Kodi zotupa zingayambe m'mitsempha yanu? Tiyeni tikambirane za zotupa za m'chifuwa mwachidule!

Mitsempha yomwe imayenda m'thupi lathu ili ngati netiweki ya mawaya omwe amanyamula mauthenga amagetsi. Ndi omwe amanyamula chidziwitso kuchokera ku ubongo kupita ku thupi lonse, komanso kuchokera ku thupi kupita ku ubongo. Tangoganizani kuti maselo amitsempha awa, magulu awo, onse ali okulungidwa ndi nembanemba zapadera zoteteza, monga chidebe cha pulasitiki chozungulira waya, kuti chiwateteze ndikuthandiza zizindikiro zamagetsi kuyenda mwachangu. Ndi m'ma nembanemba oteteza awa momwe nthawi zina zotupa za m'chidebe cha mitsempha zimakulirakulira.

Kodi Matenda a Mitsempha ya Sheath ndi Chiyani?

Mwachidule, zotupa zimenezi zimapangidwa mu "zikwama" zoteteza zomwe zimazungulira mitsempha yathu. "Chikwama" ichi kapena chophimbachi chimapangidwa ndi zigawo zingapo:

• Maselo a Schwann: Awa ndi maselo omwe amazungulira axon, gawo lalitali la selo la mitsempha, ngati chotenthetsera chozungulira waya.
• Endoneurium: Iyi ndi minofu yolumikizana yomwe imazungulira ulusi uliwonse wa mitsempha, mofanana ndi chipolopolo chozungulira waya umodzi wamkuwa mu waya.
• Perineurium: Ichi ndi chomwe chimazungulira mitolo ya ulusi wa mitsempha.

Thupi lathu la mitsempha lingagawidwe m'magawo awiri:

• Dongosolo la mitsempha yapakati: Izi zikuphatikizapo ubongo wathu ndi msana.
• Dongosolo la mitsempha ya m'mphepete mwa ubongo: Uwu ndi mgwirizano wa mitsempha yomwe imafalikira kuchokera ku ubongo ndi msana kupita ku ziwalo zonse za thupi.

Nthawi zambiri, ma neurofibroma amenewa amapangika m'mitsempha ya m'mphepete mwa mitsempha .

Kodi pali mitundu yanji ya mtedza?

Pali mitundu ikuluikulu ingapo ya ma neuromas. Tiyeni tiwone zomwe zili.

Schwannomas

Zotupa zimenezi zimakula m'maselo a Schwann omwe tawatchula kale. Pafupifupi 60% ya schwannomas imakula m'mitsempha ya vestibular yomwe ili mkati mwa khutu lathu . Mitsempha imeneyi imathandiza thupi lathu kukhalabe lolimba. Nthawi zina schwannomas zimatha kukula pansi pa khungu lathu, kapena mkati mwa minofu ndi ziwalo za thupi. Malo ofala kwambiri omwe zotupazi zimapezeka ndi awa:

• M'manja ndi m'miyendo
• Mumutu
• Mu thunthu (ndiko kuti, malo pakati pa mapewa ndi chiuno)

Schwannomas ndi mtundu wa chotupa chomwe nthawi zambiri chimaphimbidwa ndi minofu yopyapyala, kapena "yotsekedwa." Chotupachi nthawi zambiri sichimakhala ndi khansa (choipa). Komabe, nthawi zambiri, chotupa chomwe chakhalapo kwa nthawi yayitali chingakhale khansa (choopsa).

Matenda a Neurofibroma

Mtundu uwu wa chotupa umakhudza mitundu ingapo ya minofu yotchedwa maselo a Schwann, endoneurium, ndi perineurium yomwe imaphimba mitsempha. Izi nthawi zambiri zimawoneka ngati zotupa pansi pa khungu, koma nthawi zina zimatha kumera pamitsempha mkati mwa thupi.

Mosiyana ndi ma schwannoma, ma neurofibroma sakuikidwa m'mabokosi. Amakula mkati mwa mitolo ya mitsempha. Ma neurofibroma a Plexiform ndi mtundu wa chotupa chomwe chimafalikira ngati ukonde, chozungulira mitolo yambiri ya mitsempha ndipo chimatha kufalikira m'minofu yozungulira.

Matenda ambiri a neurofibroma si khansa. Komabe, pafupifupi 5% mpaka 10% ya matendawa amatha kukhala khansa . Amatchedwa kuti malignant peripheral nerve sheath tumors (MPNST) . Pafupifupi theka la anthu omwe ali ndi matendawa amakhala atafalikira kale ku ziwalo zina za thupi panthawi yomwe amapezeka.

Kodi chipatsochi n'chofala bwanji?

Zotupa za m'mitsempha zomwe sizili ndi khansa sizimachitika kawirikawiri.

• Matenda a Schwannoma amapezeka kwambiri mwa anthu azaka zapakati pa 50 ndi 60.
• Matenda a neurofibroma nthawi zambiri amapezeka mwa anthu azaka zapakati pa 20 ndi 40.
• Ma plexiform neurofibromas nthawi zambiri amakula asanakwanitse zaka 5.

Matenda a khansa ya m'mitsempha ya m'mphepete mwa mitsempha yoopsa ndi khansa yosowa kwambiri , ndipo imakhudza munthu m'modzi pa anthu 10 miliyoni chaka chilichonse.

N’chifukwa chiyani zotupa zimakhala ngati zimenezi? Kodi zimayambitsa chiyani?

Kusintha kwa majini kumakhudza kwambiri kukula kwa ma neurofibromas amenewa.

• Kukula kwa Schwannomas kumalumikizidwa ndi kusintha kwa jini yotchedwa NF2.
• Ma neurofibroma amagwirizanitsidwa ndi jini yotchedwa (NF1).

Nthawi zambiri, kusintha kwa majini kumeneku kumachitika pang'onopang'ono, popanda chifukwa chilichonse chodziwika bwino . Komabe, kuchuluka kochepa kwa ma schwannomas ndi ma neurofibromas kumachitika chifukwa cha matenda osowa a majini otchedwa neurofibromatosis , omwe amatha kuchitika m'mabanja.

Mitundu ya Neurofibromatosis

Pali mitundu itatu ikuluikulu ya matendawa:

• Mtundu wa Neurofibromatosis 1 (NF1): Anthu omwe ali ndi NF1 amakhala ndi ma neurofibromas ambiri. Alinso ndi chiopsezo chowonjezeka cha matenda a plexiform neuromas ndi matenda enaake a m'mitsempha yamagazi (MPNST). Matenda ena omwe amapezeka mwa anthu omwe ali ndi NF1 ndi monga macrocephaly , scoliosis, ndi mavuto ophunzirira .

• Mtundu wa Neurofibromatosis 2 (NF2):Pafupifupi aliyense amene ali ndi NF2 amakhala ndi ma schwannomas m'makutu onse awiri asanakwanitse zaka 30. Kuphatikiza apo, mitundu ina ya ma schwannomas ndi zotupa zimathanso kufalikira pakhungu lawo, m'maso, komanso m'mitsempha yawo.

• Schwannomatosis: Pa vutoli, ma schwannoma angapo amakula mu mitsempha ya vestibular (m'makutu onse awiri) m'malo mwa mitsempha ya vestibular.

Kodi zizindikiro za zotupa izi ndi ziti?

Anthu ambiri omwe ali ndi zotupa za neuromastoid samva ululu uliwonse kapena zizindikiro zina . Komabe, ngati chotupacho chikukulirakulira kapena kukakamiza mitsempha, zizindikiro monga:

• Chotupa kapena chotupa pansi pa khungu (chingakhale chopweteka chikakanikizidwa).
• Kufooka kwa minofu .
• Kusamva bwino .
• Kupweteka, ululu, kapena kupweteka kwambiri .
• Kumva ngati kugwedezeka ndi magetsi .

Kutengera ndi komwe chotupacho chili, zizindikiro zina zitha kuchitikanso. Nazi zitsanzo zingapo:

• Chotupa cha mitsempha ya sciatic: Ululu womwe umayenda kuchokera kumbuyo kupita pansi pa mwendo (sciatica).
• Chotupa padzanja: Zizindikiro zofanana ndi za Carpal Tunnel Syndrome.
• Chotupa cha mitsempha ya m'mimba: Kutaya kumva, kulira kwa tinnitus, mavuto a balance.

Kawirikawiri, ngati munthu ali ndi neurofibromatosis, ndi chotupa chimodzi. Komabe, mwa anthu omwe ali ndi vuto la neurofibromatosis lomwe latchulidwa kale, zotupa zingapo zimatha kuwoneka (nthawi zambiri pakhungu).

Kodi mungadziwe bwanji ngati muli ndi nthangala izi?

Dokotala wanu adzayamba kaye wakuyezani thupi lanu ndikuwunika thanzi lanu lonse. Izi zikuphatikizapo kufunsa za mbiri yanu yachipatala, mbiri yachipatala ya banja lanu, ndi zizindikiro zilizonse zomwe mungakhale nazo.

Kuti mufufuze bwino chotupa chomwe chikuoneka kale kapena chotupa chomwe chikukayikiridwa, dokotala wanu angakulangizeni mayeso otsatirawa:

• Mayeso ojambulira zithunzi zachipatala: Izi zikuphatikizapo ma MRI scans, ma ultrasound scans, ndi ma PET scans kuti muwone bwino chotupacho.
• Kufufuza za khansa: Kachidutswa kakang'ono ka minofu kamatengedwa kuchokera ku chotupacho ndikuwunikidwa pogwiritsa ntchito maikulosikopu kuti mudziwe mtundu wa maselo omwe alipo. Izi ndi zomwe zingakuuzeni motsimikiza ngati chotupacho ndi khansa kapena ayi.

Ngati muli ndi zotupa zingapo, dokotala wanu angakulangizeninso kuti muyesedwe majini kuti muwone ngati muli ndi matenda otchedwa (NF1), (NF2), ndi Schwannomatosis.

Kodi mankhwala ochizira izi ndi otani?

Ngati mulibe zizindikiro zilizonse kuchokera ku neuromastoid, dokotala wanu angakulangizeni kuti "yang'anani ndikudikirira."Mukhoza kugwiritsa ntchito njira yotchedwa "monitoring." Izi zikutanthauza kuyang'ana chotupacho pafupipafupi kuti muwone ngati chikukulirakulira kapena chikusintha.

Pa zotupa zomwe zili ndi zizindikiro, kapena ngati mukufuna kuchotsa chotupacho chifukwa cha kukongola, opaleshoni nthawi zambiri ndiyo njira yokhayo .

Ma neurofibroma ena, makamaka omwe amatchedwa plexiform neurofibroma, ndi ovuta kuwachotsa kwathunthu chifukwa amakula mkati mwa mitsempha ndi pakati pa zigawo za chophimbacho. Ngati chotupacho sichingachotsedwe kwathunthu mutachita opaleshoni, dokotala wanu adzakuyang'anirani mosamala, chifukwa chotupacho chikhoza kubwereranso kukula.

Chithandizo cha schwannomas m'mutu

Matenda a Schwannoma omwe amapangika m'mutu, monga vestibular schwannomas, amatha kukhudza mitsempha yomwe imayang'anira ntchito zofunika m'thupi lathu. Pazochitikazi, madokotala amagwiritsa ntchito njira yotchedwa stereotactic radiosurgery (monga Gamma Knife®) kuti apewe kuwonongeka kwa mitsempha.

Iyi si opaleshoni yachikhalidwe yomwe imaphatikizapo kudula. Imafuna kutumiza kuwala kolunjika bwino pakhungu kuti kuwononge kapena kuchepetsa chotupacho.

Kuchiza khansa ya m'mphepete mwa mitsempha yozungulira

Kuwonjezera pa opaleshoni, mankhwala a khansa monga radiation therapy ndi chemotherapy angagwiritsidwenso ntchito pochiza zotupa za m'mitsempha ya m'mphepete mwa mitsempha.

Kodi ndi mavuto otani omwe angabwere chifukwa cha opaleshoni?

Monga opaleshoni iliyonse, pali mavuto ambiri omwe angachitike ndi opaleshoni iyi:

• Kutuluka magazi
• Matenda a bala
• Ululu
• Zilonda

Kuphatikiza apo, opaleshoni ya mitsempha ili ndi chiopsezo cha kuwonongeka kwa mitsempha ndi chilema chokhazikika . Gulu lanu lachipatala lidzakuthandizani kuthana ndi chilema chilichonse cha nthawi yayitali chomwe chingachitike mutachita opaleshoni. Mankhwala osiyanasiyana (physiotherapy, occupational therapy, ndi speak therapy) angakuthandizeni kuchira.

Kodi zotupa izi zingalepheretsedwe kupanga?

Palibe njira yodziwika yopewera zotupazi kuti zisapangike. Komabe, dokotala wanu angakulangizeni kuti muyesedwe majini ngati:

• Ngati wina aliyense m'banja mwanu ali ndi mbiri ya matenda a neurofibromas.
• Ngati muli ndi zotupa zambiri za m'mitsempha (izi zitha kukhala chizindikiro cha matenda a neurofibromatosis).

Kodi tiyenera kuganizira chiyani za zinthu zopanda pake izi mtsogolo? (Outlook)

Ma neurofibroma ambiri si khansa . Amatha kuchiritsidwa ndi opaleshoni ndipo samabweranso kawirikawiri. Komabe, ngati chotupa chanu sichingachotsedwe kwathunthu ndi opaleshoni, muyenera kupitiriza kuyang'aniridwa ndi dokotala.

Anthu pafupifupi atatu mwa anayi omwe amalandira chithandizo cha vestibular schwannoma amatha kusunga kumva kwawo .

Chiwopsezo chakuti chotupa cha m'mitsempha chikhale khansa n'chochepa kwambiri. Chiwopsezo chachikulu ndi cha anthu omwe ali ndi vutoli (NF1) omwe ali ndi Plexiform neurofibroma. Kuyembekezeka kwa matendawa sikwabwino kwenikweni, makamaka ngati chotupacho chili chachikulu kuposa mainchesi awiri. Anthu osachepera theka omwe ali ndi vutoli amakhala ndi moyo zaka zisanu atapezeka ndi matendawa.

Kodi muyenera kupita kwa dokotala liti?

Ngati muwona chotupa pansi pa khungu lanu, kapena mukuwona zizindikiro zilizonse zomwe mukuganiza kuti zingakhale neurofibromatosis , pitani kwa dokotala nthawi yomweyo . Komanso, uzani dokotala wanu ngati wina aliyense m'banja mwanu adadwalapo mitundu iyi ya zotupa.

Uthenga Womaliza Wopita Nawo Kunyumba

Kumbukirani, zotupa zambiri za neuroendocrine ndi zabwino, osati khansa zomwe zimakula pang'onopang'ono . Ngati mulibe zizindikiro, dokotala wanu angasankhe kungokuyang'anirani. Ngati chotupa chikufunika kuchotsedwa, opaleshoni nthawi zambiri imakhala yopambana kwambiri. Sizimachitika kawirikawiri kuti mavuto (monga kusatha kuchotsa chotupa chonse, kuwonongeka kwa mitsempha) achitike, kapena kuti chotupa chikhale khansa. Dokotala wanu adzakuthandizani kupanga dongosolo la chithandizo ndi ndandanda ya mayeso amtsogolo kuti akuthandizeni kuthana ndi vuto lanu. Chifukwa chake musaope kulankhula ndi dokotala wanu za chilichonse.

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