ebiva mu bujjanjabi bw’amasannyalaze, obulwadde bw’amagumba g’akawanga, obujjanjabi bwa kookolo, okufa kw’amagumba, obulamu bw’omu kamwa