Ngaba ngamanye amaxesha ukhe uzive iinyembezi ziphuma emehlweni akho ngaphandle kwesizathu, kwaye uzive umanzi ngeenxa zonke emehlweni akho? Kusenokufuneka uzisule ngethishu ngalo lonke ixesha. Oku kuyacaphukisa kakhulu. Isizathu esiphambili soku kukuba inkqubo yetyhubhu ethambileyo ethwala iinyembezi eziveliswa emehlweni akho ukuya empumlweni yakho, ebizwa ngokuba yi-tear duct, ivaliwe. Namhlanje, siza kuthetha ngotyando oluyeyona sisombululo silungileyo koku.
Yintoni utyando lwe-DCR?
Ngamafutshane, i-dacryocystorhinostomy, okanye i-DCR, yinkqubo edala indlela entsha yokuba iinyembezi zakho ziphume ukuba zivalekile.
Ngokwesiqhelo, iinyembezi eziphuma emehlweni ethu zingena ngemingxuma emincinci esemacaleni amehlo, zidlule kwingxowa yeenyembezi, zize zingene empumlweni. Usenokukhumbula ukuba xa sikhala, okanye xa into ingena emehlweni ethu kwaye kuphuma iinyembezi, umsinga wolwelo nawo uphuma empumlweni yethu. Yiyo le nto ke. Ngoko ke, ukuba le ndlela yokutsala iinyembezi ivaliwe ndaweni ithile, iinyembezi azinandawo yokuya kuyo kwaye ziqale ukuphuphuma emehlweni. Oku akugcini nje ngokugcina amehlo emanzi ngalo lonke ixesha, kodwa ngamanye amaxesha izifo ezinzulu zinokuvela.
Le meko inokubonwa kubantwana abancinci, ingakumbi kubantu abadala abangaphezu kweminyaka engama-65 ubudala.
Ndingazilungiselela njani ngaphambi kotyando?
Ngaphambi kokuba wena okanye umntwana wakho nityande olu tyando, kuya kufuneka nidibane nogqirha oyingcali. Olu tyando ludla ngokwenziwa ngugqirha wamehlo okanye ngugqirha weendlebe, impumlo nomqala (ENT surgeon). Ngamanye amaxesha, oogqirha abavela kwicandelo elinye benza utyando kunye.
Ugqirha wakho uza kukuchazela kakuhle ngotyando aze akuyalele iimvavanyo ezininzi ukuze abone ukuba ufanelekile na kolu tyando.
Ukongeza, ingcali yokubulala iintlungu iza kuthetha nawe, njengoko olu tyando lwenziwa phantsi kwe-anesthesia.
Nje ukuba umhla wotyando umiselwe, ugqirha wakho uya kukucebisa ngezi zinto zilandelayo:
- Amayeza owasebenzisayo: Ukuba usebenzisa nawaphi na amayeza, ugqirha wakho uya kukuxelela ngqo ukuba kufuneka uyeke na ukuwasebenzisa ngaphambi kotyando, kwaye ukuba kunjalo, njani.
- Ukugcina ulusu lucocekile: Ukuze unciphise umngcipheko wokosuleleka, unokucetyiswa ukuba uhlambe ubuso bakho ngesepha ekhethekileyo ngobusuku bangaphambi kotyando.
- Ukuzila ukutya: Oku kubaluleke kakhulu. Ugqirha uza kukuxelela ukuba zingaphi iiyure ngaphambi kotyando ekufuneka uyeke ukutya nokusela. Ufanele ukusebenzise kanye ngelo xesha. Kuba ukuba kukho ukutya esiswini ngexesha le-anesthesia, ukuba uyahlanza kwaye ezo zinto zingena emiphungeni, kunokubangela imeko enzima enokuba yingozi nakubomi (`aspiration pneumonia`).
Lwenziwa njani utyando?
Njengoko utyando luqala, umgca we-IV, okanye ityhubhu yesaline, iya kufakwa emthanjeni osengalweni yakho. Oku kuya kukunika i-anesthesia kunye nolwelo. Emva koko uya kufakwa phantsi kwe-anesthesia kwaye ulale ngokupheleleyo.
Ugqirha angenza olu tyando ngeendlela ezimbini eziphambili: ngokwenza incision ngaphandle kwempumlo (ngaphandle) okanye ngaphakathi kwempumlo (endonasal).
| Indlela Yotyando | Kwenzeka ntoni (Inkqubo) |
|---|---|
| I-DCR yangaphandle | Ugqirha uza kwenza umngxuma omncinci kakhulu eluswini phakathi kwempumlo neliso lakho. Emva koko, kuza kwenziwa umngxuma omncinci kwithambo elahlula umngxuma wokukrazula empumlweni. Ngalo mngxuma, kuza kufakwa umbhobho omncinci (i-stent) kumbhobho wokukrazula, omnye umphetho uqondiswe empumlweni. Lo mbhobho uza kuthintela indlela entsha evaliweyo kwakhona. Umngxuma uza kuvalwa ngezititshi. |
| I-Endonasal DCR | Kule ndlela, akukho nxeba libonakalayo. Ugqirha ufaka isixhobo esifakwe ikhamera esibizwa ngokuba yi-endoscope empumlweni aze enze inxeba ngaphakathi empumlweni. Ngalo, uya kwindawo apho kukho i-tear sac aze enze umngxuma ethanjeni. Emva koko, kufakwa ityhubhu encinci ngomngxuma osekoneni yeliso, ingeniswe ngaphakathi empumlweni ngomngxuma osandul’ ukwenziwa, ize ilungiswe. Kwimeko enjalo, into efana negwebu ingasetyenziselwa ukulawula ukopha. |
Olu tyando luthatha ixesha elingakanani?
Ngokwesiqhelo, kutyando lokuqala, indlela yangaphandle ingathatha malunga nemizuzu engama-45-50, kwaye indlela yangaphakathi kwempumlo ingathatha malunga nemizuzu engama-30. Nangona kunjalo, eli xesha linokwahluka.
Zithini iingenelo zolu tyando?
Eyona nzuzo inkulu yoku kukuba ungasusa ngokupheleleyo imeko ecaphukisayo yokusoloko ukrazula amehlo akho. Kwakhona:
- Umbono uyacaca.
- Umngcipheko wosulelo olujikeleze amehlo uyancipha.
Into ebalulekileyo kukuba zombini ezi ndlela zinezinga eliphezulu kakhulu lempumelelo.Izinga lempumelelo liphezulu ukuya kuthi ga kwi-85% - 99%.
Ngaba kukho naziphi na iingozi kunye neengxaki zotyando?
Njengakwezinye iintlobo zotyando, kukho iingozi ezincinci. Kukwakho nezinye iingxaki ezithile ezichaphazela olu tyando.
| Uhlobo lomngcipheko | Inkcazo |
|---|---|
| Iingozi eziqhelekileyo | Intlungu, ukopha, usulelo. |
| Iingozi ezithile | Izicwili zinokwenzakala zize zibangele ukuvaleka okutsha, i-stent ingakhululeka, okanye ukuba isusiwe ngaphandle, inxeba lingavuleka kwakhona okanye inxeba lingenzeke. |
| Ingxaki enzima kodwa engaqhelekanga kakhulu | Ukuvuza kweCerebrospinal Fluid (CSF) . Kulapho ulwelo olujikeleze ingqondo luphuma khona empumlweni. Oku kunqabile kakhulu. Ukuba kuyenzeka, kuya kufuneka olunye utyando ukuze kulungiswe. |
Ugqirha wakho uza kukuchazela ngokweenkcukacha ukuba zeziphi iingozi onokujamelana nazo.
Kwenzeka ntoni emva kotyando?
Le yinkqubo edla ngokuba yeyokunyanga ngaphandle kwesibhedlele. Uza kuhlolwa iiyure ezimbalwa emva kokuba uvukile kwi-anesthesia kwaye uthunyelwe ekhaya. Ugqirha uza kukunika amayeza okudambisa iintlungu kunye namayeza okubulala iintsholongwane. Kubaluleke kakhulu ukuthatha la mayeza njengoko kumiselwe.
Uza kucelwa ukuba ubuye ukuze uhlolwe malunga neveki emva kotyando. Emva koko inxeba liza kuhlolwa kwaye naziphi na izinto zokubopha ezisetyenzisiweyo ukunqanda ukopha ziya kususwa. Ukuba kwenziwe i-incision ngaphandle, izitishi nazo ziya kususwa ngeli xesha.
Kuthatha ixesha elingakanani ukuphiliswa?
Kungathatha iiveki okanye iinyanga ezininzi ukuphola ngokupheleleyo, njengoko umngxuma owenziwe ethanjeni uthatha ixesha ukuphola.
Kukho into enye ekufuneka ungayiyenzi ngexesha lokuchacha kwakho. Oko kukuvuthela impumlo yakho. Ukwenza njalo kunokubangela ukuba inxeba livuleke kwakhona kwaye ityhubhu ijikeleze. Kufuneka uphephe ukuvuthela impumlo yakho ubuncinane iveki. Ugqirha wakho uza kukucebisa ngezinye izinto omele uziphephe.
Ufanele uye nini kugqirha?
Ukuba ufumana naziphi na ezi mpawu emva kotyando, kufuneka ufowunele ugqirha wakho ngoko nangoko:
- Ukuba ufumana umkhuhlane.
- Ukuba indawo yotyando ivakala ngathi idumbile kwaye ishushu.
- Ukuba inxeba liyaqhubeka nokopha okanye ubovu buphuma, okanye ukuba ukopha kwempumlo akupheli.
- Ukuba iinyembezi ziqala ukuqukuqela kwakhona.
Ngaba zikho ezinye iindlela zotyando endaweni yotyando lwe-DCR?
Ewe, kukho ezinye iindlela ezininzi ugqirha wakho anokuzicebisa endaweni yotyando lwe-DCR:
- Ukuqwalaselwa: Ukuba ukungakhululeki kwakho akukubi kangako, usenokungadingi unyango.
- Amayeza: Kwezinye iimeko, ungazama ukulawula imeko ngezinto ezifana nee-antibiotics kunye namaconsi eliso e-steroid.
- Ukufakwa kwetyhubhu: Ngaphandle kotyando, kufakwa ityhubhu encinci kumbhobho wendalo wokukrazula ize ishiywe endaweni yayo kangangeenyanga ezi-3-6 ukuze kubonwe ukuba iyayisombulula na ingxaki.
- Ezinye iintlobo zotyando: Kukho ezinye iintlobo zotyando ezikhethekileyo ezenziwa kwabo bangakhange baphumelele kutyando lwe-DCR.
Ukusoloko ukrazula amehlo kunokuba yintlungu yokwenyani. Kodwa i-DCR sisisombululo esikhuselekileyo nesisebenzayo kule ngxaki. Ukuba wena okanye umntu kusapho lwakho unale ngxaki, bonana nogqirha wamehlo ukuze akunike iingcebiso. Yena uza kumisela unyango olufanelekileyo kuwe aze akunike ulwalathiso olufunekayo.
Umyalezo Wokuya Ekhaya
- I-DCR lutyando oluphumelele kakhulu olwenziwayo ukunyanga iimeko apho iinyembezi zihlala ziphuma emehlweni ngenxa yemibhobho yeenyembezi evalekileyo.
- Olu tyando lungenziwa ngeendlela ezimbini eziphambili (ngaphandle nangaphakathi kwempumlo). Ugqirha wakho uya kugqiba ukuba yeyiphi indlela efanelekileyo kuwe.
- Kuza kuthatha ixesha ukuba uphile ngokupheleleyo. Ngeli xesha, qiniseka ukuba ulandela imiyalelo kagqirha, ingakumbi icebiso lokuba ungakhali kakhulu.
- Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kotyando, ezinje ngomkhuhlane, ukudumba, okanye ukopha kakhulu, yazisa ugqirha wakho ngoko nangoko.
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