Ngaba wakha waphawula umahluko omncinci kwindlela umntwana wakho osandul’ ukuzalwa aphefumla ngayo ngelixa umjongile? Mhlawumbi uphefumla kakuhle xa ekhala, kodwa xa elele kwaye ezolile, ngaba ubonakala enengxaki yokuphefumla ngempumlo yakhe? Okanye uyayeka ukuncancisa kuba eqhubeka evula umlomo wakhe ukuze aphefumle? Kuqhelekile ukuba umama okanye utata azive esoyika xa ebona izinto ezinje. Namhlanje siza kuthetha ngemeko yokuzalwa enokubangela iimpawu ezifanayo, kodwa engaziwa kakuhle. Yiyo leyo 'iChoanal Atresia'.
Ngamafutshane, yintoni iChoanal Atresia?
I-Choanal Atresia (ebizwa ngokuba yi-ko-a-nal atre-sia) yimeko apho umntwana ezalwa evalekile ngasemva kwempumlo yakhe, apho idibana khona nomqala wakhe (obizwa ngokuba yi-choana), yingcezu yesikhumba okanye ithambo. Cinga ngempumlo njengeegumbi ezimbini, ezineengcango ezimbini ngasemva kwegumbi ngalinye ezivalekileyo. Oku kuvaleka kunokubangelwa lithambo, okanye kukudibana kwethambo kunye nezicubu ezithambileyo.
Le meko inokuchaphazela ikhala elinye lomntwana (`Unilateral`) okanye zombini ikhala (`Bilateral`). Ukuba imbi kangakanani kwaye kufuneka unyango ngokukhawuleza kangakanani kuxhomekeke ekubeni ukuvaleka kukwelinye icala okanye kumacala omabini, kwaye kukude kangakanani.
Into ebalulekileyo kukuba iintsana ezisandul’ ukuzalwa ziphefumle kakhulu ngeempumlo zazo. Ziphefumla ngomlomo kuphela xa zikhala, ngoko ke ukuxinana kweempumlo kunokuba nefuthe elikhulu kuzo.
Ziziphi iintlobo ezimbini eziphambili zeChoanal Atresia?
Masiziqonde ngokucacileyo iintlobo ezimbini eziphambili zale nto. Kuya kuba lula kuwe ukuba uyijonga kwitheyibhile.
| Uhlobo lomgangatho | Kwenzeka ntoni ngale nto? | Ubunzima kunye neempawu |
|---|---|---|
| I-Unilateral Choanal Atresia (ukuvaleka kwelinye icala) | Icala elinye kuphela lempumlo yomntwana livaliwe. Uyakwazi ukuphefumla ngelinye icala. | Esi asisosifo sibi kakhulu. Ngenxa yokuba umntwana ephefumla ngenye iimpumlo, iimpawu zisenokungabonakali de kube ngumntwana. Uphawu oluqhelekileyo yimpumlo egobhozayo ephuma kwelinye icala. |
| I-Bilateral Choanal Atresia (Ukuvaleka kumacala omabini) | Amacala omabini empumlo yomntwana avaliwe. Akakwazi ukuphefumla ngempumlo yakhe. | Le yimeko engxamisekileyo kakhulu, esongela ubomi! Usana aluphefumli, ngoko ke kufuneka lungeniswe kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngoko nangoko kwaye lunikwe uncedo lokuphefumla. Usana luphefumla kuphela xa lukhala. |
I-Choanal atresia yenzeka kumntwana omnye kwabayi-7,000 abazalwayo. Kulaba, ngaphezulu kwama-60% bazalwa ngaxeshanye. Ikwaxhaphake kabini kumantombazana kunamakhwenkwe.
Zithini iimpawu zale meko?
Iimpawu ziyahluka ngokuxhomekeke kwiintlobo ezimbini esizixubushile ngaphambili.
Ukuba amacala omabini empumlo avalekile (Bilateral Choanal Atresia)
Oogqirha banokuzibona ezi mpawu kwangoko nje emva kokuba umntwana ezelwe.
- Ubunzima obukhulu bokuphefumla: Umntwana uyasokola ukuphefumla xa engakhali.
- Ulusu oluluhlaza okwesibhakabhaka kunye nemilebe ('iCyanosis'): Ulusu lomntwana, imilebe, kunye neenzipho ziqala ukujika zibe luhlaza okwesibhakabhaka kuba umzimba awufumani ioksijini eyaneleyo.
- Ukuphefumla kuphela xa ukhala: Ekubeni umntwana evula umlomo wakhe kuphela xa ekhala, uphefumla kuphela ngelo xesha, kwaye ubuluhlaza besikhumba buyehla bube pinki. Xa ukukhala kuyeka, kuba nzima ukuphefumla kwakhona aze ajike abe luhlaza okwesibhakabhaka.
Ukuba oku kuyenzeka, oogqirha baya kungenelela ngoko nangoko baze bafake umbhobho omncinci kumbhobho womoya womntwana ukuze umncede aphefumle. Xa imeko yomntwana izinzile, isigqibo malunga notyando siya kwenziwa.
Ukuba icala elinye lempumlo livalekile (i-Unilateral Choanal Atresia)
Ngenxa yokuba ezi mpawu azibonakali kangako, usenokungaziboni de kube semva kokuba umzise umntwana wakho ekhaya. Usenokungaziboni de kube yiminyaka kamva.
- Ukungaphumli ngexesha lokuncancisa: Umntwana kufuneka aphefumle ngempumlo yakhe xa encancisa. Ekubeni elinye icala livalekile, kunzima ukuphefumla kwaye umntwana uyeka ukuncancisa aze avule umlomo wakhe. Oku kunokwenza umntwana angazinzi kakhulu aze angakwazi ukuncancisa kakuhle.
- Impumlo egobhozayo engapheliyo kwelinye icala: Ukuba impumlo yomntwana wakho iqhubeka nokugobhoza kwicala elinye kuphela ngaphandle kwesizathu esicacileyo, ngaphandle komkhuhlane, olo luphawu oluphambili noluqhelekileyo lwale meko.
- Ukuntywila ngaphakathi xa ulila:Xa umntwana engakhali, isifuba sibonakala sitshona njengoko enengxaki yokuphefumla.
- I-sinusitis engapheliyo: Abantwana abadala banokufumana usulelo lwe-sinus rhoqo ngenxa yokuqokelelwa kwe-mucus kwelinye icala lempumlo.
Kutheni oku kusenzeka? Yintoni unobangela?
Isizathu esichanekileyo sale meko asikaziwa okwangoku. Nangona kunjalo, oogqirha bakholelwa ukuba ngexesha lokukhula komntwana esibelekweni, kukho inwebu eyahlula impumlo nomlomo. Ngokwesiqhelo, le nwebu iyanyibilika yodwa njengoko umntwana ekhula. Nangona kunjalo, kwezinye iintsana, le nwebu ihlala ihleli, eyaziwa ngokuba yi-'Choanal Atresia'.
Ezinye iimeko ezinxulumene noko
Malunga nesiqingatha seentsana ezineChoanal Atresia zinezinye izifo zofuzo okanye iingxaki zokuzalwa. Nangona kungaziwa ukuba kutheni kanye, le meko idla ngokuvela kunye nezinye izifo.
Phakathi kwazo, ezi zilandelayo zezona zibalulekileyo:
- I-CHARGE syndrome: Malunga nama-60% eentsana ezinempumlo evalekileyo omabini zine-CHARGE syndrome.
- Isifo sikaTreacher Collins
- `Isifo sikaCrouzon`
- `Isifo sePfeiffer`
I-Choanal Atresia inokubonwa nezinye izifo zemfuza ezifana nale. Ngoko ke, ugqirha uza kuyijonga nale.
Zeziphi iingxaki ezinokwenzeka ukuba azinyangwa?
Ingakumbi xa kukho ukuvaleka kwelinye icala, ukungazi ngayo kunokulibazisa unyango. Oku kunokuba nemiphumo yexesha elide.
- Usulelo lwendlebe oluqhelekileyo: Ekubeni kukho unxibelelwano phakathi kwempumlo nendlebe, xa elinye icala lempumlo lihlala livalekile kwaye lizaliswe yi-mucus, inokuchaphazela indlebe kwaye ibangele usulelo lwendlebe oluqhelekileyo.
- Ukulahlekelwa kukuva: Usulelo lwendlebe oluhlala ixesha elide lunokonakalisa indlebe kwaye, ekuhambeni kwexesha, lubangele ukulahlekelwa kukuva.
- Ukufutha: Kukho umngcipheko wokufutha ubisi okanye ukutya kwindlela yomoya, ingakumbi ngenxa yobunzima bokuphefumla ngexesha lokuncancisa.
Ngenxa yezi ngozi, ugqirha uya kucebisa unyango ngexesha elifanelekileyo.
Ungayibona njani le meko?
Usana olunempumlo evalekileyo kumacala omabini ludla ngokufunyaniswa esibhedlele xa luzalwa. Nangona kunjalo, xa kukho ivalekile kwelinye icala, kufuneka uvavanyo ukuze lufunyanwe.
1. Uvavanyo lokuphefumla: Ugqirha uza kubamba iqhekeza elincinci leglasi kufutshane nempumlo yomntwana aze ajonge ukuba umphunga awuphumi na kulo. Ukuba umphunga awuphumi kwelinye icala, oko kungabonisa ukuba kukho ukuvaleka kwelo cala.
2. I-CT scan:Yile nto eyenza umahluko ngokwenene. Kufana nokuthatha umfanekiso we-3D wangaphakathi kwempumlo yakho. Ingayibona ngokucacileyo indawo apho kuvaliwe khona, nokuba lithambo okanye yinwebu, kwaye ityebile kangakanani.
3. I-endoscopy yempumlo: Le ndlela isebenzisa ityhubhu enekhamera entle kakhulu efakwe empumlweni kwaye ivumela ugqirha ukuba ajonge ngaphakathi kwempumlo ngqo kwiscreen.
Iqela lezonyango liqinisekisa ukuba umntwana uphefumla kakuhle ngexesha lovavanyo, ukuze kungabikho mngcipheko kumntwana.
Iphathwa njani?
Unyango oluhlala luhleli lweChoanal Atresia lutyando.
- Ukuba amacala omabini empumlo avaliwe: Umntwana uya kufuna utyando ngokukhawuleza.
- Ukuba icala elinye lempumlo livalekile: Ngaphandle kokuba umntwana uneengxaki zokuphefumla okanye zokutya kakhulu, ugqirha unokugqiba ekubeni utyando luhlehliswe de umntwana abe mdala kancinci.
Utyando
Utyando lubandakanya ukususa ithambo okanye inwebu evalekileyo kunye nokulungelelanisa indlela yomoya ukuze ukuphefumla kuqhubeke. Oku kungenziwa ngempumlo (transnasal) okanye ngepalate (transpalatal).
Kwezinye iimeko, ityhubhu encinci (i-`stent`) ifakwa ngaphakathi kwendlela entsha emva kotyando ukuze ingavaleki kwakhona. Le tyhubhu isuswa kwakhona emva kweenyanga ezimbalwa ngotyando oluncinci. Olu tyando lwenziwa phantsi kwe-anesthesia epheleleyo, ukuze umntwana angaziva ntlungu.
Ulawulo ekhaya
Ukuba umntwana wakho une-endless ethintelekileyo kwicala elinye aze ugqirha agqibe ekubeni ahlehlise utyando, uza kukunika imiyalelo yokuba ungazilawula njani iimpawu ekhaya. Umzekelo, ungaxelelwa ukuba usebenzise amathontsi e-saline ukuze impumlo yakho ihlale icocekile.
Imibuzo omele uyibuze ugqirha wakho
Xa ufumanisa ukuba umntwana wakho unale meko, kuyinto eqhelekileyo ukuba nemibuzo emininzi engqondweni yakho. Musa ukoyika ukubuza le mibuzo kugqirha wakho.
- "Gqirha, impumlo yomntwana wam ivalekile kwicala elinye okanye kumacala omabini?"
- "Ingaba le meko inxulumene nesinye isifo esifana ne-'CHARGE syndrome'?"
- "Umntwana uza kufuneka atyandwe nini?"
- "Luhlobo luni lotyando olucetyiswa ngugqirha?"
- "Singazi njani ngokuqinisekileyo ukuba utyando luphumelele?"
Ukufumanisa ukuba umntwana wakho uneChoanal Atresia, ingakumbi ukuba unengxaki yokuphefumla xa ezalwa, kunokuba yinto eyoyikisayo kubazali. Kodwa khumbula, le meko inokunyangeka ngempumelelo ngotyando. Emva kotyando, uninzi lweentsana luyachacha ngokupheleleyo kwaye luphefumle ngaphandle kobunzima ubomi babo bonke. Ke ngoko, ukuba unesikrokro sokuba umntwana wakho unale mpawu, bona ugqirha ngokukhawuleza ukuze ahlolwe.
Umyalezo Wokuya Ekhaya
- I-Choanal atresia kukuvaleka kwendlela engasemva kwempumlo.
- Ukuvaleka kwempumlo emacaleni omabini yingxaki yezonyango. Umntwana uza kuba nobunzima bokuphefumla xa ezalwa.
- Ukuxinana kwempumlo kwicala elinye akusosiganeko sequbuliso. Iimpawu ezifana nokuphuma kwempumlo rhoqo kwelinye icala kunye nobunzima bokuginya zinokuvela kamva.
- Unyango oluhlala luhleli loku lutyando, olunika iziphumo eziphumeleleyo kakhulu.
- Ukuba ubona naziphi na iingxaki kwindlela yokuphefumla komntwana wakho okanye ukuncancisa, musa ukulibazisa kwaye uqhagamshelane nogqirha wakho ngoko nangoko.
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