Ngaba ufumene unyango lwe-radiation lomhlaza wentloko nentamo? Ngaba luyawachaphazela amathambo akho? Masifunde nge (Osteoradionecrosis - ORN)!

Ngaba wakha waba nentlungu, ukudumba, okanye isilonda emlonyeni okanye emhlathini wakho emva kokufumana unyango lwemitha yomhlaza wentloko okanye wentamo? Kusenokuba lixesha lokuba ufunde ngemeko ebizwa ngokuba yi-osteoradionecrosis. Ungakhathazeki, siza kuthetha ngayo ngokweenkcukacha nangendlela elula kakhulu.

Yintoni i-Osteoradionecrosis (ORN)?

Ngamafutshane, i-osteoradionecrosis (ORN) kukufa kweeseli zamathambo ngenxa yokuchatshazelwa yimitha. Yimeko enokwenzeka njengesiphumo sonyango lwemitha kumhlaza, ingakumbi umhlaza wentloko nentamo. Khumbula, imitha esetyenziselwa ukubulala iiseli zomhlaza ngamanye amaxesha inokonakalisa neeseli zamathambo ezisempilweni. Inokwenzeka kwiinyanga okanye kwiminyaka emva kokufumana unyango lwemitha.

Le meko idla ngokuchaphazela ithambo lomhlathi ongezantsi (i-mandibular osteoradionecrosis). Nangona kunjalo, inokwenzeka nakweyiphi na ithambo eliye lachaphazeleka yimitha, njengethambo lomhlathi ongaphezulu (i-maxillary osteoradionecrosis) okanye inxalenye engaphambili yomqolo (i-vertebral osteoradionecrosis). Amaxesha amaninzi, le meko inokuchaphazela nentloko, kodwa inokuba yingozi ngakumbi.

Unyango lwemitha kunye nempilo yamathambo - kutheni oku kusenzeka?

Ngoku, makhe sibone ukuba kutheni oku kusenzeka. Imitha yonakalisa imithambo yegazi ethambileyo ehambisa igazi emathanjeni. Njengalo naliphi na elinye ilungu lomzimba wethu, amathambo adinga igazi elifanelekileyo ukuze ahlale esempilweni kwaye aphiliswe ngokukhawuleza ukuba onakele.

Khawucinge nje, njengokuba umthi ubuna ngaphandle kwamanzi, ukuba ithambo alifumani gazi laneleyo, nalo liya kulahlekelwa bubomi balo lize liqalise ukufa.

Kwenzeka ntoni xa olu nikezelo lwegazi luphazamisekile?

• Amathambo kunye nezicubu ezingqongileyo kulula ukuba zifumane usulelo.
• Akunakwenzeka ukuphiliswa kakuhle.
• Iqala ukufiphala kancinci kancinci.

Indawo yethu yomhlathi isengozini kakhulu koku. Oku kungenxa yokuba kunzima ukuthintela imitha ukuba ingafiki kumhlathi ngexesha lonyango lwemitha yomhlaza wentloko nentamo. Kwakhona, umngcipheko wale `(ORN)` uyanda ngakumbi ziibhaktheriya ezihlala ngokwemvelo emilonyeni yethu.

Umonakalo wemitha emlonyeni unokubangela izinto ezinje:

• Ukuvezwa kwamathambo (oko kuthetha ukuba ithambo livezwa ngeentsini).
• Intlungu kunye nokudumba emhlathini ngamanye amaxesha.
• Ukuba nesilonda esingapholiyo .

Ixhaphake kangakanani le meko?

Ngokutsho kwe-American Head & Neck Cancer Society, i-osteoradionecrosis inokwenzeka phakathi kwe-4% kunye ne-8% yabantu abanomhlaza wentloko nentamo.

Zithini iimpawu ze-osteoradionecrosis (ORN)?

Ngoku makhe sibone ukuba zeziphi iimpawu onokuzibona kule meko. Ukuba unenye okanye ngaphezulu kwezi, kungcono ukufuna ingcebiso kagqirha.

• Isilonda okanye isilonda esingaphandle kweentsini, entanyeni, okanye emhlathini.
• Intlungu.
• Ukudumba.
• Usulelo (njengobovu).
• Amazinyo angadibani kakuhle (i-malocclusion).
• Imvakalelo yokurhawuzelela okanye yokukrwempa .
• Iziqwenga zamathambo eziphuma ngaphakathi emlonyeni.
• Ngamanye amaxesha, phantsi kwesilevu, ulusu luyaphuka kwaye ithambo liphume (oku kukwabizwa ngokuba yi-"fistula").
• Ukuqhekeka komhlathi.
• Ukuqina kwemisipha yomhlathi okuthintela umlomo ukuba ungavuleki kakuhle (i-trismus).

Kutheni i-osteoradionecrosis (ORN) isenzeka?

Eyona nto ibangela lunyango lwemitha entloko nasentanyeni. Le meko ixhaphake kakhulu kubantu abafumene iidosi zemitha ezingaphezulu kwama-60 eGrey (Gy). (I-Gy yiyunithi yokulinganisa imitha).

Izinto Ezibangela Umngcipheko we-Osteoradionecrosis `(ORN)` - Ngubani onokuba nayo ngakumbi?

Abanye abantu basengozini enkulu yokuhlaselwa yile meko kunabanye. Jonga ukuba ezi nyaniso ziyasebenza na kuwe:

• Ucoceko lomlomo olubi (ukungahlambi amazinyo akho ngokufanelekileyo, ukungawukhathaleli ucoceko lomlomo wakho).
• Ukuba iingxaki zamazinyo (ezifana nemingxunya kunye nesifo seentsini) azizange zilungiswe ngokufanelekileyo ngaphambi kokuba kuqalwe unyango lwemitha.
• Ukuba uqalisa ukuba nomlomo owomileyo (xerostomia) emva konyango lwemitha.
• Ukuba kukho ingozi okanye ukwenzakala emhlathini emva konyango lwe-radiation, ingakumbi kunyaka wokuqala.
• Ukuba izinyo likhutshwe kwindawo ebikhe yatshiswa ngaphambili.

Khumbula, le meko ye-osteoradionecrosis inokwenzeka nasemva kweminyaka emininzi ifumene unyango lwe-radiation lomhlaza wentloko nentamo.

Ifunyaniswa njani le nto?

I-Osteoradionecrosis (ORN) idla ngokuvela emva kweminyaka eliqela emva konyango lwemitha. Ukuba ugqirha wakho ukrokrela oku, uya kukwenza uvavanyo olucokisekileyo lwentloko nentamo yakho. Uya kuqhagamshelana nengcali yomhlaza wemitha ekunika unyango lwemitha ukuze afumane idosi iyonke yemitha oyifumeneyo.

Zeziphi iimvavanyo ezinceda ekuxilongweni?

Ukuqinisekisa ukuxilongwa, ugqirha wakho unokucebisa iimvavanyo ezifana nezi:

• Ii-X-reyi zamazinyo.
• Kwenziwa i-CT scan yomhlathi (CT - computed tomography scan).
• Kunokwenziwa i-biopsy ukujonga ukuba umhlaza awuphinde ubuye na.

Zithini iindlela zonyango zoku?

Unyango lwe-osteoradionecrosis (ORN) luxhomekeke kubungakanani kunye nobunzima bemeko yakho. Eyona nto ibalulekileyo kukuqala unyango ngokukhawuleza.Okukhona uqala unyango ngokukhawuleza, kokukhona amathuba akho okuphila ngcono. Kukho unyango lotyando nolwezinye iindlela zonyango.

Ulawulo lotyando

Kukho utyando oluninzi olwenziwayo kule meko:

• Ukususwa kwesikhumba ngotyando: Oku kwenzeka xa ugqirha esusa amathambo nezicwili ezifileyo okanye ezinentsholongwane, njengokucocwa kwendawo embi.
• Utyando lokulungisa ii-flap zasimahla: Olu lutyando oluntsonkothileyo kancinci. Lubandakanya ukuthatha imithambo yegazi, izicwili, mhlawumbi neqhekeza lethambo elivela kwenye indawo yomzimba wakho (umzekelo, umlenze okanye ingalo) uze ulifake kwindawo eyonzakeleyo yomhlathi.
• I-ALTFL (i-Anterolateral Thigh Fascia Lata Rescue Flap): Le ikwaluhlobo lwe-free flap. Kule nkqubo, kuthathwa umcu wezicubu ezidityanisiweyo (i-fascia) ngasemva kwethanga uze utyalwe kwenye indawo. Le tissue ivalwe kakhulu, nto leyo evumela indawo eyonakeleyo ukuba ifumane ioksijini kunye nezondlo. Izifundo zakutshanje zibonise ukuba le ndlela isebenza kakhulu kubantu abane-ORN.
• Ukufakelwa kwamathambo ngokupheleleyo: Le nkqubo yotyando yendabuko isetyenziswa xa kukho amathambo amaninzi afileyo, ingakumbi kumhlathi ongezantsi. Kule nkqubo, ithambo elonakeleyo lisuswa ngokupheleleyo kwaye kufakwa i-free flap equlethe amathambo endaweni yayo. Nangona le yinkqubo ephumelelayo, lutyando olukhulu. Inokubangela ukuba umntu ahlale esibhedlele ixesha elide kwaye aphile ixesha elide. Ke ngoko, oogqirha bazama ukuxilonga nokunyanga le meko kwangethuba.

Ulawulo olungelulo utyando

Kukwakho nonyango olungelulo utyando:

• Ii-antibiotics: Ukuba kukho usulelo emathanjeni okanye kwizicwili ezingqongileyo, ugqirha wakho uya kukunika ii-antibiotics.
• I-PENTOCLO: Le yindibaniselwano yamayeza aliqela: i-pentoxifylline, i-tocopherol (ivithamini E), kunye ne-clodronate. I-Pentoxifylline isebenza ngokwandisa ukuhamba kwegazi ukuya kwithambo elonakeleyo. I-Tocopherol (ivithamini E) inceda ukuqinisa inkqubo yomzimba yokuzikhusela kunye nokuthintela ukuqhekeka kwegazi. I-Clodronate inceda ukuthintela ukulahleka kwamathambo okungakumbi. Ngamanye amaxesha i-pentoxifylline kunye ne-tocopherol zinikwa ngaphandle kwe-clodronate (oku kubizwa ngokuba yi-PENTO).
• Unyango lwe-oksijini egqithisileyo (i-oksijini egqithisileyo - HBO - unyango):Abanye oogqirha basebenzisa olu nyango ukukhawulezisa inkqubo yokuphiliswa komzimba. Kule meko, ufakwa kwigumbi elikhethekileyo kwaye wenzelwe ukuphefumla ioksijini ecocekileyo. Inqanaba leoksijini ngaphakathi kwigumbi liphezulu ngokuphindwe kathathu kunakwindawo eqhelekileyo. Injongo ephambili kukongeza ioksijini eyaneleyo egazini ukulungisa izicwili ezonakeleyo. Nangona kunjalo, kukho izimvo ezahlukeneyo phakathi koluntu lwezonyango malunga nolu nyango lwe-"Hyperbaric oxygen". Nangona lusetyenziswa njengonyango oluqhelekileyo kwezinye iziko, akukabikho zifundo zilawulwayo eziqinisekisile impumelelo yalo.

Ngaba i-osteoradionecrosis (ORN) ingathintelwa?

Le meko isenokungathintelwa rhoqo, kodwa ngaphambi kokuba uqale unyango lwe-radiation entlokweni okanye entanyeni yakho, ugqirha wakho uza kuthetha nawe ngeendlela zokunciphisa le ngozi.

Ngaphambi kokuba uqale unyango lwe-radiation, kufuneka wenze oku kulandelayo:

• Ndwendwela ugqirha wamazinyo , ucoce umlomo wakho kakuhle, uze uhlolwe ngokupheleleyo .
• Fumana naluphi na unyango lwamazinyo (njengokufaka amazinyo, ukukhupha amazinyo).
• Qalisa unyango lwe-fluoride imihla ngemihla.

Kufuneka wenze ezi zinto ngexesha nasemva konyango lwe-radiation:

• Gcina ucoceko lomlomo lulungile (hlamba amazinyo akho kabini ngemini, ucoce phakathi kwamazinyo akho).
• Nciphisa ukutya okuneswekile kunye neziselo .
• Bona ugqirha wamazinyo rhoqo ukuze akuhlole kwaye ucoce umlomo wakho.
• Fumana unyango lwazo naziphi na iingxaki zamazinyo ezintsha ngokukhawuleza .
• Qhubeka nonyango lwe-fluoride imihla ngemihla.

Isasazeka ngokukhawuleza kangakanani i-osteoradionecrosis (ORN)?

Kwiimeko ezininzi, i-osteoradionecrosis (ORN) ikhula kancinci. Kungathatha iminyaka eliqela ukuba ubonakalise iimpawu.

Ngaba i-osteoradionecrosis (ORN) inganyangeka?

Nangona oogqirha bengakwazi ukuvuselela ithambo elifileyo, unyango olufanelekileyo lunokuthintela ukuqhubeka kwe-osteoradionecrosis (ORN). Kuthiwa ukuba unyango luqalwe kwangethuba, imeko inokumiswa kwi-96% yamatyala .

Ngoko ke, ukuba une-osteoradionecrosis (ORN), ukuqala unyango kwangethuba lelona thuba lilungileyo lokuphumelela. Utyando lwakho lusenokuba lufutshane, kwaye ungaphila ngokukhawuleza. Okukhona unyanga ngokukhawuleza (ORN), kokukhona kungcono.

Ukuxela kwangaphambili nge-Osteoradionecrosis (ORN)

I-Osteoradionecrosis (ORN) yimeko enyangekayo kakhulu. Uhlobo lonyango olufunekayo luxhomekeke kwindawo elikuyo ithambo elonakeleyo, ubungakanani bokufa kwethambo, kunye nonyango okhe waluzama ngaphambili.

Ngokubanzi, xa indawo eyonakeleyo yethambo incinci, kokukhona amathuba okuchacha angcono ngaphandle kotyando olukhulu. Amanye amatyala e-ORN asenokungaphenduli kunyango oluncinci kwaye anokuqhubela phambili ekubeni lusulelo lwethambo (i-osteomyelitis) okanye ukwaphuka kwamathambo. Kwiimeko ezinjalo, oogqirha botyando banokufuna ukwenza utyando olukhulu (olukhululekileyo).

Ndifanele ndimbone nini ugqirha?

Ukuba ukhe wanyangwa ngemisebe entloko okanye entanyeni yakho kwaye uqala ukuba neempawu ezifana neentlungu, ukudumba, okanye ukukrweleka, bona ugqirha wakho ngoko nangoko. Banokuqinisekisa ukuba une-osteoradionecrosis (ORN) kwaye baqalise naluphi na unyango olufunekayo ngokukhawuleza.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ukuba wena okanye umntu omthandayo nifunyaniswe ukuba ninesifo i-osteoradionecrosis (ORN), nisenokuzibuza le mibuzo:

• Isasazeke kangakanani le ntsholongwane yamathambo?
• Ziziphi iindlela zonyango endinazo?
• Ngaba ndiza kufuna utyando?
• Injani imbono yam (ukunyangeka)?

Okokugqibela, khumbula (Umyalezo Wokuya Ekhaya)

I-Osteoradionecrosis (ORN) sisiphumo esibi kakhulu sonyango lwemitha entloko nasentanyeni. Kungathatha iminyaka ukuba iimpawu zibonakale. Nangona i-ORN ingenakunyangwa ngokupheleleyo, inokulawulwa ngonyango. Iziphumo zixhomekeke kwindawo yethambo elonakeleyo, ubungakanani bokufa kwethambo, kunye nobunzima balo.

Ukuba unentlungu, ukudumba, ukuchanabeka emathanjeni, okanye ezinye iimpawu ze-osteoradionecrosis, bona ugqirha ngoko nangoko. Banokucebisa unyango olufanelekileyo kwaye bakuncede ulawule imeko yakho. Ukugcina ucoceko lomlomo oluhle kunye nokubona ugqirha wamazinyo rhoqo kubalulekile ekuthinteleni nasekufumaneni le meko kwangethuba.

I- Osteoradionecrosis, i-ORN, iziphumo ebezingalindelekanga zonyango lwemitha, isifo samathambo omhlathi, unyango lomhlaza, ukufa kwamathambo, impilo yomlomo